One-leg Hop Test Research Articles

Outcome of combined anatomic reconstruction of the anterior cruciate ligament with anterolateral ligament reconstruction versus with iliotibial band tenodesis

Abstract Background Isolated anterior cruciate ligament (ACL) tears without anterolateral structures injuries are treated successfully by isolated reconstruction of ACL. However, most ACL injuries are associated with the injuries of anterolateral stabilizers of the knee; mainly the iliotibial tract (ITB) and the anterolateral ligament (ALL). If ACL is only reconstructed in such a case, the incidence of postoperative rotational instability reaches 18%. New directions guided towards combined ACL reconstruction with extraarticular anatomical and nonanatomical reconstructions to improve knee rotation and translation and prevent pivot shift phenomena. Patients and methods We retrospectively reviewed all patients operated on for combined injuries of ACL and anterolateral stabilizers from February 2019 to February 2021. Preoperatively and postoperatively, all patients were examined clinically by knee stability tests: anterior drawer, Lachman, and pivot shift tests, applying the International Knee Documentation Committee score and return time to the sport. Results Forty patients were included with a mean age of 28 ± 8.33 years (range, 18–44 years). Patients were divided into two groups, group A 20 patients (18 males and two females) were treated by combined ACL with ALL reconstruction, and group B 20 patients (18 males and two females) were treated by combined ACL with ITB tenodesis. Sports injuries were the cause in 15 patients in group A and 14 in group B, while five injuries were due to nonsport activity in group A and six in group B. The mean follow-up period was 33.5 ± 2.1 months. Median postoperative subjective International Knee Documentation Committee scores in groups A and B were 95.4 and 94.25, respectively, without any statistically significant difference. Group A shows better postoperative improvement in pivot shift and one-leg hop test than group B with a significant difference (P<0.05). Conclusion No significant difference between ALL reconstruction or ITB tenodesis with ACL reconstruction according to subjective knee functions but there was a significant difference according to objective functions, also lateral knee pain was reported in group B and not observed in group A.

Evaluation of hop performance in children with anterior cruciate ligament reconstruction using healthy reference data: A cross-sectional study

BackgroundHop performance evaluation in children after anterior cruciate ligament (ACL) reconstruction may benefit from comparison to healthy controls. Thus, the purpose was to investigate the hop performance in children one year after ACL reconstruction with a comparison to healthy controls. MethodsHop performance data from children with ACL reconstruction one year post-surgery and healthy children were compared. Four one-legged hop test data were analyzed: 1) single hop (SH), 2) 6 m timed hop (6 m-timed), 3) triple hop (TH), and 4) cross-over hop (COH). Outcomes were the best result (longest/fastest hop) from each leg and limb asymmetry. Differences in hop performance between-limbs (operated versus non-operated) and between-groups were estimated. Results98 children with ACL reconstruction and 290 healthy children were included. Few statistically significant group differences were observed. Girls with ACL reconstruction outperformed healthy controls in two tests on the operated leg SH, COH) and in three tests on the non-operated leg (SH, TH, COH). However, the girls performed 4–5% worse on the operated leg when compared to the non-operated leg in all hop tests. No statistically significant between-group differences in the limb asymmetry were found. ConclusionThe hop performance in children with ACL reconstruction one year post-surgery was largely comparable to the level of healthy controls. Despite this, we cannot exclude that neuromuscular deficits exist among the children with ACL reconstruction. The inclusion of a healthy control group for evaluating hop performance evoked complex findings regarding the ACL reconstructed girls. Thus, they may represent a selected group.

Effectiveness of Rehabilitation for Knee Osteoarthritis Associated With Isolated Meniscus Injury: A Scoping Review.

