Literature DB >> 23593546

Functional testing to determine readiness to discontinue brace use, one year after acl reconstruction.

Noel M Goodstadt1, Airelle Hunter-Giordano, Michael J Axe, Lynn Snyder-Mackler.   

Abstract

BACKGROUND: While the use of functional knee braces for return to sports or high level physical activity after ACL reconstruction (ACLR) is controversial, brace use is still prevalent.(1,2,3,4,5) All active patients in the practice are braced after ACLR and must pass a battery of sports tests before they return to play in their brace. Criteria include a 90% score on 4 one-legged hop tests(9) burst superimposition strength test,(10) Knee Outcome Survey Activities of Daily Living Scale,(8) and a global rating of knee function.
PURPOSE: The purpose of this study was to describe the use of criterion-based guidelines to determine if athletes who had undergone an ACLR function better with or without their functional brace, one year after surgery. STUDY
DESIGN: Cross-Sectional Study.
METHODS: Sixty-four patients post ACLR performed 4 one-legged hop tests,(9) burst superimposition strength test,(10) and completed the Knee Outcome Survey Activities of Daily Living Scale,(8) and a global rating of knee function one year after surgery with and without their brace.
RESULTS: Participants included 35 men and 29 women with a mean age of 25 years. The Mean Knee Outcome Survey Activities of Daily Living score was 98%, and the global rating was 97%. Of the subjects, one patient failed hop testing by at least one criterion with and without the brace. Three additional patients failed the test while braced but passed un-braced, and one patient passed with the brace, but failed without the brace. Subjects performed significantly better un-braced than braced in all hop tests: single leg hop braced = 101%; un-braced = 107% (p<0.001); cross-over hop braced = 100%; un-braced = 105% (p<0.001); triple hop braced = 99%; un-braced = 101% (p=0.003); timed hop braced = 98%; un-braced = 103% (p = 0.004).
CONCLUSIONS: Sixty-two of 64 patients continued to score above return to play criteria one year after ACLR. All but two subjects in the cohort performed better un-braced than braced. Based on the criterion set for this testing session, 62/64 individuals performed well enough to discontinue use of their brace. LEVEL OF EVIDENCE: 2b.

Entities:  

Keywords:  ACL; functional brace; hop tests; knee

Year:  2013        PMID: 23593546      PMCID: PMC3625787     

Source DB:  PubMed          Journal:  Int J Sports Phys Ther        ISSN: 2159-2896


  17 in total

1.  The efficacy of perturbation training in nonoperative anterior cruciate ligament rehabilitation programs for physical active individuals.

Authors:  G K Fitzgerald; M J Axe; L Snyder-Mackler
Journal:  Phys Ther       Date:  2000-02

2.  Effect of functional bracing on knee injury in skiers with anterior cruciate ligament reconstruction: a prospective cohort study.

Authors:  William I Sterett; Karen K Briggs; Timothy Farley; J Richard Steadman
Journal:  Am J Sports Med       Date:  2006-07-26       Impact factor: 6.202

3.  Abnormal lower limb symmetry determined by function hop tests after anterior cruciate ligament rupture.

Authors:  F R Noyes; S D Barber; R E Mangine
Journal:  Am J Sports Med       Date:  1991 Sep-Oct       Impact factor: 6.202

4.  Strength of the quadriceps femoris muscle and functional recovery after reconstruction of the anterior cruciate ligament. A prospective, randomized clinical trial of electrical stimulation.

Authors:  L Snyder-Mackler; A Delitto; S L Bailey; S W Stralka
Journal:  J Bone Joint Surg Am       Date:  1995-08       Impact factor: 5.284

Review 5.  Rehabilitation after anterior cruciate ligament reconstruction: a systematic review.

Authors:  L M Kruse; B Gray; R W Wright
Journal:  J Bone Joint Surg Am       Date:  2012-10-03       Impact factor: 5.284

6.  Current practices and opinions in ACL reconstruction and rehabilitation: results of a survey of the American Orthopaedic Society for Sports Medicine.

Authors:  B S Delay; R J Smolinski; W M Wind; D S Bowman
Journal:  Am J Knee Surg       Date:  2001

7.  Reflex inhibition of the quadriceps femoris muscle after injury or reconstruction of the anterior cruciate ligament.

Authors:  L Snyder-Mackler; P F De Luca; P R Williams; M E Eastlack; A R Bartolozzi
Journal:  J Bone Joint Surg Am       Date:  1994-04       Impact factor: 5.284

8.  Electrogoniometry of post-surgical knee bracing in running.

Authors:  K M Knutzen; B T Bates; J Hamill
Journal:  Am J Phys Med       Date:  1983-08

9.  Development of a patient-reported measure of function of the knee.

Authors:  J J Irrgang; L Snyder-Mackler; R S Wainner; F H Fu; C D Harner
Journal:  J Bone Joint Surg Am       Date:  1998-08       Impact factor: 5.284

10.  Fate of the ACL-injured patient. A prospective outcome study.

Authors:  D M Daniel; M L Stone; B E Dobson; D C Fithian; D J Rossman; K R Kaufman
Journal:  Am J Sports Med       Date:  1994 Sep-Oct       Impact factor: 6.202

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  3 in total

1.  Current concepts for anterior cruciate ligament reconstruction: a criterion-based rehabilitation progression.

Authors:  Douglas Adams; David S Logerstedt; Airelle Hunter-Giordano; Michael J Axe; Lynn Snyder-Mackler
Journal:  J Orthop Sports Phys Ther       Date:  2012-03-08       Impact factor: 4.751

Review 2.  On-Ice Return-to-Hockey Progression After Anterior Cruciate Ligament Reconstruction.

Authors:  Jacob J Capin; William Behrns; Karen Thatcher; Amelia Arundale; Angela Hutchinson Smith; Lynn Snyder-Mackler
Journal:  J Orthop Sports Phys Ther       Date:  2017-03-29       Impact factor: 4.751

3.  Test Batteries After Primary Anterior Cruciate Ligament Reconstruction: A Systematic Review.

Authors:  Chelsey Roe; Cale Jacobs; Johanna Hoch; Darren L Johnson; Brian Noehren
Journal:  Sports Health       Date:  2021-04-24       Impact factor: 3.843

  3 in total

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