Evolution of the functional outcome after anterior cruciate ligament reconstruction
Author(s):
Bialy M. (Poland)
,
Bialy M. (Poland)
Affiliations:
Niechaj G.
,
Niechaj G.
Affiliations:
Rachwalska Joanna
,
Rachwalska Joanna
Affiliations:
Hofstede Julita
,
Hofstede Julita
Affiliations:
Kublin K.
Kublin K.
Affiliations:
ESSKA Academy. Bialy M. 05/09/18; 209398; P05-550 Topic: A1 - Anterior cruciate ligament (ACL) reconstruction
Maciej Bialy
Maciej Bialy
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Abstract
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Objectives: Functional assessment after anterior cruciate ligament (ACL) reconstruction is one of the key point when it comes to the decision to return this group of patients to full physical/sport activity. The goal of this study was to veryfy if Functional Movement Screen (FMS) and myofascial chain (Neurac) tests can be used to evaluate the functional outcome of patients after ACL reconstruction at various stages of postoperative treatment.

Methods: 307 patients (Female: 122, age 26±10.6, weight 73.4±13.6, height: 173.6±14.2, BMI: 24.7, average time from primary injury to surgery: 13.5 months) after ACL single-bundle (hamstring tendon graft) reconstruction participated in the study. Two investigators with four years of experience in functional testing have undergone data acquisition. Additionally on the group of 12 subjects interrater reliability of their assessment was verified (Kappa-Cohen coefficient: 0.75). The examination of each patient was preceded by 10-minute warm up on a bicycle ergometer during which the investigator shortly explain assessment procedure. Subsequently, FMS battery test followed by 4 myofascial tests (supine pelvic lift, supine bridging, prone bridging and side-lying hip abduction) was carried out. Functional evaluation was performed on 7 stages (S0: before surgery, S1: 3-4 mth, S2: 5-6 mth, S3: 7-8 mth, S4: 9-10 mth, S5: 11-12 mth, S6: > 12 mth). Data processing was carried by a third person who was blinded about the investigator, patient and stage of the functional examination.

Results: The mean FMS (max. 21 pts) and Neurac myofascial chain tests (max. 40 pts) at various stages of treatment were: for FMS: S0: 13,57, S1: 14,76, S2: 15,3, S3: 15,6, S4: 14,9, S5: 15,5, S6: 16,2, for Neurac: S0: 27,9, S1: 27,63, S2: 29,2, S3: 28,9, S4: 27,3, S5: 29,8, S6:29,2.

Conclusions: Functional performance expressed by FMS and Neurac myofascial chain tests, confirms the trend of improvement in patients' function after ACL reconstruction over time. The regression of the mean values of the aforementioned tests (both for FMS and Neurac) can be observed 9-10 months after surgery. This observation may be helpful in the context of the decision to return this group of patients to full physical/sport activity at this stage of postoperative treatment. Regular monitoring of functional improvements can also results in more individualized postoperative rehabilitation program.

Keywords:
ACL reconstruction, functional assessment, return to activity
Objectives: Functional assessment after anterior cruciate ligament (ACL) reconstruction is one of the key point when it comes to the decision to return this group of patients to full physical/sport activity. The goal of this study was to veryfy if Functional Movement Screen (FMS) and myofascial chain (Neurac) tests can be used to evaluate the functional outcome of patients after ACL reconstruction at various stages of postoperative treatment.

Methods: 307 patients (Female: 122, age 26±10.6, weight 73.4±13.6, height: 173.6±14.2, BMI: 24.7, average time from primary injury to surgery: 13.5 months) after ACL single-bundle (hamstring tendon graft) reconstruction participated in the study. Two investigators with four years of experience in functional testing have undergone data acquisition. Additionally on the group of 12 subjects interrater reliability of their assessment was verified (Kappa-Cohen coefficient: 0.75). The examination of each patient was preceded by 10-minute warm up on a bicycle ergometer during which the investigator shortly explain assessment procedure. Subsequently, FMS battery test followed by 4 myofascial tests (supine pelvic lift, supine bridging, prone bridging and side-lying hip abduction) was carried out. Functional evaluation was performed on 7 stages (S0: before surgery, S1: 3-4 mth, S2: 5-6 mth, S3: 7-8 mth, S4: 9-10 mth, S5: 11-12 mth, S6: > 12 mth). Data processing was carried by a third person who was blinded about the investigator, patient and stage of the functional examination.

Results: The mean FMS (max. 21 pts) and Neurac myofascial chain tests (max. 40 pts) at various stages of treatment were: for FMS: S0: 13,57, S1: 14,76, S2: 15,3, S3: 15,6, S4: 14,9, S5: 15,5, S6: 16,2, for Neurac: S0: 27,9, S1: 27,63, S2: 29,2, S3: 28,9, S4: 27,3, S5: 29,8, S6:29,2.

Conclusions: Functional performance expressed by FMS and Neurac myofascial chain tests, confirms the trend of improvement in patients' function after ACL reconstruction over time. The regression of the mean values of the aforementioned tests (both for FMS and Neurac) can be observed 9-10 months after surgery. This observation may be helpful in the context of the decision to return this group of patients to full physical/sport activity at this stage of postoperative treatment. Regular monitoring of functional improvements can also results in more individualized postoperative rehabilitation program.

Keywords:
ACL reconstruction, functional assessment, return to activity
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