Meniscus tear is the most common type of injury to the meniscus and occurs more frequently on the medial compartments than the lateral compartments. Further, it is often caused by trauma or degenerative processes and can occur anywhere on either the meniscus, anterior horn, posterior horn, or midbody. Treatment of meniscus injuries is likely to greatly impact the evolution of osteoarthritis (OA) as meniscus injuries can gradually progress to knee OA. Hence, treatment of these injuries is important for managing the progression of OA. While the types of meniscus injuries and symptoms have been reported previously, the effectiveness of rehabilitation according to the degree of meniscus injury (e.g., vertical, longitudinal, radial, and posterior horn tears) remains unknown. In this review, we aimed to investigate whether rehabilitation for knee OA associated with isolated meniscus injuries varies with the degree of injury and determine the effects of rehabilitation on outcomes. We searched PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and Physiotherapy Evidence Database for studies published before September 2021. Studies on ≥40-year-old patients with knee OA and isolated meniscus injury were included for analysis. The types of meniscus injury were classified as longitudinal, radial, transverse, flap, combined, or avulsion of the anterior and posterior roots of the medial meniscus, and assigned knee arthropathy grades of 0-4 according to the Kellgren-Lawrence classification. The exclusion criteria were meniscus injury, combined meniscus and ligament injury, and knee OA associated with combined injury in patients <40 years of age. There were no restrictions on the region, race, or gender of participants, or language or research format of the studies. The outcome measures were the Knee Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index Score, Visual Analog Scale or Numeric Rating Scale, Western Ontario Meniscal Evaluation Tool, International Knee Documentation Committee Score, Lysholm Score, 36-Item Short-Form Health Survey, one-leg hop test, timed up and go test, and re-injury and muscle strength. A total of 16 reports met these criteria. In studies that did not classify or distinguish degrees of meniscus injury, the effects of rehabilitation were generally favorable in the medium-to-long term. In cases where the intervention was not sufficiently effective, patients were recommended either arthroscopic partial meniscectomy or total knee replacement. Studies on medial meniscus posterior root tear did not confirm the effectiveness of rehabilitation due to the short intervention period. Further, Knee Osteoarthritis Outcome Score cut-offs, clinically important differences in Western Ontario and McMaster Universities Osteoarthritis Index, and minimum important changes in patient-specific functional scales were reported. Of the 16 studies reported in this review, nine met the definition. This scoping review has a few limitations such as the effect of rehabilitation alone could not be examined, and the intervention effectiveness differed at short-term follow-up. In conclusion, there was a gap in evidence regarding the rehabilitation of knee OA after isolated meniscus injury due to differences in intervention duration and methods. In addition, on short-term follow-up, intervention effects varied across studies.

Consequences of anterior knee pain after anterior cruciate ligament reconstruction: A 2015-2020 cohort study.

Anterior cruciate ligament reconstruction (ACLR) using hamstring tendon (HT) graft aims to stabilise the knee, but it may bring some complications like anterior knee (AKP) pain that can have consequences on the functional aspect of this surgery. The aim of this study was to compare isokinetic knee strength and functional outcomes between patients with and without AKP following an ACLR using HT graft during the first-year post-surgery. Three hundred and thirty subjects operated by ACLR using hamstring tendon graft were included in our retrospective cohort and divided into two groups: a group with AKP (AKP+ group) and one without AKP (AKP-group). In our population, 14.8% of the patients had AKP. At 4 post-operative months, subjects with pain had lower isokinetic strength limb symmetry index (LSI) for knee flexors and extensors, and a lower Lysholm score than subjects without pain (p < 0.0001). These differences did not persist at 7 post-operative months, and there was no difference in the one-leg hop test. After multivariate analysis, we highlighted the impact of time on the evolution of these parameters. Yet, the exact definition of AKP after ACLR remains to be clearly defined since an imprecise diagnosis may lead to inappropriate management. Pre-operative information about this type of complication, which evolves favourably with time, could be useful for patients. Indeed, AKP can occur after ACLR, even if a HT graft has been used, compared to other surgical procedures using the knee extensor apparatus as patellar tendon graft (AKP is associated with the donor site morbidity). In case of AKP after ACLR, monitoring the muscle inhibition by isokinetic tests may enable clinicians to adapt the retraining and the return to sport.

Kinetic Effects of 6 Weeks' Pilates or Balance Training in College Soccer Players with Chronic Ankle Instability.

