Open Kinetic Chain Exercises Research Articles

Hip Flexor Muscle Activation During Common Rehabilitation and Strength Exercises

Background/Objectives: The iliopsoas muscle plays an essential role in lumbopelvic and hip anterior stability, which is particularly important in the presence of limited osseous acetabular coverage anteriorly as in hip dysplasia and/or hip micro-instability. The purpose of this systematic review is to (1) describe iliopsoas activation levels during common rehabilitation exercises and (2) provide an evidence-based exercise progression for strengthening the iliopsoas based on electromyography (EMG) studies. Methods: In total, 109 healthy adult participants ranging from ages 20 to 40 were included in nine studies. PubMed, CINAHL, and Embase databases were systematically searched for EMG studies of the psoas, iliacus, or combined iliopsoas during specific exercise. The Modified Downs and Black Checklist was used to perform a risk of bias assessment. PROSPERO guidelines were followed. Results: Nine studies were included. Findings suggest that the iliopsoas is increasingly activated in ranges of hip flexion of 30–60°, particularly with leg lowering/raising exercises. Briefly, >60% MVIC activity of the iliopsoas was reported in the active straight leg raise (ASLR) in ranges around 60° of hip flexion, as well as with supine hip flexion and leg lifts. In total, 40–60% MVIC was found in exercises including the mid-range of the ASLR around 45° of hip flexion and lifting a straight trunk while in a hip flexed position. Conclusions: The findings suggest that exercises in increased hip flexion provide greater activation of the iliopsoas compared to exercises where the trunk is moving on the lower extremity. Iliopsoas activation can be incrementally progressed from closed to open kinetic chain exercises, and eventually to the addition of external loads. The proposed exercise program interprets the results and offers immediate translation into clinical practice.

The effects of open/closed kinetic chain exercises in water on the electrical activity of selected lumbar muscles, lumbopelvic control, ground reaction force and psychological factors in men with chronic non-specific low back pain: A study protocol for a randomized clinical trial

Background and aimResearch has documented chronic non-specific low back pain (CNSLBP) as one of the primary causes of absenteeism at work, often accompanied by the use of health insurance and healthcare services. Considering little research on the consequences of open/closed kinetic chain (O/CKC) exercises in water on CNSLBP improvement, the present study is to investigate the effects of such interventions on the electrical activity of selected lumbar muscles, pain, lumbopelvic control (LPC), ground reaction force (GRF), and psychological factors in men with CNSLBP. Materials and methodsThis is a randomized controlled trial that involves individuals with CNSLBP between the ages of 40 and 60 years. Participants are randomly assigned, using block randomization, to one of the following groups: open kinetic chain (OKC) exercises, closed kinetic chain (CKC) exercises, or controls. The training groups engage in the exercises for eight weeks, with three sessions per week and 60 min each at the University of Bu-Ali Sina pool, following the prescribed workout routine. The primary outcomes of the electrical activity of the multifidus (MF), transversus abdominis (TrA), gluteus medius (GM), and quadratus lumborum (QL) muscles are measured by an electromyography (EMG) device. Additionally, the pressure biofeedback (BFB) device and the visual analog scale (VAS) are utilized to assess LPC and pain intensity, respectively. The secondary outcomes of the GRF, along with foot pressure and kinesiophobia, are subsequently measured by the Tampa Scale of Kinesiophobia (TSK). ConclusionBy comparing the outcomes between the OKC exercise group, CKC exercise group, and control group, this study aims to determine the differential effects of these two water-based exercise interventions on the various physical and psychological parameters in individuals with CNSLBP. The findings provide valuable insights into the most effective approach to water-based rehabilitation for individuals with CNSLBP. By comparing the outcomes of OKC and CKC exercises, healthcare professionals can make informed decisions when designing tailored rehabilitation programs for this patient population. The results also contribute to the development of evidence-based guidelines for the management of CNSLBP using water-based exercises.

