Tag: anterior cruciate ligament

Effects of graded backward treadmill training on quadriceps strength, quadriceps muscle mass, and quality of life after anterior cruciate ligament reconstruction: a randomized controlled trial

Diker Dev Joshi, Vikram Shetty, Pravin Aaron, Dhanesh Kumar KU

Diker Dev Joshi, Vikram Shetty, Pravin Aaron, Dhanesh Kumar KU – Effects of graded backward treadmill training on quadriceps strength, quadriceps muscle mass, and quality of life after anterior cruciate ligament reconstruction: a randomized controlled trial –  Fizjoterapia Polska 2025; 25(5); 18-25

DOI: https://doi.org/10.56984/8ZGA431Z4K7

Abstract
Background. Anterior cruciate ligament (ACL) reconstruction is frequently associated with persistent quadriceps weakness and reduced quality of life. Graded backward treadmill walking has emerged as a promising intervention to enhance neuromuscular rehabilitation.
Objective. To investigate the effects of graded backward treadmill training on quadriceps strength, quadriceps muscle mass, and quality of life in individuals after ACL reconstruction.
Methodology. Sixty participants (aged 18–45 years) who underwent ACL reconstruction using a semitendinosus graft were randomly assigned to five groups (A–E; n = 12 per group). Groups A–D performed backward treadmill walking at inclinations of 0°, 5°, 10°, and 15°, respectively. Group E served as the control group and received conventional rehabilitation. Training was conducted for 20 minutes per session, three days per week, for four weeks. Outcome measures included quadriceps strength (assessed using a dynamometer), quadriceps muscle mass (assessed by ultrasound), and quality of life (measured using the IKDC and ACL-QOL questionnaires). Statistical analyses were performed using analysis of variance (ANOVA) and non-parametric tests.
Results. All groups demonstrated improvements in quadriceps strength, muscle mass, and quality of life following the intervention. Group B exhibited the greatest mean improvement in quadriceps strength, whereas Group D showed the largest increases in quadriceps muscle mass and quality of life scores. Significant between-group differences were observed at baseline for quadriceps strength (p < 0.001) and at post-test for ultrasound-derived muscle mass (p = 0.010), IKDC scores (p = 0.033), and ACL-QOL scores (p = 0.016).
Discussion. The findings indicate that backward treadmill training led to improvements in quadriceps strength, muscle mass, and quality of life across all intervention groups. The superior strength gains observed in Group B suggest that moderate incline backward walking may be optimal for enhancing force production, whereas the pronounced increases in muscle mass and quality of life in Group D indicate that higher inclinations may be particularly effective for promoting muscular hypertrophy and psychosocial recovery.
Conclusion. Graded backward treadmill training following ACL reconstruction improves quadriceps muscle mass and quality of life, with higher inclinations showing greater effects. Further research is warranted to determine long-term outcomes and to identify optimal training parameters.
Key words
anterior cruciate ligament, backward treadmill walking, rehabilitation, quadriceps strength, quality of life
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The atteration of the value of muscle forces in the programme of physiotherapy after the reconstruction of anterior cruciate ligaments

Andrzej Czamara

Andrzej Czamara – The atteration of the value of muscle forces in the programme of physiotherapy after the reconstruction of anterior cruciate ligaments. Fizjoterapia Polska 2002; 2(4); 263-272

Abstract
Introduction. The aim of this research was the analysis of the alteration of the value of forces of the extensors and flexors of knee joints in the 13th week and the 6th month of physiotherapy of the patients after the reconstruction of anterior cruciate ligaments. Material and method. The research involved 46 patients, 25 of whom were women. 39 patients, 19 of whom were women, who had undergone at least a six-month physiotherapy were qualified for the analysis of the alteration of the value of forces. The author offered a four-step physiotherapy programme. In the 13th week and then at the beginning of the 6th month the moment of forces was measured and the analysis of the balance of the moment of forces of the flexors to extensors of knee joints was made. Results. A statistically essential increase of the moment of forces of traumatic limbs, both in a group of men and women, was reached in the 6th month as compared to the 13th week of physiotherapy. No statistically important differences were noted in a men’s group at the beginning of the 6th month. The results in the traumatic limbs were comparable the value of the moment of forces of healthy limbs. At the same time a women’s group got, in the traumatic limbs, about 80-90% of the value of the moment of forces of the muscle groups of healthy limbs. Some essential statistic differences were noted. The value of the balance of the moments of forces of the operated limbs’ muscles altered approaching in the 6th month the values of healthy limbs. Conclusions. The increase of the mean value of the moment of forces in traumatic limbs was reached in the treated groups. The dynamics of the increase of the value of the moment of forces proved better in men. It appears that the analysis of the changes of balance of flexors to extensors may prove useful in the monitoring of the process of physiotherapy.