Lateral ankle sprain (LAS) is a common sports injury that frequently occurs in active individuals. LAS is characterized by a high recurrence rate, with a large proportion of patients progressing to chronic ankle instability (CAI). Pilates exercises have provided positive results in health care and in rehabilitation. This study compared Pilates training (PT) with traditional balance training (BT) in patients with CAI. Fifty-one college football players with CAI, divided into PT (n = 26) and BT (n = 25) groups, were included in the study. The groups performed PT or BT training as assigned, three times per week for 6 weeks. Isokinetic ankle strength, one-leg hop tests, Y-balance test (YBT), and foot and ankle outcome score (FAOS) were evaluated before and after training. There were considerable improvements in both the PT and BT groups after training. Group and time comparisons revealed that the PT group achieved better triple hop test results than the BT group, whereas the BT group exhibited a greater improvement in YBT posteromedial and posterolateral reach distances. In athletes with CAI, both PT and BT effectively improved symptoms and function. These findings suggest that ankle strength, balance, and core stability should be comprehensively evaluated and targeted in CAI rehabilitation programs.

Hip Adductor, Abductor Muscles Strength, and Performance in Participants with and without Low Back Pain

Introduction: Weakness of hip muscles is common in individuals with chronic non- specific low back pain (CNSLBP). Also, hip joint performance can be influenced by the weakness of hip muscles. This study aimed to compare the strength and performance of hip adductor and abductor muscles between subjects with and without CNSLBP and to investigate their association with disability level.&#x0D; Materials and Methods: This case-control study included 41 participants with CNSLBP and 41 healthy participants. The strength of hip abductor and adductor muscles were measured using a dynamometer and their performance was assessed using the one-leg hop test. The disability level in the CNSLBP group was assessed using the oswestry disability index (ODI). Data were analyzed using an independent sample t test and Pearson correlation coefficient.&#x0D; Results: No significant differences were observed between groups for hip muscle strength. One-leg hop test scores of the left lower extremity in the lateral direction were significantly higher in the CNSLBP group compared to the control group. Also, no significant relationships were observed between the total score of ODI and hip muscle strength or performance in the CNSLBP group.&#x0D; Conclusion: It’s recommended that evaluation and exercise therapy of participants with CNSLBP be performed during functional performance tasks.

PATELLOFEMORAL AĞRI SENDROMLU HASTALARDA MODİFİYE EDİLEBİLİR RİSK FAKTÖRLERİNİN ARAŞTIRILMASI

AİM: Patellofemoral pain syndrome is a knee problem, especially frequent in physically active young individuals. Patellofemoral pain syndrome is a set of symptoms rather than a specific diagnosis. It adversely affects both the quality of life and the functional activities of the patients. The aim of this study was to provide researchers and clinicians with an information concerning modifiable predictive variables for patellofemoral pain syndrome, to aid the development of preventative interventions. &#x0D; &#x0D; MATERİAL AND METHOD: A total of 130 patients with complaints of anterior knee pain and subsequently diagnosed as having patellofemoral pain syndrome and 100 healthy individuals without anterior knee pain were included in the study. All individuals were assessed in terms of shortness in soft tissues, muscle weakness, lower extremity alignment disorders, pain levels and functional levels. &#x0D; &#x0D; RESULTS: The patients with patellofemoral pain syndrome and asymptomatic subjects included in the study were similar in terms of age, gender and body mass index. In the comparison between patients with patellofemoral pain syndrome and asymptomatic subjects, J finding, one-legged hop test positivity, quadriceps atrophy, trendelenburg test positivity, iliotibial band tightness, patellar tilt, patellar hypermobility, patellar edge sensitivity, genu recurvatum, differences in leg length and external tibial torsion findings were significantly higher in patients with PFPS (p

Effects of High-Intensity Aquatic or Bicycling Training in Athletes with Unilateral Patellofemoral Pain Syndrome.