The Effects of Open and Closed Kinetic Chain Exercises on Visual Reaction Times and Certain Motor Skills in Young Male Boxers

This study aimed to determine the effects of open kinetic chain (OKC) and closed kinetic chain (CKC) exercises on visual reaction times and certain motor skills in young male boxers. Twelve young male athletes (mean age: 16.92±1.08 years) voluntarily participated in this study, which employed a pretest-posttest experimental research model, a quantitative research method, without a control group. The Ethics Committee Approval required for the research was received from Muş Alparslan University Scientific Research and Publication Ethics Committee with decision number 9/73 dated 08.11.2023. Prior to and following training in OKC and CKC exercises, the athletes were tested on visual reaction times, vertical jumping, and flexibility. The paired samples t-test was applied to normally distributed data. According to our findings, there were no significant differences in the visual reaction time and flexibility tests with respect to the pre- and post-test results for the OKC exercises (p ˃ .05), although a significant difference was detected for the vertical jump test (p ˂ .05), with the post-test values determined to be lower than the pre-test values. While there were no significant differences in the CKC exercise pre-and post-test results for the vertical jump and flexibility tests (p ˃.05), a significant difference was observed in the visual reaction test (p ˂ .05), for which the post-test values were lower than the pre-test values. Based on these results, OKC exercises were determined to have a negative impact on jumping ability, whereas CKC exercises exhibited positive effects on visual reaction times. The use of CKC exercises can thus be recommended for studies aimed at improving visual reaction performance in young male boxers.

A Comparison Between Open Kinetic and Closed Kinetic Chain Exercises Along with Conservative Treatment in Grade-I ACL Injury in Sprinters: A Randomized Controlled Trail

Background:Anterior Cruciate Ligament (ACL) injury is most common in sports players such as soccer, basketball, sprinters, which causes alleviated strength in quadriceps muscles, and Range of Motion (ROM) of Knee Joint, and along with this, decrease in efficiency of knee that impacts person’s Activity of daily living (ADL). So, after ACL injury, Rehabilitation protocol plays a great role in maintaining knee ROM, increases the strength of quadriceps muscles. This study aims to compare the effect of open kinetic chain exercises and closed kinetic chain exercises and compare to asses which type of protocol is much efficient for ACL-Injury rehab protocol. Methodology: A comparative study was done over 50 male sprinters of 18-25 years old to assess the effect of Open Kinetic chain exercises (OKC) and closed kinetic chain exercises (CKC). Study was divided into 2 groups: OKC group and CKC group. In OKC Group, subject has to do flexor-extensor bench, isotonic quadriceps exercise and long leg press-off exercises with the conventional physiotherapy whereas in CKC group, subjects has to do wall sits exercises, standing weight shift, one-legged dips exercise, and squatting lunges along with the conventional physiotherapy. Each exercise was performed with 3 sets of 20 repetition, 3 days/week for 45 days. The data was collected from various academies of Satara, Maharashtra after obtaining the ethical permission. Subjects were explained about the procedure and protocol of research. ROM, Numeric Pain Rating Scale (NPRS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) scale were used as Outcome measures. Readings were noted on Day 0 and Day 45. The data was analyzed by using JASP Software. Results: 25 subjects were there in both groups, with the mean age of 23.4 years in CKC group whereas the mean age is 23.44 in OKC group. The mean value of NPRS in OKC group is 4.280±0.843 and that of CKC groups is 4.160±0.624. And the mean value of Knee ROM in CKC group is 118±5 while that of in OKC group is 107.2±4.52. Conclusion: In summary, this study highlights the importance of a tailored rehabilitation program combining OKC and CKC exercises for Grade-I ACL injuries in sprinters. Both exercise types play a crucial role in restoring knee function and strength. As per our study, CKC exercises are better than OKC exercises. So, CKC exercises should be incorporated into rehabilitation program of grade-I ACL injuries.

