Evaluation of the myofascial chain and functional movement tests in patients after anterior cruciate ligament reconstruction

ePoster - epESMA-30

Topic: Sports Injury and Return to Competition Criteria

Bialy M.^1,2, Kublin K.², Niechaj G.¹, Rachwalska J.¹, Gnat R.^2
1Sport-Klinika, Endoscopic Surgery Clinic, Functional Diagnosis Laboratory, Żory, Poland, ²The Jerzy Kukuczka Academy of Physical Education, Motion Analysis Laboratory, Knee Research Group, Katowice, Poland

Introduction: Criteria for returning to the activity or high level sports performance after anterior cruciate ligament ACL are widely discussed in the literature.
Objective: To introduce myofascial chain tests as a new diagnostic tool for screening the patients after ACL reconstruction.
Aim: The aim of presented study was to verify whether the Functional Movement Screen (FMS) and myofascial chain (NEURAC) tests can be used to detect functional differences between the non-operated and operated lower extremity in the group of patients after ACL reconstruction.
Methods: A total of 83 patients (58 male and 25 female) who underwent primary single-bundle ACL reconstruction using autogenous semitendinosus-gracilis tendon graft were enrolled and data were registered 3 months after ACL reconstruction. Subjects received similar standardized rehabilitation program. Two experienced raters blinded to the objective of this study were involved in the functional outcome data collection for FMS and NEURAC tests. A pilot study was conducted in 12 healthy participants in order to achieve a reliable level of agreement between raters, which resulted in weighted Kappa-Kohen coefficient equal 0.75 as well for FMS and NEURAC myofacial chain tests. Data processing was carried out by the third independent rater who was blinded to the aim of the study. Due to ordinal character of the gathered data non-parametric Mann-Whitney U test was used. The research was approved by the local Bioethical Committee (No. 3/2017), and all subjects signed written informed consent before participation.
Results: Statistical comparison of the scores gained in the individual functional tests showed significant differences between the non-operated and the operated lower extremity in case of the NEURAC tests exclusively. They were: the supine bridging test (average 3.51 vs 2.92 points, respectively, P< 0.001), the prone bridging test (average 3.67 vs 2.76 points, P< 0.001) and the total score of all NEURAC tests (average 13.67 vs 12.08 points, P< 0.001). In case of all remaining functional tests no significant differences were found.
Conclusions: The NEURAC myofascial chain tests (supine and prone bridging) in comparison with the battery of FMS tests seem to be more effective in detecting functional differences between the operated and non-operated lower extremity in early postoperative phase.