Effectiveness of open and close kinetic chains after anterior cruciate ligament reconstruction: A systematic review and meta-analysis

Abstract

Background: The Anterior Cruciate Ligament (ACL) is a ligament that has the function to maintain the stability of the knee so that it does not shift excessively towards the front. ACL injuries are injuries that are often experienced by sports athletes, especially those who often make fast and sudden movements. There are non-operative and operative methods for treating ACL. Non-operative methods are considered less effective because they usually require a slightly longer recovery period. One of the most frequently used surgical methods is reconstruction. After reconstruction, there is a need for exercises to speed up recovery and improve its function. Some examples of exercises that can be used are Open Kinetic Chain (OKC) and Close Kinetic Chain (CKC) exercises.Purpose: To determine the level of effectiveness between OKC and CKC for individual after ACL reconstructionMethod: This research was a systematic review and meta-analysis with the PRISMA diagram to filter supporting articles. To assess the quality of Randomized Controlled Trial (RCT) design studies, the Critical Appraisal Checklist was used. Meanwhile, the Characteristics for Included Studies were used to assess the feasibility. The article search came from the Pubmed database with the keywords "Close Kinetic Chain" AND "Open Kinetic Chain" AND "Anterior Cruciate Ligament" AND "Reconstruction". Inclusion criteria were full text articles in Indonesian or English with an RCT study design. The relationship measure used was Mean Difference, and Revman 5.4. was used for analysis.Results: There were five articles from UK, US and Turkey for this study. The results of the study showed that there was an increasing effect after carrying out OKC and CKC exercises. However, the difference in exercise benefits between OKC and CKC exercises was not notably significant, which were shown by a p-value >0.05 (MD= -1.66; 95% CI=-18.71 to 5.42; P=0.65).Conclusion: OKC and CKC exercises had been proven to have an effect on improving ACL recovery after reconstruction, but the difference in effect between OKC and CKC had not been found.