Acute effect of an intervention with open and closed kinetic chain muscle strength exercises on postural control and muscle power in elderly people: A randomized clinical trial

IntroductionAging causes changes in stance control and muscle function. However, strength exercises can mitigate these negative effects. Intervention practices are classified into open kinetic chain (OKC) and closed kinetic chain (CKC), but it is unclear whether there are differences between them regarding muscle power and balance in the older people. Thus, this study aimed to investigate the acute effect of an intervention in OKC and CKC on stance control and muscle power in the older people. MethodsThis study is a randomized clinical trial. A total of 29 older people participated in this study, divided into 3 groups: control group (CG) (n = 9), open kinetic chain group (OKCG) (n = 10), and closed kinetic chain group (CKCG) (n = 10). Stance control was evaluated on a force platform under bipedal, semi-tandem, and unipedal support conditions. Muscle power assessed based on the time to perform the sit-to-stand test (STS). The acute intervention in OKC and CKC consisted of 2 exercises for each intervention group. ResultsThere was no difference between acute interventions in OKC and CKC on stance control and muscle power. The time in STS was shorter in the CKCG compared to the CG. The largest oscillations of the center of pressure (COP) were found in the unipedal stance condition. ConclusionAn acute intervention in OKC and CKC did not differentiate stance balance and muscle power in the older people. However, CKC exercises are more effective for functional tasks than OKC exercises. The greater complexity of the task (unipedal support) causes greater stance oscillations in the older people.

Effect of open vs. closed kinetic chain exercises in ACL rehabilitation on knee joint pain, laxity, extensor muscles strength, and function: a systematic review with meta-analysis.

PROSPERO [CRD42023475230].

Electromyographic analysis of selected shoulder muscles during shoulder rehabilitation exercises in patients after reverse total shoulder arthroplasty

BackgroundReversed shoulder arthroplasty (RSA) aims to restore function in patients with rotator cuff failure and joint arthropathy. After surgery, patients are routinely referred to a rehabilitation specialist to regain range of motion, strength, and function. A key element in these programs is active exercises. The exercises are often selected based on assumed muscle activity, investigated by electromyography (EMG). In particular, in this patient population, activation of the deltoid and the scapular muscles is the focus of exercise therapy. Currently, most studies investigating muscle activity levels during exercises are performed on healthy individuals. To our knowledge, no study exists analyzing EMG activity during exercises in a population of shoulder arthroplasty patients. Therefore, the study aimed to analyze activity in the shoulder girdle muscles during 6 commonly used rehabilitation exercises 12 weeks after RSA surgery. MethodsForty-four patients (50 shoulders) participated in this cross-sectional study, 12 weeks postoperatively (mean 99.18±12.8 days), aged 68.9±7.75 years. Surface EMG activity was measured in 10 shoulder girdle muscles: the 3 trapezius parts, serratus anterior, the 3 deltoid parts, latissimus dorsi, and 2 pectoralis major parts during 6 exercises, 3 in a closed chain, and 3 open chain elevation exercises. ResultsGravity- minimized exercises (horizontal plane) show low activity for almost all muscles. Vertical closed kinetic chain exercises show an increased activity compared to horizontal plane exercises. Open kinetic chain exercises against gravity showed the greatest activity in Deltoid and Upper trapezius. For the other muscles no consistency in progression was found. ConclusionThis study offers a progression of exercises for patients after reversed shoulder arthroplasty based on increased muscle activity.