Key words:
Anterior Cruciate Ligament, physiotherapy, moment of forces

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The usefulness of kinesitherapy in the process of rehabilitation following surgical reconstruction of the anterior cruciate ligament: a comparative analysis of exercise methods in open and closed kinematic chains

Wojciech Hagner

Wojciech Hagner – The usefulness of kinesitherapy in the process of rehabilitation following surgical reconstruction of the anterior cruciate ligament: a comparative analysis of exercise methods in open and closed kinematic chains. Fizjoterapia Polska 2003; 3(1); 1-7

Abstract
Background. Damage to the ligamental and capsular apparatus of the knee, especially the anterior cruciate ligament (ACL), leads to instability of the knee, manifesting functionally as unsatisfactory joint coordination and slippage of the plateau of the tibia. The choice of treatment should be dictated by the extent of damage incurred by the knee and the patient’s age and degree of physical activity. Surgical reconstruction of the ACL restores joint coordination, but the final outcome is largely determined by post-surgical kinesitherapy. In planning the rehabilitation program after surgical reconstruction of the ACL, it is necessary to bear in mind the impact exercises will have on knee stability, as well as on the work and load of the passive and dynamic stabilizers of the knee.Material and methods. In this article the effects of exercises in systems based on open and closed kinematic chains are subjected to statistical analysis, as well as the impact of such exercises on the relative movements of the individual structural elements of the knee.Conclusions. The results of the present study showed that kinesitherapy in open and closed kinematic chains has a positive impact on rehabilitation outcome after ACL reconstruction, while the decisive factor is the skillful combination of exercises from both types of kinematic chain.

Key words:
Anterior Cruciate Ligament, kinesitherapy, open kinematic chain, closed kinematic chain

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Assessment of the effectiveness of selected physical therapy procedures in the early post-operative period fol łowing ACL surgery. Pilot study

Anna Polak, Ewa Grymel-Kulesza, Janusz Kubacki, Piotr Król

Anna Polak, Ewa Grymel-Kulesza, Janusz Kubacki, Piotr Król – Assessment of the effectiveness of selected physical therapy procedures in the early post-operative period fol łowing ACL surgery. Pilot study. Fizjoterapia Polska 2010; 10(1); 12-24

Abstract
Background. The study aimed to assess the effectiveness ofa therapeutic regimen combining kinesiotherapy, cryotherapy and electrical stimulation in patients with a surgically treated anterior cruciate ligament (ACL). Materials and methods. Twenty-four patients with reconstructed ACL participated in the study. The patients were randomly divided into Groups A and B, each group containing 12 indMduals. Both groups received kinesiotherapy and cryotherapy according to the same programme, but Group B additionally received electrical stimulation. A therapeutic cycle comprised kinesiotherapy, cryotherapy and electrical stimulation procedures, ten of each kind. Sessions took place three times a week. The progress of healing in the patients was followed by assessing passive and active flexion at the knee, measuring the knee-joint circumference and load-testing of the limb.Results. After the treatment, both groups showed statistically significant improvements in flexion of the knee joint and reduced swelling of the joint. The leg-loading test performed after the treatment provided statistically significant improvement compared to pre-treatment data in both groups. No statistically significant differences were found between the two groups regarding treatment effectiveness.Conclusions. A combination of kinesiotherapy and cryotherapy is an effective adjunct to the treatment of patients with a surgically treated anterior cruciate ligament. The introduction of electrical stimulation did not offer additional therapeutic benefits.
Słowa kluczowe
anterior cruciate ligament, ACL, kinesiotherapy, cryotherapy, electrical stimulation
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Sensibility disorders after ACL reconstruction with BTB graft

Dariusz Grela, Anna Morawik

Dariusz Grela, Anna Morawik – Sensibility disorders after ACL reconstruction with BTB graft. Fizjoterapia Polska 2010; 10(4); 299-306

