The Return of Vertical Jump Landing Limb Symmetry after ACL Reconstruction on the Level of Healthy Individuals: Longer versus Shorter Duration of Supervised Physiotherapy
ESSKA Academy. Krolikowska A. May 11, 2018; 218188; FP52-1883
Dr. Aleksandra Krolikowska
Dr. Aleksandra Krolikowska
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Objectives: Achieving satisfactory outcome after ACL reconstruction undergoing home-based physiotherapy procedure without the direct supervision of a physiotherapist remains controversial. The study aimed to investigate if the duration of supervised physiotherapy affects the return of limb symmetry during vertical jump landing at seven months after ACL reconstruction on the level of healthy individuals.

Methods: The prospective study consisted of two groups of males averagely 30 weeks after primary unilateral ACL reconstruction with the use of autologous ipsilateral semitendinosus graft (Group I, n=20 and Group II, n=15). The time since reconstruction in both groups (Group I, 27.95±8.26 weeks; Group II, 32.47±7.74 weeks) was insignificant (p=0.11), although there were significant differences (p<0.001) between the duration of supervised physiotherapy between the two groups (Group I, 27.9±8.26 weeks; Group II, 11.28±8.20 weeks). The results were compared to the healthy individuals (Group III, n=20) matched in terms of gender, age, body mass, and body weight. Two-legged and one-legged vertical jumps landing vertical ground reaction force (VGRF) were bilaterally measured in the three studied groups with the use of force plates. The limb symmetry was analyzed by calculating the limb symmetry index (LSI). For the statistical analysis purposes, the analysis of variance (one-way ANOVA) was carried out.

Results: Significant differences (p=0.002) were found in the two-legged vertical jump LSI between Group I (LSI=99) and Group II (LSI=83), and between Group II and Group III (LSI=100), p=0.001. There were found no significant differences in the one-legged jump LSI between the groups (Group I LSI=98, Group II LSI=94, Group III LSI=99).

Conclusions: The shorter supervised physiotherapy, in contrast to the fully supervised physiotherapeutic procedure, resulted in obtaining the two-legged landing limb symmetry in patients at seven months after ACL reconstruction on a worse level than in the healthy individuals. The fully supervised postoperative physiotherapeutic procedure seems to be more effective for improving two-legged vertical jump landing limb symmetry. In terms of one-legged vertical jump landing, the limb symmetry was comparable to healthy individuals, regardless of the duration of the postoperative physiotherapeutic procedure supervision.

ACL, knee joint, jump landing
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