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Knee. 2018 Aug;25(4):588-594. doi: 10.1016/j.knee.2018.05.010. Epub 2018 Jun 6.

The relationship between performance on the modified star excursion balance test and the knee muscle strength before and after anterior cruciate ligament reconstruction.

Author information

1
Program of Professional Improvement in Physiotherapy, Orthopedic, and Traumatology at the Clinics Hospital at Ribeirão Preto School of Medicine, Ribeirão Preto, SP, Brazil.
2
Rehabilitation Center of Clinics Hospital at the Ribeirão Preto School of Medicine, Ribeirão Preto, SP, Brazil.
3
Department of Biomechanics, Medicine and Rehabilitation of Locomotor Apparatus, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil.
4
Department of Biomechanics, Medicine and Rehabilitation of Locomotor Apparatus, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil; Department of Orthopedics, University of Missouri, Columbia, MO, USA.
5
Rehabilitation Center of Clinics Hospital at the Ribeirão Preto School of Medicine, Ribeirão Preto, SP, Brazil. Electronic address: amferreira@hcrp.usp.br.

Abstract

OBJECTIVES:

The objective of this study was to evaluate the dynamic balance of the injured and uninjured limb before and after the anterior cruciate ligament (ACL) reconstruction and compare with the control group.

STUDY DESIGN:

Prospective longitudinal.

SETTING:

Biomechanics laboratory.

PARTICIPANTS:

Participants are 24 males (mean age, 27.5 years) with unilateral ACL injury (ACLG) and 24 male healthy volunteers (CG).

MAIN OUTCOMES MEASURES:

The modified star excursion balance test (SEBT) and isokinetic knee extensor and flexor strength were applied in the ACLG preoperatively and after surgery. The dominant limb of CG was evaluated at a single time.

RESULTS:

There was no difference between the injured and the uninjured limb of the ACLG (P > 0.05) before and after surgery. Preoperatively, both ACLG limbs had a significantly lower reach distance in posteromedial (PM) and posterolateral (PL) directions and in composite reach (CR) score compared to the control group (P < 0.001). Postoperatively, no significant differences were found between ACLG and CG (P > 0.05). There was a positive correlation between preoperative PL (0.59) and CR (0.51), postoperative PM (0.36), PL (0.36) and CR (0.46) with flexor strength at 12 months after surgery.

CONCLUSION:

Patients with ACL injury presented a worse performance in the SEBT in the preoperative period compared to the control group. After ligament reconstruction, the performance in the SEBT became equivalent to that of the control group. The strong correlation between flexor strength and posterior directions of the injured limb demonstrates the importance of the knee flexor muscles in the neuromuscular control of patients submitted to ACL reconstruction.

KEYWORDS:

Anterior cruciate ligament; Balance test; Dynamic balance; Postural control

PMID:
29886009
DOI:
10.1016/j.knee.2018.05.010
[Indexed for MEDLINE]

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