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http://dx.doi.org/10.18857/jkpt.2019.31.6.339

Comparing Changes in Knee Muscle Strength after Reconstruction of the Anterior and Posterior Cruciate Ligaments  

Hyun, SangWook (Department of Physical Therapy, Daegu Health College Hospital)
Kim, SoHee (Department of Physical Therapy, Daegu Dalgubeol General Welfare Center)
Kim, TaeHo (Department of Physical Therapy, College of Rehabilitation Science, Daegu University)
Publication Information
The Journal of Korean Physical Therapy / v.31, no.6, 2019 , pp. 339-345 More about this Journal
Abstract
Purpose: The purpose of this study was to identify changes in knee muscle strength after reconstruction of the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). Methods: Thirteen subjects (males) with anterior ligament injury and ten subjects (males) with posterior ligament injury voluntarily participated in this study. Both groups were evaluated at the pre-and post-reconstruction stages using an isokinetic dynamometer. Peak torque, total work, and the hamstrings to quadriceps (H/Q) peak torque ratio were calculated at angular velocities of 60°/sec and 180°/sec. Statistical analysis was conducted on SPSS 18.0 for Windows using t-tests to compare mean differences. Results: At an angular velocity of 60°/sec, both the ACL and PCL groups showed a significant increase in muscle strength in the flexors and extensors. Muscle strength in the extensors was significantly increased in the PCL group compared to the ACL group. At an angular velocity of 180°/sec, the ACL group showed a significant increase in muscle endurance in the flexors and extensors, and the PCL group showed a significant increase in muscle endurance in the flexors. At angular velocities of 60°/sec and 180°/sec, the H/Q peak torque ratio increased in the ACL group but decreased in the PCL group. Consequently, the H/Q peak torque ratio was significantly different for the two groups. Conclusion: The results suggest that the patients with ACL injury should focus on strengthening the knee extensors and that the patients with PCL injury need to strengthen the knee flexors.
Keywords
Anterior cruciate ligament; Posterior cruciate ligament; Muscle strength;
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1 Kim DK. The effect of pre-operative exercise training program on laxity and proprioception and knee strength after ACL reconstruction. Sungkyunkwan University. Dissertation of Doctorate Degree. 2008.
2 Park JT. Effects of the application pre-operative rehabilitation program on isokinetic muscle strength and functional performance after ACL reconstruction. Korea University. Dissertation of Master's Degree. 2018.
3 Lee SJ. Effects of accelerated rehabilitation exercise on femoral muscle strength and dynamic balance stability in patients after ACL and PCL reconstruction. Kunsan National University. Dissertation of Doctorate Degree. 2018.
4 Machado F, Debieux P, Kaleka CC et al. Knee isokinetic performance following anterior cruciate ligament reconstruction: patellar tendon versus hamstrings graft. Phys Sportsmed. 2018;46(1):30-5.   DOI
5 van Melick N, van Cingel RE, Brooijmans F et al. Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus. Br J Sports Med. 2016;50(24):1506-15.   DOI
6 Acevedo RJ, Rivera-Vega A, Miranda G et al. Anterior cruciate ligament injury: identification of risk factors and prevention strategies. Curr Sports Med Rep. 2014;13(3):186-91.   DOI
7 Wind WM Jr, Bergfeld JA, Parker RD. Evaluation and treatment of posterior cruciate ligament injuries: revisited. Am J Sports Med. 2004;32(7): 1765-75.   DOI
8 Fukubayashi T, Torzilli PA, Sherman MF et al. An in vitro biomechanical evaluation of anterior-posterior motion of the knee. Tibial displacement, rotation, and torque. J Bone Joint Surg Am. 1982;64(2):258-64.   DOI
9 Harner CD, Xerogeanes JW, Livesay GA et al. The human posterior cruciate ligament complex: an interdisciplinary study. Ligament morphology and biomechanical evaluation. Am J Sports Med. 1995;23(6):736-45.   DOI
10 Hughston JC, Andrews JR, Cross MJ et al. Classification of knee ligament instabilities. Part I. The medial compartment and cruciate ligaments. J Bone Joint Surg Am. 1976;58(2):159-72.   DOI
11 Boden BP, Sheehan FT, Torg JS et al. Noncontact anterior cruciate ligament injuries: mechanisms and risk factors. J Am Acad Orthop Surg. 2010;18(9):520-7.   DOI
