Becky Heinert, Kari Willett1, Thomas W Kernozek. 1. University of Wisconsin-La Crosse, Department of Health Professions, Physical Therapy Program, La Crosse, WI, 54601, USA.
Abstract
BACKGROUND: Athletes that have had anterior cruciate ligament (ACL) reconstruction are at a greater risk for reinjury. The relationship between ACL reconstruction and the dynamic postural sway index (DPSI) has not yet been examined. HYPOTHESIS/ PURPOSE: The purpose of this study was to examine the DPSI in a surgically reconstructed ACL limb compared to the uninjured leg in athletes that had been cleared for sport. It was hypothesized that in a bilateral limb comparison, the leg that underwent ACL reconstruction would demonstrate poorer postural stability measures (greater DPSI) during a single leg landing activity as compared to the non-surgical limb. DESIGN: Case-control study. METHODS: 14 subjects (7 male, 7 female; age range 16-23 years) with a history of unilateral ACL reconstruction and clearance for return to sport (mean 14 months post-operatively, range 8 to 24 months) performed five single leg hops over a 12 inch hurdle in the anterior direction from a distance corresponding with 40% of their height, onto a force platform. DPSI for the medial-lateral, anterior-posterior, vertical directions and a composite score were calculated for each trial on the surgical and non-surgical legs. A multivariate analysis with repeated measures was used to compare surgical and non-surgical legs for the total DPSI measure as well as for each component. RESULTS: Significant differences (p < .05) in dynamic postural stability were observed in the medial-lateral, anterior-posterior, vertical indices and DPSI total between the surgical and non-surgical limb. CONCLUSION: Deficits in dynamic postural control persist in ACL-reconstructed limbs compared to the non-surgical limb after the clearance for full activity. Clinicians should consider assessing single limb dynamic stability prior to releasing the athlete back to full activity. LEVEL OF EVIDENCE: Level 3.
BACKGROUND: Athletes that have had anterior cruciate ligament (ACL) reconstruction are at a greater risk for reinjury. The relationship between ACL reconstruction and the dynamic postural sway index (DPSI) has not yet been examined. HYPOTHESIS/ PURPOSE: The purpose of this study was to examine the DPSI in a surgically reconstructed ACL limb compared to the uninjured leg in athletes that had been cleared for sport. It was hypothesized that in a bilateral limb comparison, the leg that underwent ACL reconstruction would demonstrate poorer postural stability measures (greater DPSI) during a single leg landing activity as compared to the non-surgical limb. DESIGN: Case-control study. METHODS: 14 subjects (7 male, 7 female; age range 16-23 years) with a history of unilateral ACL reconstruction and clearance for return to sport (mean 14 months post-operatively, range 8 to 24 months) performed five single leg hops over a 12 inch hurdle in the anterior direction from a distance corresponding with 40% of their height, onto a force platform. DPSI for the medial-lateral, anterior-posterior, vertical directions and a composite score were calculated for each trial on the surgical and non-surgical legs. A multivariate analysis with repeated measures was used to compare surgical and non-surgical legs for the total DPSI measure as well as for each component. RESULTS: Significant differences (p < .05) in dynamic postural stability were observed in the medial-lateral, anterior-posterior, vertical indices and DPSI total between the surgical and non-surgical limb. CONCLUSION: Deficits in dynamic postural control persist in ACL-reconstructed limbs compared to the non-surgical limb after the clearance for full activity. Clinicians should consider assessing single limb dynamic stability prior to releasing the athlete back to full activity. LEVEL OF EVIDENCE: Level 3.
Entities:
Keywords:
Anterior cruciate ligament; Dynamic postural stability index; kinetics; single limb hop
Authors: Mark V Paterno; Laura C Schmitt; Kevin R Ford; Mitchell J Rauh; Gregory D Myer; Timothy E Hewett Journal: J Orthop Sports Phys Ther Date: 2011-08-01 Impact factor: 4.751
Authors: Karl F Orishimo; Ian J Kremenic; Michael J Mullaney; Malachy P McHugh; Stephen J Nicholas Journal: Knee Surg Sports Traumatol Arthrosc Date: 2010-06-12 Impact factor: 4.342
Authors: Nathan D Schilaty; Christopher Nagelli; Nathaniel A Bates; Thomas L Sanders; Aaron J Krych; Michael J Stuart; Timothy E Hewett Journal: Orthop J Sports Med Date: 2017-08-18