title: Effects of distally fixated versus nondistally fixated leg extensor resistance training on knee pain in the early period after anterior cruciate ligament reconstruction.
abstract: OBJECTIVE
  Nondistally fixated (ie, what is often referred to as "open kinetic chain" [OKC]) knee extensor resistance training appears to have lost favor for some forms of rehabilitation due partly to concerns that this exercise will irritate the extensor mechanism. In this randomized, single-blind clinical trial, nondistally fixated versus distally fixated (ie, often called "closed kinetic chain" [CKC]) leg extensor training were compared for their effects on knee pain.
  
  
  METHODS
  Forty-three patients recovering from anterior cruciate ligament (ACL) reconstruction surgery (34 male, 9 female; mean age=29 years, SD=7.9, range=16-54).
  
  
  METHODS
  Knee pain was measured at 2 and 6 weeks after ACL reconstruction surgery using visual analog scales in a self-assessment questionnaire and during maximal isometric contractions of the knee extensors. Between test sessions, subjects trained 3 times per week using either OKC or CKC resistance of their knee and hip extensors as part of their physical therapy.
  
  
  RESULTS
  No differences in knee pain were found between the treatment groups.
  
  
  CONCLUSIONS
  Open kinetic chain and CKC leg extensor training in the early period after ACL reconstruction surgery do not differ in their immediate effects on anterior knee pain. Based on these findings, further studies are needed using different exercise dosages and patient groups.
authors.affiliation: Physiotherapy Division, GKT School of Biomedical Sciences, King's College London, Shepherd's House, Guy's Campus, London SE1 1UL, United Kingdom. matt.morrissey@kcl.ac.uk
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Morrissey
authors.forename: Wendy I
authors.initials: WI
authors.lastname: Drechsler
authors.forename: Dylan
authors.initials: D
authors.lastname: Morrissey
authors.forename: Philippa R
authors.initials: PR
authors.lastname: Knight
authors.forename: Paul W
authors.initials: PW
authors.lastname: Armstrong
authors.forename: Thomas B
authors.initials: TB
authors.lastname: McAuliffe
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007537:Isometric Contraction; D007718:Knee Injuries / Q000534:rehabilitation* / Q000601:surgery*; D007866:Leg / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D010146:Pain / Q000209:etiology / Q000503:physiopathology*; D010147:Pain Measurement; D026741:Physical Therapy Modalities / Q000379:methods*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome