Download or read book Quadriceps Strength and the ACL Deficient Non coper written by Wendy J. Hurd and published by . This book was released on 2007 with total page 192 pages. Available in PDF, EPUB and Kindle. Book excerpt: The second goal of this work was to garner insight to the movement strategies of the non-coper, and determine their responsiveness to physical therapy intervention designed to improve quadriceps strength. Gait analysis of 21 subjects classified as non-copers during the mid-stance (peak knee flexion to peak knee extension) portion of stance we identified a control strategy novel to this phase of the gait cycle that includes a shift in the support moment from the knee to the ankle and variable combinations of muscle adaptations that produce joint stiffness. Preliminary results from a clinical trial indicate a stable knee may be more permissive of quadriceps strengthening, as individuals who participated in neuromuscular training and quadriceps strengthening exercises had greater improvements in strength than those who performed only strengthening exercises. Both improved knee stability and quadriceps strength contributed to the normalization of movement patterns after the clinical intervention. These results indicate there is a complementary relationship between strength and stability after ACL injury.

Download or read book The Fickle ACL Deficient Athlete written by Stephanie L. Di Stasi and published by . This book was released on 2011 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background. Anterior cruciate ligament (ACL) injuries are the most prevalent sports-related knee injury and are estimated to affect up to 250,000 athletes in the United States every year. Gait abnormalities, quadriceps strength deficits, knee joint effusion, and limited range of motion are ubiquitous acutely after ACL rupture and often persist following ACL reconstruction. Early identification of those athletes at risk for poor outcomes after surgery can assist rehabilitation specialists in tailoring the most efficacious treatment protocol for this group. Purpose. The goal of this work was to identify and intervene with noncopers that may be more likely to require additional rehabilitation in order to achieve normal neuromuscular strategies after surgery and meet their return to sport goals. Unilateral stance mechanics were used to evaluate whether pre-operative neuromuscular intervention changes single limb positioning strategies. We also compared the differences between the clinical performance and gait variables of ACL-deficient males and females before and after ACL reconstruction. To further investigate the restoration of function after surgery, the effects of a post-operative neuromuscular intervention are described. Methods. The effects of injury, neuromuscular training, and ACL reconstruction were examined on male and female non-copers during (1) a unilateral stance task and walking gait using current motion analysis techniques and (2) clinical performance tests. Non-copers from a larger randomized controlled trial underwent each of the testing procedures before and after pre-operative physical therapy, and 6 months after ACL reconstruction. The same walking gait biomechanics and clinical performance measures were evaluated on ten additional non-copers who received post-operative perturbation training. Significance. The information gathered during this investigation adds to our understanding of non-copers in two distinct ways: (1) women were identified as a uniquely functioning group of non-copers and (2) the timing of neuromuscular training appears to affect the recovery process in a subgroup of non-copers. Biomechanical changes found in response to rehabilitation further suggest the malleability and diversity of this group of ACL-deficient athletes. By evaluating gender-specific responses to ACL injury, intervention, and surgery, we have defined important neuromuscular differences within the non-coper cohort that may be effectively addressed by tailored physical therapy intervention. This body of work provides a foundation for future research to investigate the effects of different neuromuscular treatments on the recovery of function in athletes who sustain ACL injuries.

Download or read book Neuromuscular Coordination Impairments written by Toran D. MacLeod and published by . This book was released on 2012 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The purpose of this series of studies was to (1) establish a standing and weight-bearing target-matching task to characterize neuromuscular control and (2) characterize the altered neuromuscular control and morphology resulting from ACL injury and surgical reconstruction using a quadruple-bundle hamstring autograft and allograft. First, a standing target-matching neuromuscular control task was developed and the neuromuscular control strategies used by uninjured athletes was established using electromyography and a weight-bearing protocol to examine the effect of limb task. Visual feedback was given of the forces and moments of the "mobilizer" limb, while the "stabilizer" limb produced nearly identical forces and moments was given no visual feedback. The biarticulate muscles were the primary directional activators in this task, and the uniarticulate vasti muscles acted synergistically to brace the knee in both hip flexion and extension force postures, while subjects produced bidirectional controlled static isometric forces by pushing on two force-platforms. The lateral hamstring was recruited with more refined control while acting as a mobilizer, and the medial hamstring was used with more refined control while performing the stabilizer task. While the medial gastrocnemius was activated in a principally forwards direction for both tasks, the lateral gastrocnemius was principally activated in a backwards direction when subjects performed the stabilizer task. This suggests that neuromuscular control is specific to limb task, even though the external forces are nearly identical. Second, the neuromuscular control of the ACL deficient individuals was compared to uninjured individuals using the standing target-matching task. ACL deficient individuals demonstrated reduced neuromuscular control of the muscles about the knee for both limb tasks in comparison to uninjured individuals matched for age, sex, and activity level. ACL deficient individuals activated their lateral hamstrings primarily while pushing their foot in the forwards direction while performing the stabilizer task, which was the opposite direction of control subjects or when the ACL deficient individuals performed the mobilizer task. Voluntary neuromuscular control was significantly affected in the ACL deficient subjects, and the lateral hamstrings muscle may be activated to brace the knee when subjects are not paying attention to their limb (acting as the stabilizer). Thirdly, the muscle morphology and neuromuscular control of a sample of ACL deficient individuals who were predicted to compensate well after ACL injury (potential coper) was compared to individuals that were predicted to not compensate well after ACL injury (non-copers). Both groups demonstrated quadriceps atrophy, but the non-copers used reduced neuromuscular control of the muscles about the knee while the potential copers used symmetrical neuromuscular control. Findings suggest that the potential to compensate following ACL injury is dependent more on how the individual uses their muscle rather than the amount of quadriceps atrophy. Fourthly, the effect of graft harvest on muscle morphology was made using a pre-post ACL reconstruction comparison between a semitendinosus-gracilis (STG) tendon autograft group and a cadaveric allograft group. The autograft group demonstrated synergistic muscle hypertrophy, while the autograft group remained symmetrical morphologically following surgery. Muscle morphology changes in the autograft group indicate that the muscles remaining following graft harvest hypertrophy to compensate for the functional loss of the STG. Finally, a long-term follow-up of morphology was performed on individuals that underwent STG graft harvest 6 years prior in comparison to both pre-operatively and at the time of return-to-sports. STG tendon regeneration occurred in two out of three participants; however the third had fatty inclusions within both STG muscles indicating that this muscle was no longer functional. Graft harvest technique may have played a role in the amount of regeneration of the STG muscles. In summary, this series of studies establishes a new tool to examine standing and weight-bearing neuromuscular control and examines the neuromuscular and morphological response to ACL injury and reconstruction in both the short and long term.

