title: The Effects of Open versus Closed Kinetic Chain Exercises on Patients with ACL Deficient or Reconstructed Knees: A Systematic Review.
abstract: BACKGROUND
  There is no consensus among the existing published evidence as to whether closed kinetic chain (CKC) or open kinetic chain (OKC) exercises should be the intervention of choice following an anterior cruciate ligament (ACL) injury or reconstruction. The commonly held belief has been that OKC exercises cause increased strain on the ACL as well as increased joint laxity and anterior tibial translation.
  
  
  OBJECTIVE
  To investigate the effects of OKC and CKC exercises on the knees of patients with ACL deficiency or reconstruction.
  
  
  METHODS
  MEDLINE, ProQuest Medical Library, and CINAHL STUDY SELECTION: Six articles were chosen for inclusion in the systematic review. The authors narrowed 50 articles down to 6 by review of titles and abstracts. Included articles were randomized controlled trials written in English, published during 2000-2008, that evaluated the effects of OKC and CKC exercises on ACL deficient or reconstructed knees.
  
  
  METHODS
  Quality of the included studies was defined by the PEDro scale(1), which has been found to be reliable.(2)
  
  
  RESULTS
  Scores on the PEDro scale(1) ranged from 4-6/10. One article found positive significant effects with inclusion of OKC exercises in the rehabilitation program and another found significant benefits with combining OKC and CKC exercises. CKC exercises alone were not found by any studies to be superior to OKC exercises.
  
  
  CONCLUSIONS
  These studies reveal favorable results for utilization of both open and closed kinetic chain exercises for intervention with ACL deficient or reconstructed knees. However, further research needs to be completed.
authors: Grand Valley State University, Grand Rapids, MI USA.
authors: Rebekah
authors: R
authors: Glass
authors: Janessa
authors: J
authors: Waddell
authors: Barbara
authors: B
authors: Hoogenboom
references: J Orthop Sports Phys Ther. 1995 Nov;22(5):202-6
references: 8580947
references: Knee Surg Sports Traumatol Arthrosc. 2005 Jul;13(5):357-69
references: 15678299
references: J Orthop Sports Phys Ther. 1999 Jan;29(1):39-48
references: 10100120
references: Am J Sports Med. 2008 Feb;36(2):298-307
references: 17940146
references: Knee Surg Sports Traumatol Arthrosc. 2000;8(6):343-8
references: 11147152
references: Knee Surg Sports Traumatol Arthrosc. 2007 Apr;15(4):402-14
references: 17219226
references: Knee Surg Sports Traumatol Arthrosc. 2005 Nov;13(8):638-48
references: 15877221
references: Phys Ther. 2003 Aug;83(8):713-21
references: 12882612
references: Knee Surg Sports Traumatol Arthrosc. 2000;8(6):337-42
references: 11147151
references: Phys Ther. 2002 Jan;82(1):35-43
references: 11784276
references: J Orthop Sports Phys Ther. 1998 Jul;28(1):23-31
references: 9653687