Patellofemoral pain syndrome (PFPS) is one of the most common overuse injuries experienced by athletes. It is characterized by pain and functional deficits that lead to decreased performance, thereby limiting sports activity. Therefore, optimal training interventions are required to improve physical fitness and function while minimizing pain due to PFPS. This study aimed to compare and analyze the effects of high-intensity aquatic training (AT) and bicycling training (BT) in male athletes with PFPS. Fifty-four athletes with PFPS were divided into AT and BT intervention groups. Intervention training was conducted three times per week for 8 weeks. Cardiorespiratory fitness was evaluated using the graded exercise test (GXT) based on peak oxygen uptake (VO2 peak), and anaerobic threshold. For the knee strength test, extension and flexion were performed and measured using isokinetic equipment. One-leg hop tests and the Y-balance test (YBT) were performed to evaluate dynamic balance, and the International Knee Documentation Committee (IKDC) scoring system was used for subjective knee evaluation. The GXT, YBT, and IKDC scores were reported according to the group and duration of the intervention. After training, VO2 peak, YBT, knee extension strength, and IKDC score improved significantly in both the AT and BT groups compared with the pre-training values. Furthermore, the AT group exhibited significant improvement compared with the BT group. We demonstrated that AT and BT effectively improved the symptoms and muscle strength of athletes with PFPS who were only able to engage in limited high-intensity field training. AT produced a modestly better effect than BT.

A quantitative evaluation of the individual components contributing to the functional ankle instability in patients with modified Broström procedure

Residual functional ankle instability regardless of the restoration of mechanical stability after the lateral ligament repair or reconstruction can cause recurrent sprain. The purpose of this study was to identify the sequential changes of joint-position sense, peroneal strength, postural control, and functional performance ability after the modified Broström procedure (MBP) for chronic ankle instability. A total of 46 patients (46 ankles) underwent the MBP for chronic ankle instability were eligible for this study and were followed for 1 year postoperatively. The changes of joint-position sense and peroneal strength were periodically evaluated with an isokinetic dynamometer. Postural control ability was evaluated using a one-leg stance test with eyes closed. The functional performance ability examination comprised a one-leg hop test, a 6-meter hop test, and a cross 3-meter hop test. The error in joint-position sense significantly improved from a mean 4.3º to 2.8º (p < .001). Peak torque for eversion significantly improved from a mean 18.2 Nm to 21.2 Nm (p = .024). Balance retention time significantly improved from a mean 4.7 seconds to 6.4 seconds (p < .001). Among the functional performance tests, only the one-leg hop test showed a significant improvement postoperatively (p = .031). At 1 year postoperatively, the recovery ratios compared to the unaffected ankle were 67.9% in joint-position sense (p < .001), 86.9% in peroneal strength (p = .012), and 74.4% in postural control (p < .001) with significant side-to-side differences. Although joint-position sense, peroneal strength, postural control, and functional performance ability were significantly improved after the MBP, recovery ratios compared to the unaffected ankle were insufficient up to 1 year postoperatively.

The changes of joint-position sense, peroneal strength, postural control, and functional performance ability after the modified Broström procedure for chronic ankle instability.

Purpose: Residual functional ankle instability regardless of the restoration of mechanical stability after the lateral ligament repair or reconstruction can cause recurrent sprain. The purpose of this study was to identify the sequential changes of joint-position sense, peroneal strength, postural control, and functional performance ability after the modified Broström procedure (MBP) for chronic ankle instability. Methods: A total of 46 patients (46 ankles) who underwent the MBP for chronic ankle instability were eligible for this study and were followed up for 1year postoperatively. The changes of joint-position sense and peroneal strength were periodically evaluated with an isokinetic dynamometer. Postural control ability was evaluated using a one-leg stance test with eyes closed. The functional performance ability examination comprised a one-leg hop test, a six-meter hop test, and a cross three-meter hop test. Results: The error in joint-position sense significantly improved from a mean 4.3° to 2.8° (p < 0.001). Peak torque for eversion significantly improved from a mean 18.2Nm to 21.2Nm (p = 0.024). Balance retention time significantly improved from a mean 4.7 s to 6.4 s (p < 0.001). Among the functional performance tests, only the one-leg hop test showed a significant improvement postoperatively (p = 0.031). At 1year postoperatively, the recovery ratios compared to the unaffected ankle were 67.9% in joint-position sense (p < 0.001), 86.9% in peroneal strength (p = 0.012), and 74.4% in postural control (p < 0.001), with significant side-to-side differences. Conclusion: Although joint-position sense, peroneal strength, postural control, and functional performance ability were significantly improved after the MBP, recovery ratios compared to the unaffected ankle were insufficient up to 1year postoperatively. Level of Evidence: Level IV (prospective case series).

