title: Symmetry restoration and functional recovery before and after anterior cruciate ligament reconstruction.
abstract: OBJECTIVE
  The aims of this study were to evaluate the functional recovery before and after ACL reconstruction and to evaluate the sensitivity to change in performance-based and self-reported outcomes prior to and after ACL reconstruction and to determine whether these changes represent clinically relevant improvement.
  
  
  METHODS
  Eighty-three athletes participated in this study. Athletes were tested after an ACL injury, after preoperative training, and 6 and 12 months after ACL reconstruction. Athletes completed quadriceps strength testing, hop testing, and self-reported questionnaires for knee function (International Knee Documentation Committee subjective knee form, Knee Outcome Survey-Activities of Daily Living Scale, and the Global Rating Scale of Perceived Function) at each testing period.
  
  
  RESULTS
  A significant interaction of limb by time was seen in normalized quadriceps strength, and single, triple, and 6-m timed hop, where the involved limb improved more than the uninvolved limb over time. A main effect of time was noted for performance-based limb symmetry indexes and self-reported measures.
  
  
  CONCLUSIONS
  Limb-to-limb asymmetries are reduced, and normal limb symmetry is restored after perturbation training and aggressive quadriceps strengthening and returned to similar levels 6 months after reconstruction. Performance-based values on the involved limb and self-reported outcomes are sensitive to change over time, and these were clinically relevant improvements.
authors.affiliation: Department of Physical Therapy, University of Delaware, 301 McKinly Lab, Newark, DE 19716, USA. davlog@udel.edu
authors.forename: David
authors.initials: D
authors.lastname: Logerstedt
authors.forename: Andrew
authors.initials: A
authors.lastname: Lynch
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Axe
authors.forename: Lynn
authors.initials: L
authors.lastname: Snyder-Mackler
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction; D001265:Athletic Injuries / Q000503:physiopathology / Q000601:surgery*; D005080:Exercise Test; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery; D008137:Longitudinal Studies; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D055815:Young Adult