The Comparison Close Kinetic Chain Exercise And Open Kinetic Chain Exercise After Infra Red To Increasing Functional Ability In Primary Osteoarthritis Genu At Bhayangkara Kediri Hospital

Osteoarthritis is a degenerative health disorder characterized by stiffness and inflammation of the joints, characterized by damage to the cartilage, which can cause pain in the joints of the hands, neck, back, lower body, back and often the knee joints. Pain in genuine osteoarthritis can last a long time causing limitations in the ability to function functional activities. One non-pharmacological method is kinetic chain exercise. This study aims to determine the comparison of close kinetic chain exercise and open kinetic chain exercise after giving infrared to increase functional ability in conditions of primary genu osteoarthritis. This research uses a quasi experimental design with a pre and post test two group design approach. The sample for this research was 30 respondents. 15 respondents were treated with close kinetic chain exercise after giving infrared and 15 respondents were treated with open kinetic chain exercise after giving infrared. There is an effect of close kinetic chain exercise after administering infrared on increasing functional ability in primary genu osteoarthritis conditions at Bhayangkara Kediri Hospitalwith a significance of 0.001< α (α=0.05).There is an effect of open kinetic chain exercise after administering infrared on improving functional abilities in primary genu osteoarthritis conditions at Bhayangkara Kediri Hospital with a significance of 0.006< α (α=0.05).There is a difference in the effect of close kinetic chain exercise after giving infrared and open kinetic chain exercise after giving infrared on increasing functional ability in primary genu osteoarthritis conditions at Bhayangkara Kediri Hospital with a significance value of 0.035< α (α=0.05). Close kinetic chain exercise after giving infra red is more effective than open kinetic chain exercise after giving infra red in improving the ability of primary genu osteoarthritis conditions at Bhayangkara Kediri Hospital in 2023.

Current views on preoperative rehabilitation practice after anterior cruciate ligament injury among licensed physical therapists in Saudi Arabia: An online-based cross-sectional survey.

Preoperative rehabilitation is an important stage to both physically and mentally prepare patients for anterior cruciate ligament reconstruction (ACLR) and postoperative rehabilitation. This study aimed to investigate the current preoperative rehabilitation practice after anterior cruciate ligament injury among licensed physical therapists in Saudi Arabia. This was an online-based cross-sectional survey. A total of 114 physical therapists completed the survey. The survey consisted of 16 mandatory questions about management strategies, prescribed exercises, patients' physical and psychological concerns, and discussions about nonoperative management. The majority of the respondents used the following preoperative interventions: education (89.5%), closed kinetic chain exercises (66.7%), stretches (63.2%), open kinetic chain exercises (61.4%), proprioceptive exercises (59.6%), cold (56.1%), and activity modification advice (52.6%). More than half of the respondents would recommend patients awaiting ACLR to complete the exercises 2 to 4 times weekly (56.1%) for up to 8 weeks (80.7%) before ACLR. The respondents (73.7%) reported that patients awaiting ACLR did not receive preoperative rehabilitation due to 2 primary factors: the orthopedic team did not refer patients to rehabilitation specialists, and there was a lack of awareness about preoperative rehabilitation. Most therapists (86%) would discuss conservative management if a patient returned to their preinjury level of function before surgery. The surveyed physical therapists reported using various interventions and preoperative rehabilitation lengths with patients awaiting ACLR. The majority of the therapists indicated that patients awaiting ACLR did not receive preoperative rehabilitation. Future studies are needed to establish a consensus on the optimal preoperative rehabilitation program.

PERBEDAAN PENGARUH OPEN KINETIC CHAIN EXERCISE DAN CLOSE KINETIC CHAIN EXERCISE TERHADAP KEKUATAN OTOT QUADRICEPS FEMORIS PASCA OPERASI ANTERIOR CRUCIATE LIGAMEN DITINJAU DARI USIA

