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. 2018 Mar;52(6):375.
doi: 10.1136/bjsports-2016-097095. Epub 2017 Sep 27.

Functional performance 6 months after ACL reconstruction can predict return to participation in the same preinjury activity level 12 and 24 months after surgery

Zakariya Nawasreh  1   2 , David Logerstedt  3   4 , Kathleen Cummer  1 , Michael Axe  5   6 , May Arna Risberg  7 , Lynn Snyder-Mackler  1   4   5
Affiliations

Functional performance 6 months after ACL reconstruction can predict return to participation in the same preinjury activity level 12 and 24 months after surgery

Zakariya Nawasreh et al. Br J Sports Med. 2018 Mar.

Abstract

Background: Assessing athletes' readiness is a key component for successful outcomes after ACL reconstruction (ACLR).

Objectives: To investigate whether return-to-activity criteria, individually or in combination, at 6 months after ACLR can predict return to participation in the same preinjury activity level at 12 and 24 months after ACLR.

Methods: Ninety-five level I/II participants completed return-to-activity criteria testing (isometric quadriceps index, single-legged hop tests, Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) and Global Rating Score (GRS)) at 6 months after ACLR. The PASS group was defined as scoring >90% on all criteria and the FAIL group as scoring <90% on any criteria. At 12 and 24 months after ACLR, participants were asked if they had returned to participate in the same preinjury activity level or not. All return-to-activity criteria, except quadriceps index, were entered into the logistic regression model.

Results: 81% and 84.4% of the PASS group returned to participation in the same preinjury activity level, while only 44.2% and 46.4% of the FAIL group returned at 12 and 24 months, respectively, after ACLR. The 6-meter timed hop, single hop and triple hop limb symmetry indexes; GRS; and KOS-ADLS individually predicted the outcome of interest at 12 months after ACLR (range: R2: 0.12-0.22, p<0.024). In combination, they explained 27% of the variance (p=0.035). All hop tests, individually, predicted the outcome of interest at 24 months after ACLR (range: R2: 0.26-0.37; p<0.007); in combination they explained 45% of the variance (p<0.001).

Conclusion: Return to participation in the same preinjury activity level at 12 and 24 months after ACLR was higher in those who passed the criteria compared with those who failed. Individual and combined return-to-activity criteria predicted the outcomes of interest, with the hop tests as consistent predictors at 12 and 24 months after ACLR.

Keywords: functional movement screen; knee ACL; sporting injuries; sports medicine; sports physiotherapy.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow diagram for participant’s participation at 6, 12 and 24 months follow-up testing after ACLR.
See this image and copyright information in PMC

References

    1. Daniel DM, Stone ML, Dobson BE, et al. Fate of the ACL-injured patient. A prospective outcome study. Am J Sports Med. 1993;22:632–44. - PubMed
    1. Marx RG, Jones EC, Angel M, et al. Beliefs and attitudes of members of the American Academy of Anterior Cruciate Ligament Injury. Arthroscopy. 2003;19:762–70. - PubMed
    1. Ardern CL, Webster KE, Taylor NF, et al. Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med. 2011;45:596–606. - PubMed
    1. Lee DY, Karim SA, Chang HC. Return to sports after anterior cruciate ligament reconstruction - a review of patients with minimum 5-year follow-up. Ann Acad Med Singapore. 2008;37:273–8. - PubMed
    1. Nakayama Y, Shirai Y, Narita T, et al. Knee functions and a return to sports activity in competitive athletes following anterior cruciate ligament reconstruction. J Nippon Med Sch. 2000;67:172–6. - PubMed