Abualhasan J1,2,3, Anley C4, Snow M4, Grey M2
1Kuwait Ministry of Health, Physical Therapy, Kuwait, Kuwait, 2University of Birmingham, Sport, Exercise and Rehabilitation Sciences, Birmingham, United Kingdom, 3Kuwait University, Physiotherapy Department, Kuwait, Kuwait, 4Royal Orthopaedic Hospital, Surgery, Birmingham, United Kingdom
Background: The anterior cruciate ligament (ACL) plays an important role in anterior knee stability by preventinganterior t ransl ation of the tibia on the femur. Rapid translation of the tibia with respect to the femur produces anACL-hamstring stretch reflex which may provide an object measure of neuromuscular function following ACL injuryor reconstruction.
Purpose: The aim of this study was to determine if the ACL-hamstring stretch reflex could be reliably andconsistently obtained using the KT-2000 arthrometer.
Methods: A KT-2000 arthrometer was used to translate the tibia on the femur while recording the electromyographyover the biceps femoris muscle in 20 participants, all with intact ACLs. In addition, a sub-group comprising 4 patientsundergoing a knee arthroscopy for meniscal pathology, were tested before and after anaesthetic and with directtraction on the ACL during arthroscopy. The remaining 16 participants underwent testing to elicit the reflex using theKT-2000 only.
Results: A total number of 182 trials were performed from which 70 trials elicited stretch reflex (38.5 %). The mean onset latency of the hamstring stretch reflexes was 58.9 ± 17.9 ms. The average pull force was 195 ± 47 N, stretch velocity 48 ± 35 mm/s and rate of force 19.7 ± 6.4 N/s.
Conclusion(s): Based on these results, we concluded that the response rate of the anterior cruciate ligament-hamstringreflex is too low for it to be reliably used in a clinical setting, and thus would have limited value in assessing the returnof neuromuscular function following ACL injuries.
Implications: Further studies need to be conducted to investigate other robust ways to objectively measure kneeneuromuscular stability.
Keywords: Anterior Cruciate Ligament (ACL), Hamstring Activity, Short-latency response
Funding acknowledgements: JA is funded by a scholarship obtained from the Cultural Office at Kuwait
Embassy in London
Purpose: The aim of this study was to determine if the ACL-hamstring stretch reflex could be reliably andconsistently obtained using the KT-2000 arthrometer.
Methods: A KT-2000 arthrometer was used to translate the tibia on the femur while recording the electromyographyover the biceps femoris muscle in 20 participants, all with intact ACLs. In addition, a sub-group comprising 4 patientsundergoing a knee arthroscopy for meniscal pathology, were tested before and after anaesthetic and with directtraction on the ACL during arthroscopy. The remaining 16 participants underwent testing to elicit the reflex using theKT-2000 only.
Results: A total number of 182 trials were performed from which 70 trials elicited stretch reflex (38.5 %). The mean onset latency of the hamstring stretch reflexes was 58.9 ± 17.9 ms. The average pull force was 195 ± 47 N, stretch velocity 48 ± 35 mm/s and rate of force 19.7 ± 6.4 N/s.
Conclusion(s): Based on these results, we concluded that the response rate of the anterior cruciate ligament-hamstringreflex is too low for it to be reliably used in a clinical setting, and thus would have limited value in assessing the returnof neuromuscular function following ACL injuries.
Implications: Further studies need to be conducted to investigate other robust ways to objectively measure kneeneuromuscular stability.
Keywords: Anterior Cruciate Ligament (ACL), Hamstring Activity, Short-latency response
Funding acknowledgements: JA is funded by a scholarship obtained from the Cultural Office at Kuwait
Embassy in London
Topic: Musculoskeletal: lower limb; Sport & sports injuries; Orthopaedics
Ethics approval required: Yes
Institution: University of Birmingham
Ethics committee: Science, Technology, Engineering and Mathematics (STEM) Ethics Committee
Ethics number: (ERN_13-0290)
All authors, affiliations and abstracts have been published as submitted.
