External Supports Improve Knee Performance In Anterior Cruciate Ligament Reconstructed Individuals With Higher Kinesiophobia Levels

Background: The objectives of this studywere to investigate the effects of knee brace (KB) and kinesiotaping (KT) on functional performance and self-reported function in individuals sixmonths post-ACLRwho desired to return to their pre-injury activity levels but felt unable to do so due to kinesiophobia. Methods: This was a cross-sectional study involving 30 individuals six months post-ACLR with Tampa Kinesiophobia Scores N37. Individuals were tested under three conditions: no intervention, KB and KT in a randomized order. Isokinetic concentric quadriceps and hamstring strength tests, one leg hop test, star excursion balance test and global rating scale were assessed under the three conditions. Results: The involved side showed that KT and KB significantly increased the hop distance (P=0.01, P = 0.04) and improved balance (P = 0.01, P = 0.04), respectively, but only KB was found to increase the quadriceps and hamstring peak torques compared to no intervention (P b 0.05). Individuals reported having better knee function with KB when compared to no intervention (P b 0.001) and KT (P=0.03). Conclusions: Both KB and KT have positive effects in individuals post-ACLR which may assist in reducing kinesiophobia when returning to their pre-injury activity levels, with the KB appearing to offer the participants better knee function compared to KT

Whole-body biomechanical differences between limbs exist 9 months after ACL reconstruction across jump/landing tasks

© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Introduction: Previous studies examining jump tasks after anterior cruciate ligament reconstruction (ACLR) have focused on performance measures without examining joint kinematic and kinetic variables. The aim of this study was to identify differences in biomechanical and performance measures between limbs across tests 9 months after surgery. Methods: Four jump tests (double-leg drop jump (DLDJ), single-leg drop jump (SLDJ), single-leg hop for distance (SLHD) and hurdle hop (HH)) were carried out on 156 male subjects in a 3D motion capture laboratory 9 months after surgery. Statistical parametric mapping was used to identify differences in jump performance and biomechanical variables between limbs. Results: Biomechanical measures were lower on the ACLR side across all four tests for internal knee valgus moment (effect size (ES) 0.77-0.92), knee internal rotation angle (ES 0.59-0.8), and ankle external rotation moment (ES 0.59-0.73), with the center of mass less posterior to the knee during the single-leg tests (ES 0.61-0.82). The timing of the largest difference between limbs was not at the same % stance between variables within a test or for any variable across tests. Large ES differences were observed in performance in the SLDJ (ES 0.73-0.81; LSI 78%) and small differences in the SLHD (ES 0.36; LSI 94%) between the limbs. Conclusion: Findings highlighted biomechanical differences between limbs which are consistent across jump tasks suggesting insufficient rehabilitation at 9 months post surgery. Results indicate that the SLDJ may identify greater performance deficits between limbs than SLHD, which may over-estimate rehabilitation status

Intra-rater reliability, measurement precision, and inter-test correlations of 1RM single-leg leg-press, knee-flexion, and knee-extension in uninjured adult agility-sport athletes: Considerations for right and left unilateral measurements in knee injury control

Objectives Knowledge of single-leg knee strength test reliability for the right and left limb is critical for between-limb clinical decision-making. Knowledge of between-test correlations is essential for understanding whether tests measure similar or different aspects of muscle strength. This study investigated the intra-rater, test-retest reliability and measurement precision of one repetition maximum (1RM) single-leg leg-press (LP), knee-flexion (KF), and knee-extension (KE) for both limbs, and inter-test correlations. Design Repeated measures; Setting University. Participants Six males, seven females (age 25.6±5.5yr; height 171.4±8.4cm; mass 71.8±13.4kg). Main outcome measures Normalised 1RM (percent body-mass (%BM)), intraclass correlation coefficient (ICC) (Avery, 1995; Rivara, 2003), standard error of measurement (SEM; %BM), Pearson's correlation (r), coefficient of determination (r2). Results Mean 1RM test-retest values were (right, left): LP, 214.2–218.5%BM, 213.5–215.4%BM; KF, 35.9–38.9%BM, 37.7–38.2%BM; KE, 43.3–44.6%BM, 36.2–39.3%BM. The ICCs/SEMs were (right, left): LP, 0.98/7.3%BM, 0.94/14.2%BM; KF, 0.75/4.9%BM, 0.95/1.9%BM; KE, 0.87/3.4%BM, 0.78/4.4%BM. Correlations were significant (P < 0.01), r/r2 values were: LP-KF, 0.60/0.36; LP-KE, 0.59/0.35; KF-KE, 0.50/0.25. Conclusions Tests demonstrated good reliability and measurement precision, although ICCs and SEMs were different between limbs. Tests were correlated, but only one-third of the variance was shared between tests. Practitioners should be cognisant of between-limb differences in reliability and include all tests for knee clinical decision-making