Kublin K1, Biały M1,2, Niechaj G2, Rachwalska J2, Gnat R1
1Jerzy Kukuczka Academy of Physical Education, Knee Research Group, Motion Analysis Laboratory, Katowice, Poland, 2Sport-Klinika, Endoscopic Surgery Clinic, Żory, Poland
Background: Functional evaluation after the anterior cruciate ligament (ACL) reconstruction is one of the key points when it comes to the decision concerning the return to complete and unrestricted physical activity. Criteria for returning to activity or high levels of sport performance are widely discussed in the literature. However, there is still no consensus concerning standardized and objective test protocols granting the safe return to pre-injury training loads as well as reducing the risk of subsequent injuries.
Purpose: The objective of the study was to verify if Functional Movement Screen (FMS) and myofascial chain (NEURAC®) tests can be used to detect functional differences between the healthy and operated limb in the group of patients 3 months after ACL reconstruction.
Methods: This was a retrospective review of prospectively collected data registered in early postoperative phase - 3 months after surgery. A total of 83 patients (25 female) who underwent primary single-bundle ACL reconstruction using autogenous semitendinosus-gracilis tendon graft were recruited. Subjects received similar standardized rehabilitation program. Two experienced raters blinded to the objective of this study were involved in functional outcome data collection for FMS and NEURAC® tests. A pilot study was conducted with 12 healthy participants in order to achieve a reliable level of agreement between raters (weighted Kohen's Kappa equal 0.75 for both the FMS and NEURAC® tests). Data processing was carried out by the third independent rater who was blinded to the aim of the study.
Results: Statistical analysis of individual tests revealed significant differences between the healthy and operated limb only in the group of NEURAC® tests. In assessment of function and movement quality in supine bridging the average score was 3.51 points for the healthy limb as opposed to 2.92 points for the operated one, P 0.001. In prone bridging average scores equaled 3.67 and 2.76 points, P 0.001 respectively. Moreover, the average summary score of all NEURAC® tests was 13.67 in healthy extremity versus 12.08 points in the operated one, P 0.001. None of the individual tests in the group of FMS showed significant differences with only a slightly noticeable trend unveiling that the operated limb was weaker.
Conclusion(s): NEURAC® tests (supine and prone bridging) in comparison with battery of FMS tests seem to be more effective in detecting functional differences between the healthy and operated limb 3 months after ACL reconstruction.
Implications: The valid information concerning functional status of the operated lower limb may be helpful in the process of planning further rehabilitation, load progression and taking decision about the return of the patient to physical activity at this stage of postoperative treatment. The future work needs to concentrate on the evaluation of the functional outcome at various stages of postoperative treatment with standardized and objective tests.
Keywords: Functional assessment, FMS tests, NEURAC® tests
Funding acknowledgements: No funding to declare.
Purpose: The objective of the study was to verify if Functional Movement Screen (FMS) and myofascial chain (NEURAC®) tests can be used to detect functional differences between the healthy and operated limb in the group of patients 3 months after ACL reconstruction.
Methods: This was a retrospective review of prospectively collected data registered in early postoperative phase - 3 months after surgery. A total of 83 patients (25 female) who underwent primary single-bundle ACL reconstruction using autogenous semitendinosus-gracilis tendon graft were recruited. Subjects received similar standardized rehabilitation program. Two experienced raters blinded to the objective of this study were involved in functional outcome data collection for FMS and NEURAC® tests. A pilot study was conducted with 12 healthy participants in order to achieve a reliable level of agreement between raters (weighted Kohen's Kappa equal 0.75 for both the FMS and NEURAC® tests). Data processing was carried out by the third independent rater who was blinded to the aim of the study.
Results: Statistical analysis of individual tests revealed significant differences between the healthy and operated limb only in the group of NEURAC® tests. In assessment of function and movement quality in supine bridging the average score was 3.51 points for the healthy limb as opposed to 2.92 points for the operated one, P 0.001. In prone bridging average scores equaled 3.67 and 2.76 points, P 0.001 respectively. Moreover, the average summary score of all NEURAC® tests was 13.67 in healthy extremity versus 12.08 points in the operated one, P 0.001. None of the individual tests in the group of FMS showed significant differences with only a slightly noticeable trend unveiling that the operated limb was weaker.
Conclusion(s): NEURAC® tests (supine and prone bridging) in comparison with battery of FMS tests seem to be more effective in detecting functional differences between the healthy and operated limb 3 months after ACL reconstruction.
Implications: The valid information concerning functional status of the operated lower limb may be helpful in the process of planning further rehabilitation, load progression and taking decision about the return of the patient to physical activity at this stage of postoperative treatment. The future work needs to concentrate on the evaluation of the functional outcome at various stages of postoperative treatment with standardized and objective tests.
Keywords: Functional assessment, FMS tests, NEURAC® tests
Funding acknowledgements: No funding to declare.
Topic: Orthopaedics; Sport & sports injuries; Outcome measurement
Ethics approval required: Yes
Institution: The Jerzy Kukuczka Academy of Physical Education in Katowice
Ethics committee: Ethics Committee at the Jerzy Kukuczka Academy of Physical Education
Ethics number: 42795
All authors, affiliations and abstracts have been published as submitted.