Download or read book Knee Function After ACL Rupture and Reconstruction Effects of Neuromuscular Training written by and published by . This book was released on 2009 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The overall goal of this work was to determine effective interventions to address strength, gait, and functional deficits in patients with complete unilateral anterior cruciate ligament (ACL) rupture who do not compensate well for the injury (non-copers). Determining whether pre-operative strength training with and without perturbation training allows non-copers' involved limbs to resemble the uninvolved limb will impact rehabilitative paradigms. Understanding the functional and biomechanical impact of rupturing the ACL and undergoing ACL reconstruction may improve the outcomes of non-copers. Non-copers were randomly assigned to a strengthening group (STR) or a group who received perturbation and strength training (PERT). Our first study compared (n=19) quadriceps strength indices and knee excursions during the midstance phase of gait pre-operatively to data collected 6 months after ACL reconstruction. Quadriceps strength indices improved 6 months after surgery in both groups. The PERT group demonstrated symmetrical knee excursions 6 months after surgery, whereas the STR group continued to reduce the involved limb's knee excursions during gait. This was a first indication that non-copers could benefit from pre-operative perturbation training. Secondly, we measured (n=32) quadriceps strength, four hop score indices, and two self-report questionnaires 3, 6, and 12 months post-operatively. No differences were found between groups, except a greater number of athletes in the PERT group achieved global knee rating scores necessary to pass return to sports (RTS) criteria 6 months and 12 months after surgery. Mean scores for each functional outcome met RTS criteria 6 and 12 months post-operatively. Frequency counts of individual data, however, indicated that 12% of non-copers passed RTS criteria at 3, 45% at 6, and 78% at 12 months after surgery. Functional outcomes suggest that certain non-copers require additional intervention to pass RTS criteria. Next, we examined (n=39) aberrant knee moments and muscle co-contractions during gait to determine if pre-operative physical therapy would alter these gait patterns prior to and following ACL reconstruction. Involved knee flexion moments increased over time in the PERT and STR groups. The uninvolved limb increased as well, thereby maintaining asymmetrical gait patterns at each follow-up session. Co-contraction variability was much larger than anticipated limiting interpretations of our co-contraction findings. The ability for non-copers to modify knee moments pre-operatively is a promising indicator that non-copers are malleable and potential candidates for non-operative rehabilitation. Lastly, 38 non-copers were grouped based on their ability to pass RTS criteria 6 months after ACL reconstruction. We hypothesized that after accounting for age and quadriceps indices, knee moments would continue to predict the ability to pass RTS criteria 6 months after ACL reconstruction. Age; quadriceps strength index; and knee flexion moments contributed to the predictability of the model even after accounting for the previous variable. The final model had the highest R 2 value and a high ability to predict those who did (69%) and did not (82%) pass RTS criteria 6 months after surgery. Rehabilitation specialists should to council non-copers on these pre-operative factors that effect the prognostication for athletes to pass return to sport criteria post-operatively.

Download or read book The ACL Deficient Knee written by Edward M. Wojtys and published by . This book was released on 1994 with total page 164 pages. Available in PDF, EPUB and Kindle. Book excerpt: A review of surgical and nonsurgical treatment options of anterior cruciate ligament (ACL) injuries. This text includes a discussion of ACL injuries, procedures and outcome evaluations.

Download or read book Knee Ligaments written by Dale M. Daniel and published by Lippincott Williams & Wilkins. This book was released on 1990 with total page 584 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Return to Sport after ACL Reconstruction and Other Knee Operations written by Frank R. Noyes and published by Springer Nature. This book was released on 2019-11-05 with total page 709 pages. Available in PDF, EPUB and Kindle. Book excerpt: The wealth of information provided in this unique text will enable orthopedic surgeons, medical practitioners, physical therapists, and trainers to ensure that athletes who suffer anterior cruciate ligament (ACL) injuries, or who require major knee operations for other reasons, have the best possible chance of safely resuming sporting activity at their desired level without subsequent problems. Divided into seven thematic sections, the coverage is wide-ranging and encompasses common barriers to return to sport, return to sport decision-based models, and the complete spectrum of optimal treatment for ACL injuries, including preoperative and postoperative rehabilitation. Advanced training concepts are explained in detail, with description of sports-specific programs for soccer, basketball, and tennis. Readers will find detailed guidance on objective testing for muscle strength, neuromuscular function, neurocognitive function, and cardiovascular fitness, as well as validated assessments to identify and manage psychological issues. In addition, return to sport considerations after meniscus surgery, patellofemoral realignment, articular cartilage procedures, and knee arthroplasty are discussed. Generously illustrated and heavily referenced, Return to Sport after ACL Reconstruction and Other Knee Operations is a comprehensive resource for all medical professionals and support staff working with athletes and active patients looking to get back in the game with confidence.

Download or read book ACL Injuries in Female Athletes written by Robin West and published by Elsevier Health Sciences. This book was released on 2018-12-07 with total page 400 pages. Available in PDF, EPUB and Kindle. Book excerpt: This easy-to-read reference presents a succinct overview of clinically-focused topics covering the prevention, treatment, and rehabilitation of ACL injuries in the female athlete. Written by two professional team physicians, it provides practical, focused information for orthopaedic and sports medicine surgeons and physicians. Covers ACL injury risk factors and prevention, including biomechanics, biology, and anatomy of the female athlete. Discusses graft choices, the biology of healing, rehabilitation and return to play, future options for treatment, and more. Addresses special considerations such as pediatric ACL and revision ACL. Consolidates today’s available information and experience in this timely area into one convenient resource.