This research is an experimental research. The sample is post-Anterior Cruciate Ligament surgery patients at the Solo Sport Physiotherapy Clinic as many as 16 people including Open and Close exercise categories and based on adolescent and adult age categories. Samples were taken using purposive sampling technique. The variables in this study include: 1) Quadriceps Femoris Muscle Strength (Y); 2) Open Exercise (a1); 3) Close Exercise (a2); and 4) Age (b). Research data were obtained from measurements using an Electromyograph. Hypothesis testing using two-way Anova test and t test. Conclusion, (1) There is a difference in the effect of quadriceps femoris muscle strength after being given open kinetic chain and close kinetic chain exercises in ACL postoperative patients. Which means that close kinetic chain training has a better improvement than open kinetic chain in ACL postoperative patients. (2) There are differences in the effect of quadriceps femoris muscle strength in adolescent and adult athletes. Which means that adult athletes have a better increase in quadriceps femoris muscle strength compared to adolescent athletes. (3) There is no interaction between open kinetic chain and close kinetic chain training methods with adolescent and adult age on increasing quadriceps muscle strength.

Intrinsic graft laxity variation with open kinetic chain exercise after anterior cruciate ligament reconstruction: A non-randomized controlled study

ObjectivesTo determine whether quadriceps and hamstring strengthening in a rehabilitation program involving early open kinetic chain (OKC) and/or closed kinetic chain (CKC) knee joint exercises had an influence on graft laxity at 1, 3, and 6 months after anterior cruciate ligament reconstruction (ACLR). DesignRetrospective study. MethodsTwo groups (n = 53) of ACLR patients (combination of OKC and CKC exercises group compared to a CKC exercise group) were recruited. OKC protocol was introduced at 2 weeks post-operatively without external resistance and progressed at 4 weeks with load. Comparative ACL graft laxity measurement and isokinetic strength testing were prospectively performed up to 6 months in both groups. ResultsNo significant differences were observed in the knee laxity at 1 (p = 0.263), 3 (p = 0.263), and 6 months (p = 0.256) follow up between the groups.Similarly, no significant results were observed in within-group knee laxity between 1 and 6 months after ACLR in the intervention (p = 0.155) and control group (p = 0.690). ConclusionThe early initiation of OKC along with CKC exercises doesn't seem to increase the ACLR graft laxity as compared to a rehabilitation program with only CKC exercises.

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

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.

Novel Multi-View RGB Sensor for Continuous Motion Analysis in Kinetic Chain Exercises: A Pilot Study for Simultaneous Validity and Intra-Test Reliability.

As the number of musculoskeletal disorders caused by smartphone usage, sedentary lifestyles, and active sports activities increases, there is a growing demand for precise and accurate measurement and evaluation of issues such as incorrect compensation patterns, asymmetrical posture, and limited joint operation range. Urgent development of new inspection equipment is necessary to address issues such as convenience, economic feasibility, and post-processing difficulties. Using 4DEYE®, a new multi-view red, green, and blue (RGB) sensor-based motion analysis equipment, and the VICON® ratio, which are infrared-based markers, we conducted a comparative analysis of the simultaneous validity of the joint angle (trajectory) and reliability. In this study, five healthy participants who could perform movements were selected for the pilot study and two movements (Y-balance and side dip) were analyzed. In addition, the ICC (Intraclass Correlation Coefficient) was analyzed using the SPSS (Statistical Package for the Social Sciences) V.18 while the number of data frames of each equipment was equalized using the MATLAB program. The results revealed that side dips, which are open kinetic chain exercises (intraclass correlation coefficient ICC(2.1), 0.895-0.996), showed very high concordance with the Y-balance test, a closed kinetic chain exercise (ICC(2.1), 0.678-0.990). The joint measurement results were similar regardless of the movement in the open or closed kinetic chain exercise, confirming the high reliability of the newly developed multiview RGB sensor. This is of great significance because we obtained important and fundamental results that can be used in various patterns of exercise movements in the future.

