Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 12, Issue 5, pp 350–356 | Cite as

Ability of a new hop test to determine functional deficits after anterior cruciate ligament reconstruction

Knee

Abstract

The aim of this study was to investigate the ability of a new hop test to determine functional deficits after anterior cruciate ligament (ACL) reconstruction. The test consists of a pre-exhaustion exercise protocol combined with a single-leg hop. Nineteen male patients with ACL reconstruction (mean time after operation 11 months) who exhibited normal single-leg hop symmetry values (≥90% compared with the non-involved extremity) were tested for one-repetition maximum (1 RM) strength of a knee-extension exercise. The patients then performed single-leg hops following a standardised pre-exhaustion exercise protocol, which consisted of unilateral weight machine knee-extensions until failure at 50% of 1 RM. Although no patients displayed abnormal hop symmetry when non-fatigued, 68% of the patients showed abnormal hop symmetry for the fatigued test condition. Sixty-three per cent exhibited 1 RM strength scores of below 90% of the non-involved leg. Eighty-four percent of the patients exhibited abnormal symmetry in at least one of the tests. Our findings indicate that patients are not fully rehabilitated 11 months after ACL reconstruction. It is concluded that the pre-exhaustion exercise protocol, combined with the single-leg hop test, improved testing sensitivity when evaluating lower-extremity function after ACL reconstruction. For a more comprehensive evaluation of lower-extremity function after ACL reconstruction, it is therefore suggested that functional testing should be performed both under non-fatigued and fatigued test conditions.