Correlation of body composition with speed and agility of children aged 9-10

Purpose: Physical growth of children is measured by changes in body size and/or body composition, as well as by changes in motor skills. Motor skills can be affected by many factors, such as genetic predisposition, body composition, socio-economic conditions, and the like. Accordingly, the aim of the research is to determine the correlation between body composition with speed and agility of children aged 9 to 10 years.&#x0D; Methods: The sample included 40 participants (29 boys and 11 girls, 9.47 ± 0.5 years). Body height (BH), body weight (BW), body mass index (BMI) and body fat (BF), and basal metabolism (BMR) were determined to assess body composition. The BOT-2 subtest was used to assess speed and agility, which includes: Shuttle Run (1SAA), Stepping Sideways over a Balance Beam (2SAA), One-Legged Stationary Hop (3SAA), One-Legged Side Hop (4SAA), Two-Legged Side Hop (5SAA), and Total Speed and Agility (TSAA).&#x0D; Results: The results of correlation statistics indicated the existence of negative correlations between: height and 3SAA (r=-.353, p=.026); weight and 3SAA (r=-.422, p=. 007); weight and TSAA (r=-.359, p=.023); BMI and 3SAA (r=-.342, p=. 031); BMI and TSAA (r=-.333, p=.036); BMR and 3SAA (r=-.369, p=. 019); BMR and TSAA (r=-.363, p=.021).&#x0D; Conclusion: Based on the results obtained in this study, it can be concluded that there is a correlation between body composition and speed and agility. In addition to body composition, a correlation was found between body height and performance of one-legged stationary hop, as well as between basal metabolism, the one-legged stationary hop test and the overall results achieved in motor skill tests.

An arthroscopic repair technique for proximal anterior cruciate tears in children to restore active function and avoid growth disturbances

PurposeThe aim of this study was to assess midterm clinical outcomes in Tanner 1–2 patients with proximal anterior cruciate ligament (ACL) tears following arthroscopic-surgical repair using an absorbable or an all-suture anchor.MethodsFourteen (9.2 ± 2.9 years-old) of 19 skeletally immature patients reached the 2 years of clinical follow-up. Physical examinations included the Lachman test, Pivot-shift test, One-leg Hop test, Pedi-IKDC as well as Lysholm and Tegner activity scores; knee stability was measured with a KT-1000 arthrometer. Overall re-rupture rates were also evaluated in all operated patients.ResultsAt 2 years post-surgery, the Lysholm score was 93.6 ± 4.3 points, and the Pedi-IKDC score was 95.7 ± 0.1. All patients returned to the same sport activity level as prior to ACL lesion within 8.5 ± 2.9 months, with one exception who reported a one-point reduction in their Tegner Activity score. No leg-length discrepancies or malalignments were observed. Four patients presented grade 1 Lachman scores, and of these, three presented grade 1 (glide) score at Pivot-shift; clinical stability tests were negative for all other patients. Anterior tibial shift showed a mean side-to-side difference of 2.2 mm (range 1–3 mm). The One-leg Hop test showed lower limb symmetry (99.9% ± 9.5) with the contralateral side. Overall, 4 out of 19 patients presented a re-rupture of the ACL with a median time between surgery and re-rupture of 3.9 years (range 1–7).ConclusionThis surgical technique efficiently repairs proximal ACL tears, leading to a restoration of knee stability and a quick return to an active lifestyle, avoiding growth plate disruption.Level of evidenceIV.