Clinical practice and barriers among Swiss physiotherapists treating patients with anterior cruciate ligament reconstruction: A survey of pre-operative rehabilitation to return to sport

ObjectivesTo investigate current clinical practice of Swiss physiotherapists treating patients with anterior cruciate ligament reconstruction (ACLR) from pre-operative rehabilitation until return to sport (RTS). We assessed optimisation strategies in daily practice and the perceived barriers to these optimisations, and evaluated whether there was a relevant difference in clinical practice for physiotherapists with post-graduate certification in sports physiotherapy or deep clinical experience and those without such experience. DesignCross-sectional survey. SettingOnline survey platform. ParticipantsSwiss physiotherapists. Main outcome measuresThe survey comprised six sections: participant information, pre-operative rehabilitation, post-operative rehabilitation, RTS, re-injury prevention, and optimisation strategies and barriers. ResultsA minority of physiotherapists treated ACLR patients pre-operatively. Overall, 91% included quadriceps open kinetic chain exercise in their treatment, 37% used patient-reported outcomes measures (PROMs) and 39% considered psychological criteria when making decisions about RTS. Most physiotherapists (67%) felt limited due to the time available, the number of prescriptions and the tariffication system. ConclusionThis study highlights areas within ACLR rehabilitation practice in Switzerland that could be improve. Improvements in understanding of the barriers to implementation of best evidence in practice and a redefinition of the clinical process around ACLR rehabilitation in Switzerland are necessary.

Acute effect of open and closed kinetic chain training on lower limb muscle strength in young adults

Among training prescription variations for improving muscle strength, we can highlight open kinetic chain (OKC) and closed kinetic chain (CKC) exercises. The aim of this study was to investigate the acute effect of OKC and CKC exercises on lower limb muscle strength in young adults. Subjects were invited to participate in an acute training consisting of three OKC exercises and three CKC exercises and performed three sets of ten repetitions. To evaluate the torque and muscle power, an isokinetic dynamometer and a force platform were used. The analyzed variables were: peak of torque, time to peak torque, mean power and average power. Univariate analyses were used to compare the performance of participants in OKC and CKC exercises in torque and power tests. Peak torque was higher in the extensor and plantar flexion movements than knee and ankle joints, respectively. When comparing OKC and CKC exercises, OKC exercises produced a higher peak of torque and mean power in all the joints than CKC. We concluded that OKC exercises can be used for improving strength in young adults.

Neuromuscular Characteristics of Unilateral and Bilateral Maximal Voluntary Isometric Contractions following ACL Reconstruction.

Despite the advancement of diagnostic surgical techniques in anterior cruciate ligament (ACL) reconstruction and rehabilitation protocols following ACL injury, only half of the athletes return to sports at a competitive level. A major concern is neuromechanical dysfunction, which occurs with injuries persisting in operated and non-operated legs following ACL rehabilitation. One of the criteria for a safe return to sports participation is based on the maximal voluntary isometric contraction (MVIC) performed unilaterally and a comparison between the 'healthy knee' and the 'operated knee'. The present study aimed to investigate MVIC in athletes following ACL rehabilitation during open kinetic chain exercise performed unilaterally and bilateral exercises. Twenty subjects participated in the present investigation: 10 male athletes of regional-national level (skiers, rugby, soccer, and volleyball players) who were previously operated on one knee and received a complete rehabilitation protocol (for 6-9 months) were included in the ACL group (age: 23.4 ± 2.11 years; stature: 182.0 ± 9.9 cm; body mass: 78.6 ± 9.9 kg; body mass index: 23.7 ± 1.9 kg/m2), and 10 healthy male athletes formed the control group (CG: age: 24.0 ± 3.4 years; stature: 180.3 ± 10.7 cm; body mass: 74.9 ± 13.5 kg; body mass index: 22.8 ± 2.7 kg/m2). MVICs synchronised with electromyographic (EMG) activity (recorded on the vastus lateralis, vastus medialis, and biceps femoris muscles) were performed during unilateral and bilateral exertions. The rate of force development (RFD) and co-activation index (CI) were also calculated. The differences in the MVIC and RFD between the two legs within each group were not significant (p > 0.05). Vastus lateralis EMG activity during MVIC and biceps femoris EMG activity during RFD were significantly higher in the operated leg than those in the non-operated leg when exertion was performed bilaterally (p < 0.05). The CI was higher in the operated leg than that in the non-operated leg when exertion was performed bilaterally (p < 0.05). Vice versa, vastus medialis EMG activity during RFD was significantly higher in the right leg than that in the left leg when exertion was performed bilaterally (p < 0.05) in the CG. MVICs performed bilaterally represent a reliability modality for highlighting neuromechanical asymmetries. This bilateral exercise should be included in the criteria for a safe return to sports following ACL reconstruction.

