Rehabilitation after anterior cruciate ligament injury influences joint loading during walking but not hopping.
OBJECTIVE
The purpose of this study was to identify changes in clinical outcome and lower extremity biomechanics during walking and hopping in ACL-injured subjects before and after a 20-session neuromuscular and strength training programme.


METHODS
Pre and post experimental design.


METHODS
Outpatient clinic, primary care.


METHODS
32 subjects with unilateral ACL injury, mean 60 (SD 35) days after injury, with a mean age of 26.2 (5.4) years.


METHODS
The rehabilitation programme consisted of neuromuscular and strength exercises.


METHODS
Outcome measurements assessed before and after a 20-session rehabilitation programme were: self-assessment questionnaires (KOS-ADL, IKDC2000, Global function), four single-leg hop tests, and isokinetic muscle strength tests. Lower extremity kinematics and kinetics were captured during the stance phase of gait and landing after a single leg hop, synchronised with three force plates.


RESULTS
These ACL-injured individuals significantly improved their clinical outcome after rehabilitation. Gait analysis disclosed a significantly improved knee extension moment after rehabilitation, but no change in hip or knee excursions. During landing after hop no change in knee excursion or knee moment was recorded.


CONCLUSIONS
After rehabilitation the ACL-injured subjects showed a significantly improved clinical outcome, but lower extremity biomechanics were still significantly impaired during both walking and hopping. The rehabilitation programme influenced knee joint loading during walking, but not during hopping. Longer rehabilitation should be considered before ACL-injured individuals return to jumping activities.
Risberg
M A
MA
Norwegian research center for Active Rehabilitation, Oslo University Hospital, Ullevaal, Kirkeveien 166, 0407 Oslo, Norway. mayarna.risberg@hjelp24.no
Moksnes
H
H
Storevold
A
A
Holm
I
I
Snyder-Mackler
L
L
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology; D000070598:Anterior Cruciate Ligament Injuries; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D055070:Resistance Training / Q000379:methods*; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*; D016474:Weight-Bearing / Q000502:physiology; D055815:Young Adult