Functional recovery at discharge from rehabilitation following anterior cruciate ligament reconstruction

Almalki, HAS

Abstract

Functional performance, as well as objective and subjective measures, and psychological factors tests are used in clinically based settings to assess knee function, as well as to determine when patient is ideally suited to return to sport (RTS). Success following ACLR has been defined as a return to pre-injury or healthy levels of function and activity. Therefore, outcomes should be assessed according to this standard. The aim of this thesis is to investigate single-leg hop for distance, isometric muscle strength, self-reported knee function and psychological factors for ACLR patients at discharge from rehabilitation. The LSI (limb symmetry index) is used to assess the performance of the injured limb compared the non-injured limb as a percentage score according to the performance, however, non-injured leg weakness could overestimate the injured leg performance. The reference values from a healthy population and associated age-leg-matched scores may be used for developing more accurate outcome measures.
20 healthy active male participants volunteered to take part to evaluate the reliability and validity of testing the strength of the knee extensors and flexors muscles to discover the reliability and validity of the Handheld Dynamometer within this context. 35 patients who had undergone ACL reconstruction were recruited to translate and culturally adapt the IKDC and ACL-RSI to make them suitable for Arabic speaking patients with ACL injuries. 255 healthy active male participants in three age categories (18-24; 25-34 and 35-44 years) were recruited to complete the KOOS, IKDC questionnaires and to perform the single-leg hop test and to measure isometric quadriceps and hamstring muscle strength for both legs, using a hand-held dynamometer (HHD) to establish normative data scores. In addition, the study included 47 ACLR patients with a mean age of (29.26 ± 6 years) at time of discharge from rehabilitation (5-6 months) after ACLR to investigate single-leg hop for distance, isometric muscle strength, self-reported knee function and psychological factors. The results showed that none of the ACLR patients passed the current literature based RTS criteria at discharge from rehabilitation following ACLR when we compared the injured leg to matched leg-age of heathy control subjects, which suggests that the performance criteria is probably too stringent to pass before returning to sport, or the rehabilitation programme was insufficient to achieve these criteria which could lead to poor outcome measures after ACLR.
It can be concluded that the results from LSI should be used tentatively, as this approach can hide bilateral deficits due to the non-injured leg also possibly being affected by the injury and the length of time of relative inactivity. Therefore, normative data is recommended for analysing ACLR patients’ performance. In the current study, using normative data as a comparison revealed that the participants did not meet the normal required performance for both the injured and non-injured leg six months post ACLR. In general, it has been found that the ACL-reconstructed leg is weaker than the uninjured leg, but the uninjured leg is weaker than the leg of healthy matched controls.

Citation

Almalki, H. Functional recovery at discharge from rehabilitation following anterior cruciate ligament reconstruction. (Thesis). University of Salford

• Thesis Type: Thesis
• Deposit Date: Apr 21, 2020
• Publicly Available Date: Apr 21, 2020
• Award Date: Jan 1, 2019