Evaluation of Muscle Strength and Graft Laxity With Early Open Kinetic Chain Exercise After ACL Reconstruction: A Cohort Study.

Open kinetic chain (OKC) exercise is an effective method to improve muscle function during rehabilitation after anterior cruciate ligament reconstruction (ACLR); however, there is controversy about its use in the early phase of rehabilitation. To determine (1) whether the use of OKC and closed kinetic chain (CKC) exercises improves quadriceps and hamstring strength in the early phase of rehabilitation after ACLR and (2) whether the early use of OKC exercise affects graft laxity at 3 and 6 months postoperatively in patients with a hamstring tendon graft. Cohort study; Level of evidence, 3. This study included an intervention group that underwent OKC + CKC exercises (n = 51) and a control group that underwent CKC exercise only (n = 52). In the intervention group, OKC exercise for the quadriceps and hamstring was started at 4 weeks after ACLR. At 3 and 6 months postoperatively, isokinetic testing was performed to calculate the limb symmetry index (LSI) and the peak torque to body weight ratio (PT/BW) for the quadriceps and hamstring. Anterior knee laxity was measured by an arthrometer. At 3 and 6 months postoperatively, quadriceps strength was higher in the intervention group than in the control group for the LSI (3 months: 76.14% ± 0.22% vs 46.91% ± 0.21%, respectively; 6 months: 91.05% ± 0.18% vs 61.80% ± 0.26%, respectively; P < .001 for both) and PT/BW (3 months: 1.81 ± 0.75 vs 0.85 ± 0.50 N·m/kg, respectively; 6 months: 2.40 ± 0.73 vs 1.39 ± 0.70 N·m/kg, respectively; P < .001 for both). There were similar findings regarding hamstring strength for the LSI (3 months: 86.13% ± 0.22% vs 64.26% ± 0.26%, respectively; 6 months: 91.90% ± 0.17% vs 82.42% ± 0.24%, respectively; P < .001 at three months, P = .024 at 6 months) and PT/BW (3 months: 1.09 ± 0.36 vs 0.67 ± 0.39 N·m/kg, respectively; 6 months: 1.42 ± 0.41 vs 1.07 ± 0.39 N·m/kg, respectively; P < .001 for both). No significant difference in laxity was observed between the intervention and control groups at 3 or 6 months. Early use of OKC exercise for both the quadriceps and the hamstring, in addition to conventional CKC exercise, resulted in better correction of quadriceps and hamstring strength deficits without increasing graft laxity.

Effects of closed and open kinetic chain exercises on pain, muscle strength, function, and quality of life in patients with knee osteoarthritis.

Therapeutic exercises are well documented for the treatment of osteoarthritis; there is less evidence on what the effect of closed kinetic chain exercises is for knee osteoarthritis. The aim of this study was to investigate the effects of open kinetic chain exercises and closed kinetic chain exercises on pain, muscle strength, functional status, and quality of life in patients with knee osteoarthritis. The study included a total of 60 patients with primary unilateral knee osteoarthritis grade I and II. The patients were categorized into three groups as open kinetic chain exercises (n=20), closed kinetic chain exercises (n=20), and control group (n=20). The outcome measures, including pain, isokinetic muscle strength, functional status, and quality of life, were collected at baseline and at the end of 6 and 12 weeks. Closed kinetic chain exercises and open kinetic chain exercises had significant improvement in pain, muscle strength, WOMAC, and SF-36 scores after the treatment and at their 6th and 12th week follow-ups compared to their baseline values and compared to the control group (p<0.05). The changes in all outcome measures were similar between closed kinetic chain exercises and open kinetic chain exercises (p>0.05). Closed kinetic chain exercises and open kinetic chain exercises were similar for knee osteoarthritis grade I and II. Closed kinetic chain exercises could be safely added to the exercise programs of patients with low-grade knee osteoarthritis.

