DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20202063

A short term study for core stabilization as post operative protocol in post operated anterior cruciate ligament and its outcome

N. V. Siva Rama Krishna, Prathyush Chitithoti

Abstract


Background: The aim of the study was to assess the role of core stability exercises post op protocol for anterior cruciate ligament (ACL) reconstructed cases.

Methods: Out of 100 only selected were ninety-two male athletes who got ACL reconstruction with anatomical positioning of tunnels and adequate graft were enrolled in the study that was conducted between 2017 January to 2019 February. The enrolled were divided into two groups based on random number sequence i.e. group A (conventional rehabilitation; n=46) and group B (core stabilization and conventional rehabilitation; n=46). Assessment was done at 6 months, 9 months and 12 months for assessing the functional outcome by International Knee Documentation Committee (IKDC) score, triple hop test, single leg hop test and knee laxity (KT-1000) test.

Results: At the end of study it was observed that scores of IKDC was higher in group B as compared to group A (p<0.005). Similarly, single and triple hop test jump distances were more in group B as compared to group A (p<0.05). In group A, 24 out of 43 sports persons returned to sports as compared to group B, where 35 out of 45 patients returned to sports (p value=0.02). There was no difference in KT-1000 score between two groups.

Conclusions: Addition of core stability exercises in the ACL rehabilitation program improves the functional outcome and incidence of return to sports. However, core stability exercises have no effect on knee stability.

 


Keywords


Core stability postoperatively, ACL reconstructed cases, Conventional rehabilitation

Full Text:

PDF

References


Moksnes H, Risberg MA. Performance-based functional evaluation of non-operative and operative treatment after anterior cruciate ligament injury. J Med Sci Sports. 2009;19(3):345-55.

Awad OB, Alqarni SAM, Alkhalaf HM, Alnemer FA, Alahmari KAA, Alshahrani SMS, et al. A systemic review of ACL reconstruction rehabilitation. Egyptian J Hospital Med. 2017;68(1):845-64.

Naik AA, Das B, Kamat YD. Avoid Post Operative Bracing to Reduce ACL Rerupture Rates. Eur J Orthop Surg Traumatol. 2019;29(8):1-5.

Janssen RPA, van Melick N, van Mourik JBA, Reijman M, van Rhijn LW. ACL reconstruction with hamstring tendon autograft and accelerated brace-free rehabilitation: a systematic review of clinical outcomes. BMJ Open Sport Exerc Med. 2018;4(1):e000301.

Pope MH, Panjabi M. Biomechanical definitions of spinal instability. Spine (Phila Pa 1976). 1985;10(3):255-6.

Myklebust G, Engebretsen L, Braekken IH, Skjølberg A, Olsen OE, Bahr R. Prevention of Anterior Cruciate Ligament Injuries in Female Team Handball Players: A Prospective Intervention Study Over Three Seasons. Clin J Sport Med. 2003;13(2):71-8.

Paterno MV, Myer GD, Ford KR, Hewett TE. Neuromuscular Training Improves Single-Limb Stability in Young Female Athletes. J Orthop Sports Phys Ther. 2004;34(6):305-16.

Bliven KCH, Anderson BE. Core Stability Training for Injury Prevention. Sports Health. 2013;5(6):514-22.

Escamilla RF1, Lewis C, Bell D, Bramblet G, Daffron J, Lambert S, et al. Core Muscle Activation During Swiss Ball and Traditional Abdominal Exercises. J Orthop Sports Phys Ther. 2010;40(5):265-76.

Cugliari G, Boccia G. Core Muscle Activation in Suspension Training Exercises. J Hum Kinet. 2017;15(56):61-71.

Boyle M. Functional training for sports. J Hum Kinet. 2004.

Vera-Garcia FJ, Grenier SG, McGill SM. Abdominal Muscle Response During Curl-Ups on Both Stable and Labile Surfaces. Phys Ther. 2000;80(6):564-9.

Assessment of Differences Between the Modified Cincinnati and International Knee Documentation Committee Patient Outcome Scores. Available at: http://drrobertlaprademd.com/wp-content/uploads/ 2015/07/assessment-of-modified-cincinnati-and-ikdc-scores-2009.pdf. Accessed on 2 January 2020.

Myer GD, Ford KR, Palumbo OP, Hewett TE. Neuromuscular training improves performance and lower-extremity biomechanics in female athletes. J Strength Cond Res. 2005;19(1):51-60.