Keywords

Anterior cruciate ligament Knee Rehabilitation Muscle fatigue Exercise test 

References

  1. 1.
    Ageberg E (2002) Consequences of a ligament injury on neuromuscular function and relevance to rehabilitation—using the anterior cruciate ligament-injured knee as model. J Electromyogr Kinesiol 12:205–212CrossRefPubMedGoogle Scholar
  2. 2.
    Anderson JL, Lamb SE, Barker KL, Davies S, Dodd CA, Beard DJ (2002) Changes in muscle torque following anterior cruciate ligament reconstruction: a comparison between hamstrings and patella tendon graft procedures on 45 patients. Acta Orthop Scand 73:546–552CrossRefPubMedGoogle Scholar
  3. 3.
    Arangio GA, Chen C, Kalady M, Reed JF III (1997) Thigh muscle size and strength after anterior cruciate ligament reconstruction and rehabilitation. J Orthop Sports Phys Ther 26:238–243PubMedGoogle Scholar
  4. 4.
    Augustsson J, Esko A, Thomeé R, Svantesson U (1998) Weight training of the thigh muscles using closed vs. open kinetic chain exercises: a comparison of performance enhancement. J Orthop Sports Phys Ther 27:3–8PubMedGoogle Scholar
  5. 5.
    Augustsson J, Thomeé R, Hörnstedt P, Lindblom J, Karlsson J, Grimby G (2003) Effect of pre-exhaustion exercise on lower-extremity muscle activation during a leg press exercise. J Strength Cond Res 17:411–416PubMedGoogle Scholar
  6. 6.
    Augustsson J, Thomeé R (2000) Ability of closed and open kinetic chain tests of muscular strength to assess functional performance. Scand J Med Sci Sports 10:164–168CrossRefPubMedGoogle Scholar
  7. 7.
    Barber SD, Noyes FR, Mangine RE, McCloskey JW, Hartman W (1990) Quantitative assessment of functional limitations in normal and anterior cruciate ligament-deficient knees. Clin Orthop 255:204–214PubMedGoogle Scholar
  8. 8.
    Carter T, Edinger S (1999) Isokinetic evaluation of anterior cruciate ligament reconstruction: hamstring versus patellar tendon. Arthroscopy 15:169–172PubMedGoogle Scholar
  9. 9.
    De Carlo M, Shelbourne KD, Oneacre K (1999) Rehabilitation program for both knees when the contralateral autogenous patellar tendon graft is used for primary anterior cruciate ligament reconstruction: a case study. J Orthop Sports Phys Ther 29:144–153PubMedGoogle Scholar
  10. 10.
    Dugan SA, Frontera WR (2000) Muscle fatigue and muscle injury. Phys Med Rehabil Clin N Am 11:385–403PubMedGoogle Scholar
  11. 11.
    Ernst GP, Saliba E, Diduch DR, Hurwitz SR, Ball DW (2000) Lower extremity compensations following anterior cruciate ligament reconstruction. Phys Ther 80:251–260PubMedGoogle Scholar
  12. 12.
    Feagin JA, Lambert KL, Cunningham RR, Anderson LM, Riegel J, King PH, VanGenderen L (1987) Consideration of the anterior cruciate ligament injury in skiing. Clin Orthop 216:13–18PubMedGoogle Scholar
  13. 13.
    Fitzgerald GK, Axe MJ, Snyder-Mackler L (2000) A decision-making scheme for returning patients to high-level activity with nonoperative treatment after anterior cruciate ligament rupture. Knee Surg Sports Traumatol Arthrosc 8:76–82PubMedGoogle Scholar
  14. 14.
    Fitzgerald GK, Lephart SM, Hwang JH, Wainner RS (2001) Hop tests as predictors of dynamic knee stability. J Orthop Sports Phys Ther 31:588–597PubMedGoogle Scholar
  15. 15.
    Hennessey LC, Watson AWS (1994) The interference effects of training for strength and endurance simultaneously. J Strength Cond Res 8:12–19CrossRefGoogle Scholar
  16. 16.
    Hiemstra LA, Webber S, MacDonald PB, Kriellaars DJ (2000) Knee strength deficits after hamstring tendon and patellar tendon anterior cruciate ligament reconstruction. Med Sci Sports Exerc 32:1472–1479PubMedGoogle Scholar
  17. 17.
    Howell S, Taylor M (1996) Brace-free rehabilitation, with early return to activity, for knees reconstructed with a double-looped semitendinosus and gracilis graft. J Bone Joint Surg Am 78:814–825PubMedGoogle Scholar
  18. 18.
    Jones K, Hunter G, Fleisig G, Escamilla R, Lemak L (1999) The effects of compensatory acceleration on upper-body strength and power in collegiate football players. J Strength Cond Res 13:99–105CrossRefGoogle Scholar
  19. 19.
    Juris PM, Phillips EM, Dalpe C, Edwards C, Gotlin RS, Kane DJ (1997) A dynamic test of lower extremity function following anterior cruciate ligament reconstruction and rehabilitation. J Orthop Sports Phys Ther 26:184–191PubMedGoogle Scholar
  20. 20.
    Keays SL, Bullock-Saxton JE, Newcombe P, Keays AC (2003) The relationship between knee strength and functional stability before and after anterior cruciate ligament reconstruction. J Orthop Res 21:231–237CrossRefPubMedGoogle Scholar
  21. 21.
    Kim PS, Mayhew JL, Peterson DF (2002) A modified YMCA bench press test as a predictor of 1 repetition maximum bench press strength. J Strength Cond Res 16:440–445PubMedGoogle Scholar
  22. 22.
    Lewek M, Rudolph K, Axe M, Snyder-Mackler L (2002) The effect of insufficient quadriceps strength on gait after anterior cruciate ligament reconstruction. Clin Biomech 17:56–63CrossRefGoogle Scholar
  23. 23.
    Noyes FR, Barber SD, Mangine RE (1991) Abnormal lower limb symmetry determined by function hop tests after anterior cruciate ligament rupture. Am J Sports Med 19:513–518PubMedGoogle Scholar
  24. 24.
    Pfeifer K, Banzer W (1999) Motor performance in different dynamic tests in knee rehabilitation. Scand J Med Sci Sports 9:19–27PubMedGoogle Scholar
  25. 25.
    Risberg MA, Ekeland A (1994) Assessment of functional tests after anterior cruciate ligament surgery. J Orthop Sports Phys Ther 19:212–217PubMedGoogle Scholar
  26. 26.
    Sapega AA (1990) Muscle performance evaluation in orthopaedic practice. J Bone Joint Surg Am 72:1562–1574PubMedGoogle Scholar
  27. 27.
    Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428CrossRefGoogle Scholar
  28. 28.
    Sleivert G, Backus R, Wenger H (1995) The influence of a strength-sprint training sequence on multi-joint power output. Med Sci Sports Exerc 27:1655–1665PubMedGoogle Scholar
  29. 29.
    Tegner Y, Lysholm J, Lysholm M, Gillquist J (1986) A performance test to monitor rehabilitation and evaluate anterior cruciate ligament injuries. Am J Sports Med 14:156–159Google Scholar
  30. 30.
    Urbach D, Nebelung W, Becker R, Awiszus F (2001) Effects of reconstruction of the anterior cruciate ligament on voluntary activation of quadriceps femoris: a prospective twitch interpolation study. J Bone Joint Surg Br 83:1104–1110CrossRefPubMedGoogle Scholar
  31. 31.
    Wilk KE, Romaniello WT, Soscia SM, Arrigo CA, Andrews JR (1994) The relationship between subjective knee scores, isokinetic testing, and functional testing in the ACL-reconstructed knee. J Orthop Sports Phys Ther 20:60–73PubMedGoogle Scholar
  32. 32.
    Williams GN, Chmielewski T, Rudolph K, Buchanan TS, Snyder-Mackler L (2001) Dynamic knee stability: current theory and implications for clinicians and scientists. J Orthop Sports Phys Ther 31:546–566PubMedGoogle Scholar
  33. 33.
    Wilson G, Newton R, Murphy A, Humphries B (1993) The optimal training load for the development of dynamic athletic performance. Med Sci Sports Exerc 25:1279–1286PubMedGoogle Scholar
  34. 34.
    Wojtys EM, Huston LJ (2000) Longitudinal effects of anterior cruciate ligament injury and patellar tendon autograft reconstruction on neuromuscular performance. Am J Sports Med 28:336–344PubMedGoogle Scholar
  35. 35.
    Östenberg A, Roos H (2000) Injury risk factors in female European football. A prospective study of 123 players during one season. Scand J Med Sci Sports 10:279–285CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Jesper Augustsson
    • 1
    • 2
  • Roland Thomeé
    • 1
  • Jon Karlsson
    • 1
  1. 1.Lundberg Laboratory for Human Muscle Function and Movement Analysis, Department of Orthopaedics, Sahlgrenska University HospitalGöteborg UniversityGöteborgSweden
  2. 2.Department of Rehabilitation Medicine, Sahlgrenska University HospitalGöteborg UniversityGöteborgSweden

Personalised recommendations