Download or read book ACL Injuries in the Female Athlete written by Frank R. Noyes and published by Springer Science & Business Media. This book was released on 2013-01-04 with total page 536 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nearly a million anterior cruciate ligament (ACL) injuries occur each year worldwide, causing long-term problems in the knee joint. This textbook examines the short- and long-term impacts of ACL injuries on the basis of hundreds of published studies. Risk factors for such injuries are explored using data from hypothesis-driven investigations, and possible causes of the higher risk of noncontact ACL injuries in female athletes are analyzed. Neuromuscular training programs shown to reduce the rate of these injuries in female athletes are described in step-by-step detail with the aid of numerous color photographs and video demonstrations. In addition, detailed descriptions are provided for rehabilitation programs to be used after ACL reconstruction in order to reduce the risk of a future injury. The book will be of value to orthopedic surgeons, physical therapists, athletic trainers, sports medicine primary care physicians, and strength and conditioning specialists.

Download or read book Rotatory Knee Instability written by Volker Musahl and published by Springer. This book was released on 2016-09-27 with total page 505 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is designed to equip the reader with the knowledge and tools required for provision of individualized ACL treatment based on the best available evidence. All major aspects of the assessment of rotatory knee instability are addressed in depth. A historical overview of arthrometers, both invasive and non-invasive, is provided, and newly developed devices for the measurement of rotatory knee laxity are considered. Recent advances with respect to the pivot shift test are explained and evidence offered to support a standardized pivot shift test and non-invasive quantification of the pivot shift. Specific surgical techniques for rotatory laxity are described, with presentation of the experience from several world-renowned centers. In addition, functional rehabilitation and “return to play” are discussed. In keeping with the emphasis on an individualized approach, the book highlights individualization of surgical reconstruction techniques in accordance with the specific injury pattern and grade of rotatory knee laxity as well as the use of individualized rehabilitation techniques. Numerous high-quality images illustrate key points and clear take-home messages are provided.

Download or read book Sports Injuries written by Mahmut Nedim Doral and published by Springer Nature. This book was released on 2015-06-29 with total page 3295 pages. Available in PDF, EPUB and Kindle. Book excerpt: Sports Injuries: Prevention, Diagnosis, Treatment and Rehabilitation covers the whole field of sports injuries and is an up-to-date guide for the diagnosis and treatment of the full range of sports injuries. The work pays detailed attention to biomechanics and injury prevention, examines the emerging treatment role of current strategies and evaluates sports injuries of each part of musculoskeletal system. In addition, pediatric sports injuries, extreme sports injuries, the role of physiotherapy, and future developments are extensively discussed. All those who are involved in the care of patients with sports injuries will find this textbook to be an invaluable, comprehensive, and up-to-date reference.

Download or read book Unicompartmental Knee Arthroplasty written by P. Cartier and published by Elsevier Science Limited. This book was released on 1997-05-01 with total page 328 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Revision ACL Reconstruction written by Robert G. Marx and published by Springer Science & Business Media. This book was released on 2013-09-05 with total page 286 pages. Available in PDF, EPUB and Kindle. Book excerpt: Although anterior cruciate ligament (ACL) reconstruction has a high success rate, a substantial number of patients are left with unsatisfactory results. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. Concise chapters by a leading group of international orthopedic surgeons cover the diagnosis of failed ACL reconstruction, patient evaluation, preoperative planning for revision ACL surgery and complex technical considerations.

Download or read book Science Theory and Clinical Application in Orthopaedic Manual Physical Therapy Applied Science and Theory written by Ola Grimsby and published by Lulu.com. This book was released on 2008-09-16 with total page 558 pages. Available in PDF, EPUB and Kindle. Book excerpt: This long awaited textbook from The Ola Grimsby Institute provides decades of clinical experience and reasoning, with both historical and current evidence, with rationale for both passive and active treatments in orthopaedic manual therapy. Practical guidelines for joint mobilization and exercise rehabilitation are presented with this logical and exciting work. Incorporating experience and science, this book provides new approaches and treatment principles to make what you already do more effective. Extensive Content: Over 535 pages and 275 illustrations, photographs and tables Ola Grimsby and his co-authors have compiled a significant resource for the practicing physical therapist, manual therapist or osteopath.