신경근 트레이닝이 우슈선수의 자세안정화와 기능성 운동수행능력에 미치는 영향

This study was to investigate the effects of neuromuscular training on posture stability and functional exercise performance abilities in wushu player. In order to achieve the purpose of this study, wushu player at Chungcheongnam-do and daejeon, were selected at random and allocated 12 wushu player each for the Non Exercise group(NEG), Deficient Exercise group(DEG), Over Exercise group(OEG) and measured posture stability and functional exercise performance abilitiesbefore and after the experiment. The neuromuscular training program for 12 weeks. The results of this study were as follows: First, As for the posture stability abilities, there were significantly increased in SEBT-A, SEBT-AM, SEBT-M, SEBT-PM, SEBT-P, SEBT-PL, SEBT-L and SEBT-AL in OEG compared with NEG after 12 weeks. Second, As for the functional exercise performance abilities, there were significantly increased in carioca, co-contraction, shuttle-run, cross over up step and one-leg hop test in OEG compared with NEG after 12 weeks.<BR> As conclusions, this study confirmed that the neuromuscular training could improve the posture stability and functional exercise performance abilities in wushu player. However, there is a need for more specific exercise programs to be developed for the continual improvement of athletic performance in athletics along with further studies to confirm the physiological benefits of those programs.

Xenograft for anterior cruciate ligament reconstruction was associated with high graft processing infection

PurposeTo evaluate clinical ad radiological outcomes of anterior cruciate ligament (ACL) reconstruction with an immunochemically modified porcine patellar tendon xenograft controlled against human Achilles tendon allograft at 24-month minimum follow-up.Methods66 patients undergoing arthroscopic ACL reconstruction were randomized into 2 groups: 34 allografts and 32 xenografts treated to attenuate the host immune response. Follow-up was 24-month minimum. Anterior knee stability was measured as KT − 1000 side-to-side laxity difference (respect to the contralateral healthy knee). Functional performance was assessed by one-legged hop test. Objective manual pivot-shift test and subjective (IKDC, Tegner and SF-36) outcomes were collected. MRI and standard X-Ray were performed.Results61 subjects (32 allograft, 29 xenograft) were evaluated at 12 and 24 months. Six of the subjects in xenograft group (20.6%) got an infection attributed to a water-based pathogen graft contamination in processing.Intention-to-treat analysis (using the last observation carried forward imputation method) revealed higher KT − 1000 laxity in xenograft group at 24-month follow-up (P = .042). Also pivot-shift was higher in xenograft group at 12-month (P = .015) and 24-month follow-up (P = .038).Per-protocol analysis (missing/contaminated subjects excluded) did not revealed clinical differences between groups.Tibial tunnel widening in the allograft group was low, whereas xenograft tunnel widening was within the expected range of 20–35% as reported in the literature.No immunological reactivity was associated to xenograft group.ConclusionsHigh infection rate (20.6%) was reported in xenograft group. Both groups of patients achieved comparable clinical outcomes if missing/contaminated subjects are excluded. Improved harvesting/processing treatments in future studies using xenografts for ACL reconstruction are needed to reduce infection rate, otherwise xenograft should not be used in ACL reconstruction.Level of evidenceMulticenter and double-blinded Randomized Controlled Clinical Trial, Level I.

Higher Vertical Jumping Asymmetries and Lower Physical Performance are Indicators of Increased Injury Incidence in Youth Team-Sport Athletes.