Abstract
Background. The purpose of the research was to analyse data concerning superficial sensibility disorders on the lateral side of knee joint occurring after reconstruction of anterior cruciate ligament (ACL) with bone-tendon-bone (BTB) graft.
The research was mainly to find out the span of time after which ailments of this type subsided.
Material and methods. The research was carried out among 137 patients who underwent ACL reconstruction with BTB. They were asked to fill in question naires after 3, 4, 5, 6, 12, 18 and 24 months after the surgery. Questions were to find out information about the region of sensibility disorders, current quality of the disorders and the time span after which the disorders sustained.
Results. Patients after anterior cruciate ligament reconstruction with a graft taken from patellar tendon report sensibility disorders on the lateral side of the knee joint below the patella on the level of the scar. Most often these ailments subside after 12-18 months after the surgery. Superficial sensibility was back after 4 months at the earliest.
Conclusions. In case of most patients, superficial sensibility in the discussed region was fully restored. This allows to state that the examined disorders are temporary. Before a patient regains normal sensibility, many procedures in physiotherapy of the region we are discussing should be applied very carefully.
Key words:
sensation disorders, nerve regeneration, anterior cruciate ligament
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Evaluation of pre and post operative physiotherapy using the Lysholm scale on functional Outcomes in Patients undergoing Anterior Cruciate Ligament Reconstruction

Sebastian Zduński, Witold Rongies

S. Zduński, W. Rongies – Evaluation of pre and post operative physiotherapy using the Lysholm scale on functional Outcomes in Patients undergoing Anterior Cruciate Ligament Reconstruction. Fizjoterapia Polska 2020; 20(1); 130-143

DOI: https://doi.org/10.56984/8ZG078S84

Abstract
Background. Most anterior cruciate ligament (ACL) injuries require surgery and physiotherapy. One important factor that determines physiotherapeutic success is achieving optimal function already before an ACL reconstruction surgery.
Material and methods. A total of 72 randomly enrolled patients, who had been diagnosed with a complete ACL tear and qualified for surgical reconstruction, were included in this study. The experimental group comprised 37 patients aged from 18 to 60 years (mean age 37 ± 10.3 years). All patients from this group underwent a physiotherapy regimen based on established rehabilitation practices over a period of 4 weeks preceding the surgery. The control group comprised 35 patients aged from 18 to 60 years (mean age 34 ± 10.0 years) who did not undergo any preoperative physiotherapy regimen.
Results. At the second time point, both the experimental and control groups exhibited significant improvement in Lysholm scores in comparison with baseline scores (p < 0.05). The Lysholm-Gillquist score in the experimental group was better in the experimental group. There was a significant difference in Lysholm functional knee scores in experimental and control subjects at postsurgical week 6 and 12 (p < 0.05).
Conclusions. 1. Physiotherapy in patients with a complete ACL tear is an important and beneficial factor improving knee function prior to ACL reconstruction.
2. Functional knee scores (assessed with the Lysholm scale) obtained in both groups after the reconstruction surgery confirmed the effectiveness of surgical procedures and physiotherapeutic protocols.

Key words:
knee joint, anterior cruciate ligament, Lysholm-Gillquist scale

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Characteristic of the anterolateral ligament of the knee and its correlation with trauma of the anterior cruciate ligament in athletes

Patrycja Szkutnik, Marcin Domżalski

P. Szkutnik, M. Domżalski: Characteristic of the anterolateral ligament of the knee and its correlation with trauma of the anterior cruciate ligament in athletes. FP 2015;15(4);74-81

Abstract

Traumas of the anterior cruciate ligament (ACL) are the most common injuries of a knee joint in athletes. We diagnose them by specific clinical tests – Lachman test, anterior drawer test, pivot-shift test and additional imaging studies. Form of the treatment is to reconstruct the ligament with a graft taken muscle. After treatment, there is still a problem with the rotational instability. Only 60% of the athletes returned to pre-injury form. This is due to anterolateral ligament (ALL) of knee. It is a ligament that occurs in approximately 95% of the population. It’s located on the anterolateral side of the knee joint which connects the femur with the tibia bone, it is responsible for rotational stability of the knee, especially when bent knee (30-90 deg) and it`s supports the function of the ACL. ALL trauma that may be asymptomatic, they can imply subsequently breaking of the ACL. However, when ACL is ruptured, almost always the ALL is damaged too. Ruptures and damages of ALL have a connection with Segond fractures. Undetected damage of ALL causes treatment failure of the anterior cruciate ligament injuries. It should be taken into consideration that with concomitant ACL and ALL injuries conservative treatment of damaged ALL is enough for treatment and rehabilitation success or if reconstruction of the ALL also necessary. The aim of the study is to highlight the widespread problem of knee injuries in athletes and how they should be treated so it will lead to full recovery of the competitor and his/her faster return to the game.

Key words:
knee joint, anterolateral ligament of the knee, anterior cruciate ligament, characteristic, trauma

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