Type of Article : Original Research
Year: 2016 | Volume 4 | Issue 2 | Page No. 1459-1467
Date of Publication: 11-04-2016
DOI: 10.16965/ijpr.2016.118
OBJECTIVE CRITERIA ASSOCIATED WITH UNRESTRICTED RETURN TO SPORTS ACTIVITIES AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION
Mohammed A. Fakhro 1, Nancy Wehbe 2, Khodor Haidar Hassan *3.
1 Coordinator of the Physical Therapy Department, Faculty of Public Health, Lebanese German University, Tyre, Lebanon.
2 Coordinator of the Physical Therapy Department, Faculty of Public Health, Lebanese German University, Sahel Alma, Lebanon.
*3 Assistant Professor,Dept. of Physical Therapy, Faculty of Public Health, Lebanese University, Lebanon.
E-Mail:drkhodorhaidar@hotmail.com
Background: After an anterior cruciate ligament reconstruction (ACLR), athletes return to full sports activities based on a clinical decision following postoperative rehabilitation. The purpose of this study was to find if clinical decision to release athletes back to unrestricted sports activities afterACLR matches the findings of objective criteria of muscle strength and lower limb symmetry.
Materials and Methods: The study used a cross-sectional observational design.Thirty-two athletes who were released within 1 to 7 months to full sports activities were recruited from Lebanese first, second and third sports divisions. Participants performed a battery of tests including: knee extension/flexion, single leg press to assess muscle strength and single leg hop, triple hop, cross-over hop, timed hop and single hop after fatigue for distance to assess lower limb symmetry.
Results: Demographic results showed that mean age of participants was 24.37 years. Bone-patellar tendon bone (BPTP) autograft was the most used surgical technique for ACLR. Ten athletes passed the muscle strength testing, whereas twelve athletes had passed that of lower limb symmetry. Therefore, only 18.75% (six athletes out of thirty-two) could be released back to full sports activities following the combined testing of muscle strength and lower limb symmetry, whereas, they all had been released previously to full sports activities based on clinical decision.
Discussion and Conclusion: Despite that athletes have been released by a clinical decision in a range of one to seven months, there were still significant deficit in muscle strength and lower limb symmetry. The results of this study show noteworthy problems in muscle strength and lower limb symmetry following ACLR. Use of objectives criteria might be a useful adjunct to clinical decision before release of athletes to unrestricted sports activities.
Key Words: Anterior cruciate ligament reconstruction, Clinical decision, Return to athletics.
References
- Schmitt L, Paterno M, Hewett T. The Impact of Quadriceps Femoris Strength Asymmetry on Functional Performance at Return to Sport Following Anterior Cruciate Ligament Reconstruction. J Orthop Sports Phys Ther. 2012;42(9):750-759.
- Ardern C, Taylor N, Feller J, Webster K. A systematic review of the psychological factors associated with returning to sport following injury. British Journal of Sports Medicine. 2012;47(17):1120-1126.
- Barber-Westin S, Noyes F. Factors Used to Determine Return to Unrestricted Sports Activities After Anterior Cruciate Ligament Reconstruction. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2011;27(12):1697-1705.
- Angelozzi M, Madama M, Corsica C, Calvisi V, Properzi G, McCaw S et al. Rate of Force Development as an Adjunctive Outcome Measure for Return-to-Sport Decisions After Anterior Cruciate Ligament Reconstruction. J Orthop Sports Phys Ther. 2012;42(9):772-780.
- Thomeé R, Kaplan Y, Kvist J, Myklebust G, Risberg M, Theisen D et al. Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy. 2011;19(11):1798-1805.
- McNair P, Colvin M, Reid D. Predicting maximal strength of quadriceps from submaximal performance in individuals with knee joint osteoarthritis. Arthritis Care Res. 2011;63(2):216-222.
- Ciolac E, Greve J. Muscle strength and exercise intensity adaptation to resistance training in older women with knee osteoarthritis and total knee arthroplasty. Clinics. 2011;66(12):2079-2084.
- Augustsson J, Thomee R, Linden C, Folkesson M, Tranberg R, Karlsson J. Single-leg hop testing following fatiguing exercise: reliability and biomechanical analysis. Scand J Med Sci Sports. 2006;16(2):111-120.
- Logerstedt D, Grindem H, Lynch A, Eitzen I, Engebretsen L, Risberg M et al. Single-Legged Hop Tests as Predictors of Self-Reported Knee Function After Anterior Cruciate Ligament Reconstruction: The Delaware-Oslo ACL Cohort Study. The American Journal of Sports Medicine. 2012;40(10):2348-2356.
- Hunt D. The anterior cruciate ligament: reconstruction and basic science Edited by C. Prodromos Pp. 650. Philadelphia: Elsevier, 2008. ISBN-13: 918-1-4160-3834-4.£ 118.00. Journal of Bone & Joint Surgery, British Volume. 2008 Nov 1;90(11):1540.
- Bowers AL, Spindler KP, McCarty EC, Arrigain S. Height, weight, and BMI predict intra-articular injuries observed during ACL reconstruction: evaluation of 456 cases from a prospective ACL database. Clinical Journal of Sport Medicine. 2005 Jan 1;15(1):9-13.
- Barber-Westin S, Noyes F. Objective Criteria for Return to Athletics After AnteriorCruciate Ligament Reconstruction and Subsequent Reinjury Rates: A Systematic Review. The Physician and Sportsmedicine. 2011;39(3):100-110.
- Hamilton RT, Shultz SJ, Schmitz RJ, Perrin DH. Triple-hop distance as a valid predictor of lower limb strength and power. Journal of athletic training. 2008 Mar;43(2):144-51
- Reid A, Birmingham T, Stratford P, Alcock G, Giffin J. Hop Testing Provides a Reliable and Valid Outcome Measure During Rehabilitation After Anterior Cruciate Ligament Reconstruction. Physical Therapy. 2007;87(3):337-349.
Mohammed A. Fakhro, Nancy Wehbe, Khodor Haidar Hassan. OBJECTIVE CRITERIA ASSOCIATED WITH UNRESTRICTED RETURN TO SPORTS ACTIVITIES AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION. Int J Physiother Res 2016;4(2):1459-1467. DOI: 10.16965/ijpr.2016.118