Loaded open-kinetic-chain exercises stretch the anterior cruciate ligament more than closed-kinetic-chain exercises: In-vivo assessment of anterior cruciate ligament length change

BackgroundUsage of open-kinetic-chain (OKC) or closed-kinetic-chain (CKC) exercises during rehabilitation planning after anterior cruciate ligament (ACL) reconstruction has been debated for decades. However, the ACL elongation pattern during different rehabilitation exercises at different loadings remains unclear. ObjectivesThis study aimed to determine the effects of OKC and CKC exercises on the length of ACL anteromedial bundle (AMB) and posterolateral bundle (PLB) to provide biomechanical support for making rehabilitation schedules. DesignLaboratory Descriptive Study. MethodEighteen healthy volunteers were asked to perform two OKC motions, including non-weight-bearing and 10 kg loaded seated knee extension (OKC-0, OKC-10), as well as two CKC motions, including box squat (BS) and deep single-legged lunge (Lunge). Techniques of 2D-to-3D image registration and 3D ligament simulation were used to quantify length changes of ACL. ResultsThe motion which led to the least and most ACL elongation were OKC-0 and OKC-10, respectively. The AMB and PLB were significantly longer in OKC-10 than those in OKC-0 during 0–60° and 0–55° of knee flexion (p < 0.01). Compared with reference length, the AMB and PLB were stretched during 0–30° and 0–10° respectively during OKC-10. During CKC exercises, the AMB and PLB were also stretched from 0 to 25°and 0–5°, respectively. Additionally, no significant difference was found in the length change of ACL bundles between BS and lunge. ConclusionsOKC-0 may be safe for the rehabilitation program after ACL reconstruction, and loaded exercises shall be applied when restricted with >30° in early-stage rehabilitation.

Open Versus Closed Kinetic Chain Exercise: a Comparison of Walking Capacity in Chronic Post-Stroke Phase

Introduction: The chronic post-stroke phase is often accompanied by various sensory, cognitive, motoric, coordination, and balance impairments. Decreased strength and motoric control contribute to walking capacity in patients with stroke. This study aims to evaluate the effect of Open Kinetic Chain (OKC) vs Closed Kinetic Chain (CKC) exercise on walking capacity in the chronic post-stroke phase. Open Kinetic Chain (OKC) and Closed Kinetic Chain (CKC) were reported to improve functional mobility and balance in the chronic post-stroke phase. However, there is a lack of studies emphasizing the effect of OKC and CKC on walking capacity.&#x0D; Methods: This study is a quasi-experimental pre- and post-controlled trial group design. Twenty subjects were randomized into two groups of equal size: the CKC group (n=10) and the OKC group (n=10). There was one subject from each group who dropped out at the end of the study. CKC and OKC groups were trained for 6 weeks. The walking capacity was measured with 2 Minutes Walking Test (2WMT).&#x0D; Results: 2WMT results showed improvement in both groups after 6 weeks of intervention, 56,17 ± 10,95 ± to 57,43 ± 11,29 in CKC group (p&lt;0.001) and 57,04 ± 8,58 to 58,19 ± 8,77 in OKC group (p&lt;0.002).&#x0D; Conclusion: CKC and OKC exercise significantly improve the 2WMT results after 6 weeks of intervention.&#x0D; Keywords: Chronic post-stroke phase, walking capacity, open kinetic chain exercise, closed kinetic chain exercise