Roetert P. 3D balance and core stability. High-performance sports conditioning: modern training for ultimate athletic development Champaign (IL). J Hum Kinet. 2001.

Stanton R, Reaburn PR, Humphries B. The effect of short-term Swiss ball training on core stability and running economy. J Strength Cond Res. 2004;18(3):522-8.

Tse MA, McManus AM, Masters RS. Development and validation of a core endurance 187 intervention program: implications for performance in college-age rowers. J Strength Cond Res. 2005;19(3):547-52.

Arneja S, Leith J. Validity of the KT-1000 Knee Ligament Arthrometer, J Orthop Surg (Hong Kong). 2009;17(1):77-9.

KT1000 Arthrometer: Test Knee Laxity, 2007. Available at: https://drrobertlaprademd.com/kt-1000-testing-for-acl-tear/. Accessed on 2 January 2020.

Gambetta V. Let’s get physio. For swim-specific weight training, get on the ball It’s easy with our simple but effective physioball routine. Rodale’s Fitness Swimmer. 1999;8(3):30-3.

Myer GD, Ford KR, Palumbo JP, Hewett TE. Neuromuscular Training Improves Performance and Lower-Extremity Biomechanics in Female Athletes. J Strength Cond Res. 2005;19(1):51-60.

Foran B. High-performance sports conditioning: modern training for ultimate athletic development Champaign (IL). J Hum Kinet. 2001.

Stanton R, Reaburn PR, Humphries B. The Effect of Short-Term Swiss Ball Training on Core Stability and Running Economy. J Strength Cond Res. 2004;18(3):522-8.

Tse MA, McManus AM, Masters RS. Development and Validation of a Core Endurance Intervention Program: Implications for Performance in College-Age Rowers. J Strength Cond Res. 2005;19(3):547-52.

Kibler WB, Press J, Sciascia A. The Role of Core Stability in Athletic Function. Sports Med. 2006;36(3):189-98.

Willson JD, Dougherty C, Ireland ML, Davis IS. Core Stability and Its Relationship to Lower Extremity Function and Injury. J Am Acad Orthop Surg. 2005;13(5):316-25.

Vleeming A, Pool-Goudzwaard AL, Stoeckart R, van Wingerden JP, Snijders CJ. The Posterior Layer of the Thoracolumbar Fascia. Its Function in Load Transfer From Spine to Legs. Spine. 1995;20(7):753-8.

Relph N, Herrington L, Tyson S. The Effects of ACL Injury on Knee Proprioception: A Meta-Analysis. Physiotherapy. 2014;100(3):187-95.

Vaugoyeau M, Viel S, Amblard B, Azulay JP, Assaiante C. Proprioceptive Contribution of Postural Control as Assessed From Very Slow Oscillations of the Support in Healthy Humans. Gait Posture. 2008;27(2):294-302.

Tecco S, Salini V, Teté S, Festa F. Effects of Anterior Cruciate Ligament (ACL) Injury on Postural Control and Muscle Activity of Head, Neck and Trunk Muscles. J Oral Rehabil. 2006;33(8):567-87.

Medeni OC. Core Stabilization Training After Anterior Cruciate Ligament Reconstruction. Orthop J Sports Med. 2014; 2(3): 2325967114S00150.

Paterno MV1, Schmitt LC, Ford KR, Rauh MJ, Myer GD, Huang B, et al. Biomechanical Measures During Landing and Postural Stability Predict Second Anterior Cruciate Ligament Injury After Anterior Cruciate Ligament Reconstruction and Return to Sport," Am J Sports Med. 2010;38(10):1968-78.

Chaudhari AM. Proximal risk factors for ACL injury: role of core stability. In: ACL Injuries in the Female Athlete. Springer. 2018: 189-205.

Nesser TW, Huxel KC, Tincher JL, Okada T. The Relationship Between Core Stability and Performance in Division I Football Players. J Strength Cond Res. 2008;22(6):1750-4.

Cinar-Medeni O, Baltaci G, Bayramlar K, Yanmis I. Knee Muscle Strength, and Anterior Translation Are Correlated With Postural Stability in Anterior Cruciate Ligament-Reconstructed Patients. Am J Phys Med Rehabil. 2015;94(4):280-7.