Fort-Vanmeerhaeghe, A, Milà-Villarroel, R, Pujol-Marzo, M, Arboix-Alió, J, and Bishop, C. Higher vertical jumping asymmetries and lower physical performance are indicators of increased injury incidence in youth team-sport athletes. J Strength Cond Res 36(8): 2204-2211, 2022-To date, the literature about the association between injury-risk factors and actual injury incidence in young elite team-sports athletes is scarce. The main objective of this study was to examine how modifiable factors may affect injury incidence. Eighty-one young elite team-sports athletes (age: under-14 to under-18) performed the countermovement jump (CMJ), a single leg CMJ (SLCMJ), the one-legged hop test (OLHT), a 30-m sprint test, the V-cut test, a repeated sprint ability, and the 30-15 intermittent fitness test (IFT) during the pre-season period. Interlimb asymmetries were calculated for SLCMJ and OLHT. Injuries were recorded prospectively for the entirety of the 2017-2018 season. Comparison of injury and noninjury data was performed using a two-way analysis of variance (ANOVA). Results of the ANOVA according to injury showed significant differences in CMJ ( p = 0.01), SLCMJ on the lowest performing limb ( p = 0.03), and SLCMJ asymmetry (<0.001). Sex × injury interaction was significant from CMJ ( p = 0.018) and 30-15 IFT ( p = <0.001). In conclusion, this study indicated that athletes with greater interlimb asymmetries, less vertical jump capacity, and lower intermittent aerobic fitness had a greater predisposition to injury. Therefore, monitoring CMJ, aerobic performance, and interlimb asymmetries is recommended given their sensitivity to detect significant differences between injured and healthy youth athletes.

The Effect Of Plyometric Training With Blood Flow Restriction After Anterior Cruciate Ligament Reconstruction

Quadriceps and hamstring muscles weakness are common after anterior cruciate ligament reconstruction (ACLR). Despite rehabilitation programs, the problem persists and has negative effects on knee function. Plyometric exercises are used during rehabilitation to facilitate muscle strength, function and return to sports. However, the effects of plyometric training with blood flow restriction (BFR) have never been investigated on patients with ACLR. PURPOSE: The aim of this study was to investigate the effects of plyometric training with BFR on muscle strength, muscle thickness and knee function after ACLR. METHODS: Twenty-eight patients who completed a 12-week rehabilitation program after ACLR were included in the study. Patients were randomly allocated into two groups. Group-1 (n=14, age: 19.6±2.1 years) performed plyometric training with BFR 3 days a week for 8 weeks. Group-2 (n=14, age: 20.3±3.3 years) performed the same plyometric training without BFR. Knee muscle strength, muscle thickness and knee function were evaluated before and after the interventions. Concentric knee extension and flexion muscle strength were evaluated with isokinetic dynamometer at 60°/s and 180°/s angular velocities. The thickness of the rectus femoris (RF), vastus medialis obliques and lateralis (VMO-VL) were assessed with ultrasonography. Vertical jump (VJ) and one-leg hop (OLH) tests were used to assess the performance of the patients. The subjective knee function was evaluated with IKDC knee form and ACL-RSI score. In addition one leg hop test and ACL-RSI score were evaluated only after intervention. Mann Whitney-U test was used to analyze the change before and after the intervention between groups. RESULTS: Group-1 had significantly higher quadriceps (p<0.05, p<0.05) hamstring muscle strength (p<0.05, p<0.05) at 60°/s and 180°/s angular velocities respectively and higher muscle thickness of RF (p<0.05), VL (p<0.05) and VMO (p<0.05) compared to group-2. In addition, the VJ test (p<0.05) and ACL-RSI score (p<0.05) were higher in group-1 compared to group-2. CONCLUSIONS: The results of the study indicated that plyometric training with BFR was more effective in improving the muscle thickness, muscle strength and knee function.

The relationship between upper extremity strength and performance in elite amputee football players

Background: ‪Despite having similar requirements to regular football, amputee football may also require different dynamics due to using crutches. This study investigated the relationship between upper extremity strength and performance in amputee players. Material and methods: ‪Twenty amputee players participated in this study. Running performance of amputee players was measured with sprint tests; aerobic performance with a shuttle run test; jumping performance with a one-leg hop test and upper extremity strength with a digital dynamometer. The relationship between the types of performance was evaluated by multiple regression analysis. Results: T‪he 10 (p = 0.009) and 20 meters sprint performance (p = 0.035) was associated with latissimus dorsi muscle and the 30 meters (p=0.030) with shoulder extension strength. In addition, 10 (p = 0.018), 20 (p = 0.020) and 30 meters sprint performance (p=0.036) was associated with one-leg hop performance. However, there were no related data with the max VO2 (p = 0.339), and the aerobic performance test duration (p = 0.348). Conclusions: ‪The results indicated that the sprinting performance of amputee players was not only related with lower extremity strength but also with upper extremity strength. It may be beneficial to include shoulder extension and particularly latissimus dorsi strengthening exercises in training programs of amputee football players to provide an increase in anaerobic performance.