12 Olsen OE, Mtklebust G, Engerbretsen L et al. Injury mechanisms for anterior cruciate ligament injuries in team handball: a systematic video analysis. Am J Sports Med. 2004;32(4):1002-12.   DOI
13 Boden BP, Dean GS, Feagin JA et al. Mechanisms of anterior cruciate ligament injury. Orthopedics. 2000;23(6):573-8.   DOI
14 Schulz MS, Russe K, Weiler A et al. Epidemiology of posterior cruciate ligament injuries. Arch Orthop Trauma Surg. 2003;123(4):186-91.   DOI
15 McAllister DR, Petrigliano FA. Diagnosis and treatment of posterior cruciate ligament injuries. Curr Sports Med Rep. 2007;6(5):293-9.   DOI
16 Fowler PJ, Messieh SS. Isolated posterior cruciate ligament injuries in athletes. Am J Sports Med. 1987;15(6):553-7.   DOI
17 Grindem H, Snyder-Mackler L, Moksnes H et al. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. Br J Sports Med. 2016;50(13):804-8.   DOI
18 Kannus P, Bergfeld J, Jarvinen M et al. Injuries to the posterior cruciate ligament of the knee. Sports Med. 1991;12(2):110-31.   DOI
19 Beynnon BD, Johnson RJ, Abate JA et al. Treatment of anterior cruciate ligament injuries, part 2. Am J Sports Med. 2005;33(11):1751-67.   DOI
20 Beynnon BD, Johnson RJ, Abate JA et al. Treatment of anterior cruciate ligament injuries, part I. Am J Sports Med. 2005;33(10):1579-602.   DOI
21 Huber R, Viecelli C, Bizzini M et al. Knee extensor and flexor strength before and after anterior cruciate ligament reconstruction in a large sample of patients: influence of graft type. Phys Sportsmed. 2019;47(1): 85-90.   DOI
22 Schuttler KF, Ziring E, Ruchholtz S et al. Posterior cruciate ligament injuries. Unfallchirurg. 2017;120(1):55-68.   DOI
23 Shim JK, Choi HS. Effects of sensorimotor training volume om recovery of knee joint stability in patients following anterior cruciate ligament reconstruction. J Kor Phys Ther. 2016;28(1):27-32.   DOI
24 Janousek AT, Jones DG, Clatworthy M et al. Posterior cruciate ligament injuries of the knee joint. Sports Med. 1999;28(6):429-41.   DOI
25 Beynnon BD, Johnson RJ. Anterior cruciate ligament injury rehabilitation in athletes. Biomechanical considerations. Sports Med. 1996;22(1): 54-64.   DOI
26 Lim HW. Evidence-based physical therapy for anterior cruciate ligament injury: literature review. J Kor Phys Ther 2019:31(4):161-168.   DOI
27 Senese M, Greenberg E, Todd Lawrence J et al. Rehabilitation following isolated posterior cruciate ligament reconstruction: a literature review of published protocols. Int J Sports Phys Ther. 2018;13(4):737-51.   DOI
28 Best R, Begg R. A method for calculating the probability of tripping while walking. J Biomech. 2008;41(5):1147-51.   DOI
29 Simonsen EB, Dyhre-Poulsen P, Voigt M et al. Bone-on-bone forces during loaded and unloaded walking. Acta Anat (Basel). 1995;152(2): 133-42.   DOI
30 Waters RL, Mulroy S. The energy expenditure of normal and pathologic gait. Gait Posture. 1999;9(3):207-31.   DOI
31 Cromwell RL, Aadland-Monahan TK, Nelson AT et al. Sagittal plane analysis of head, neck, and trunk kinematics and electromyographic activity during locomotion. J Orthop Sports Phys Ther. 2001;31(5):255-62.   DOI
32 Ortega JD, Farley CT. Minimizing center of mass vertical movement increases metabolic cost in walking. J Appl Physiol. 2005;99(6):2099-107.   DOI
33 Huegel M, Indelicato PA. Trends in rehabilitation following anterior cruciate ligament reconstruction. Clin Sports Med. 1988;7(4):801-11.   DOI
34 Petrie RS, Harner CD. Evaluation and management of the posterior cruciate injured knee. Operative Techniques in Sports Medicine. 1999;7(3): 93-103.   DOI
35 Kim HM. Comparison of functional recovery after rehabilitation exercise between isolated PCL and combined PLC reconstruction. Dankook University. Dissertation of Master's Degree. 2016.
36 Margheritini F, Rihn J, Musahl V et al. Posterior cruciate ligament injuries in the athlete: an anatomical, biomechanical and clinical review. Sports Med. 2002;32(6):393-408.   DOI
37 Bin SI, Cho WS, Moon HS et al. Cybex evaluation of muscle strength following arthroscopic anterior cruciate ligament reconstruction. J Korean Orthop Assoc. 1995;30(2):262-8.   DOI
38 Andrade Mdos S, De Lira CA, Koffes Fde C et al. Isokinetic hamstrings-to-quadriceps peak torque ratio: the influence of sport modality, gender, and angular velocity. J Sports Sci. 2012;30(6):547-53.   DOI