Use of strength and function to predict outcomes post ACLR
Return to sport post anterior cruciate ligament reconstruction (ACLR) continues to plague health care practioners. This is due to the multitude of variables, both internal and external, that influence the decision in an attempt to mitigate risk of reinjury.
The authors of this study concluded the use of hop testing was most predicitve of subjective outcomes and should be considered when determining return to play guidelines.
This cross-sectional study included 88 participants who had undergone ACLR with a mean post operative time of 6.9 months. Strength testing through both isokinetic and isometric dynamometry as well as functional hop testing were evaluated in addition to IKDC and KOOS questionnaires.
The authors concluded no significant correlations were found between time from surgery and strength or hop limb symmetry index. This supports previous literature which focuses on a task oriented vs. time oriented approach in ACLR rehabilitation. A positive relationship was found between the single leg hop test and the triple hop test, more specifically, identifying a 85%-90% cut-off most closely associated with successful patient reported outcomes.
Although isokinetic strength asymmetries were found in the current study, they did not prove to be a significant predictor in subjective outcomes. The authors concluded however, this did not keep with recent literature and that further study was necessary.
Use of patient reports has proven useful in the return to play conversation post ACLR, as poor patient reports have been associated with inability to return to sport. Therefore, the predictive relationship seen between positive subjective outcomes and use of functional tests suggests its consideration in return to play decision making.
> From: Menzer et al., Ortho J Sport Med 5 (2018-03-16 15:16:34) 2325967117744758. All rights reserved to The Author(s). Click here for the online summary.