Preseason assessment of anaerobic performance in elite soccer players: comparison of isokinetic and functional tests

ABSTRACT Isokinetic and functional jump tests are frequently performed for assessing the physical qualities of soccer players during preseason. The purpose of this investigation was to explore, in an elite soccer players population, the relationships between isokinetic strength and functional jump performances. Thirty-eight professional soccer players were evaluated as follows: isokinetic knee assessment in concentric (CON) mode (60, 240°/s) for quadriceps and hamstrings, and in eccentric (ECC) mode for the hamstrings only (30°/s); one-leg hop tests for distance (single hop (SH), triple hop (TH) and triple crossover hop (TCH)); one-leg vertical jump tests (countermovement jump, drop jump). Players with a low bodyweight normalised (BWN) quadriceps (Q) strength (<2.71 Nm/kg) performed, for a majority of the measured variables, significantly reduced jump performances compared to the players with high BWN Q strength (>3.14 Nm/kg; p < 0.05). Greater bilateral differences between uninjured and past injured lower limbs were found with isokinetics (Q CON 60°/s (mean bilateral difference (MBD): 10.3%; p < 0.01), Q CON 240°/s (MBD: 9.9%; p < 0.05), H ECC 30°/s (MBD: 16.1%; p < 0.001) than with functional tests (MBD: 2 to 9%; p > 0.05. In conclusion, due to their complementary role and implications for performance, functional and isokinetic tests should be associated in a preseason soccer players assessment.

Muscle training in chronic anterior cruciate ligament insufficiency--a comparative study

The aim of the investigation was to study and compare the effect of two basically different training methods on muscle strength and knee function on a consecutive and prospective series of 26 conservatively treated patients with chronic anterior cruciate ligament injury. The two training models were: model Q directed towards specific training of knee extensor muscle strength and model F aiming at training of the lower extremity and trunk muscles in functional weightbearing patterns. The parameters evaluated were: isometric and isokinetic muscle strength, a performance test (one-leg hop test), and a functional score. The results after a three-month training period showed in both groups a significant increase of muscle strength in both knee extensors and knee flexors. No significant difference of isokinetic strength values between the two groups was observed. The isometric gain of knee extension was significantly higher in the Q group. The one-leg hop test value and the functional score were also significantly increased in both groups. However, the hop test indicated a more favourable result in the group who were trained functionally.

Preservation of the Tibial Remnant in Anterior Cruciate Ligament Reconstruction May Improve Postoperative Proprioceptive Function.

The purpose of this study was to retrospectively compare clinical results, including proprioceptive function, after anterior cruciate ligament (ACL) reconstruction between 2 groups using techniques that preserve and eliminate the tibial remnant. Forty-eight patients who were followed for at least 24 months after ACL reconstruction with 4-strand hamstring tendon autografts were enrolled in this study. They were then divided into 2 groups: the remnant-preserving group (group A, 26 patients), in whom more than 7 mm of the remnant tibial stump (approximately 20% of the mean length of the ACL) was preserved; and the remnant-eliminating group (group B, 22 patients), in whom the tibial remnant was eliminated during ACL reconstruction. The average duration of follow-up was 25.5 months. At last follow-up, patients were evaluated using the International Knee Documentation Committee scale, Hospital for Special Surgery score, Lachman test, arthrometer, reproduction of passive positioning (RPP) test, threshold to detection of passive motion (TTDPM) test, one-leg hop test, and single-limb standing test. The clinical results between the 2 groups were statistically compared. Group A showed significantly better results on the RPP test at 15° (P=.040) and 30° (P=.010), one-leg hop test (P=.017), and single-limb standing test (P=.007) compared with group B. The other results showed no significant differences. The remnant-preserving technique in ACL reconstruction yields better proprioceptive and functional outcomes and may help achieve postoperative patient satisfaction. [Orthopedics. 2020;43(4):e231-e236.].