Download or read book The Multiple Ligament Injured Knee written by Gregory C. Fanelli and published by Springer Science & Business Media. This book was released on 2012-08-16 with total page 469 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Multiple Ligament Injured Knee: A Practical Guide to Management includes the most developed knowledge needed to successfully diagnose and treat knee ligament injuries. This thorough work presents anterior and posterior cruciate and collateral ligament anatomy and biomechanics along with non-invasive methods for diagnosing the extent of injury, such as radiographic and arthroscopic evaluation. Various injuries are discussed in addition to useful treatment techniques, including arthroscopic reconstruction, posterolateral and posteromedial corner injury and treatment, assessment and treatment of vascular injuries, assessment and treatment of nerve injuries, rehabilitation, and post-operative results. Each of these clearly written chapters is accompanied by a wealth of line drawings and photographs that demonstrate both the surgical and non-surgical approaches to examination and treatment.

Download or read book Evidence Based Sports Medicine written by Domhnall MacAuley and published by John Wiley & Sons. This book was released on 2008-04-15 with total page 640 pages. Available in PDF, EPUB and Kindle. Book excerpt: This second edition of the popular book Evidence-based Sports Medicine builds on the features that made the first edition such a valuable text and provides a completely up-to-date tool for sports medicine physicians, family practitioners and orthopedic surgeons. Updated to take into account new evidence from systematic reviews and controlled trials, Evidence-based Sports Medicine is a unique reference book on the optimum management of sports-related conditions. This second edition: contains sections on acute injury, chronic conditions, and injuries to the upper limb, groin and knee and to the lower leg pays increased attention to the important and emerging area of injury prevention features thoroughly revised methodology sections within each chapter, reflecting changes in technique and application MCQs and essay questions that allow readers to continually assess their knowledge and understanding of the topics covered

Download or read book Current Concepts in ACL Reconstruction written by Freddie H. Fu and published by SLACK Incorporated. This book was released on 2008 with total page 468 pages. Available in PDF, EPUB and Kindle. Book excerpt: From evaluation to outcome, Current Concepts in ACL Reconstruction will help you keep pace with the latest techniques for the treatment of anterior cruciate ligament injuries. This text provides the most complete and up-to-date information for the surgical reconstruction of a torn ACL including details about the newer double-bundle procedure. Both American and international perspectives on the treatment of ACL injuries are included to provide the most comprehensive review on the market today. Inside this richly illustrated text, Drs. Freddie H. Fu and Steven B. Cohen along with contributions from the world's most experienced knee surgeons review the basic science, kinematic, imaging, and injury patterns surrounding the ACL. Surgical concepts, various techniques for reconstruction, and diverse opinions on approaching the ACL are also included. Current Concepts in ACL Reconstruction explains the anatomical basis in order to provide the most current surgical principles to ensure the patient receives the best surgical outcomes. To reflect recent advancements in ACL treatment, the emerging double-bundle technique is comprehensively covered. The differences between the single- and double-bundle techniques are discussed with perspectives from leading international experts in double-bundle reconstruction. An accompanying video CD-ROM demonstrates the various procedures mentioned throughout the text. In addition, several of the world's most experienced surgeons provide their perspective from what they have learned by performing ACL surgery for over 25 years, along with their insight into the future treatment of ACL injuries. What you will want to learn more about: - Differences between single- and double-bundle reconstruction techniques - Outcomes of single- and double-bundle reconstruction - Pediatric ACL reconstruction - Gender differences in ACL injury - Radiographic imaging - Computer navigation assistance for ACL reconstruction - Injury patterns of the ACL - Graft choices in ACL surgery - Revision ACL surgery - Postoperative rehabilitation after ACL reconstruction - Outcome measures to assess success after surgery Current Concepts in ACL Reconstruction answers the need for a comprehensive information source on the treatment of ACL injuries. Orthopedic residents and surgeons will be prepared with this thorough review of ACL reconstruction by their side.