Date of Award
Master of Physical Therapy (MPT)
Anterior Cruciate Ligament -- rehabilitation; Postural Balance; Weight-Bearing
Currently in the United States, anterior cruciate ligament reconstruction (ACLR) has become one of the most commonly performed surgeries of the lower extremity. Although sports activities commonly cause injury to the ACL, non-athletic individuals are affected as well. With the increasing prevalence of the ACLR procedure, a need appears for researching the effects an ACLR has on balance and weight bearing.
The purpose of this study was to examine the effects an ACLR has on balance and weight bearing using the NeuroCom® Balance Master (NBM), version 8.02, Weight Bearing Squat (WBS) and Step Up/Over (SUO) tests with individuals who were at least 3 months post-op. Thirty-one participants (21 female and 10 males) between the ages of 18-53 (mean age = 24.74 years) with an ACLR took part in a one-time test session. Participants completed the Lysholm Knee Rating Scale functional assessment, a health questionnaire, and then had bilateral knee range of motion measured. The participants performed the WBS test at 0, 30, 60, and 90 degrees of knee flexion for a one second time interval at each position. They then performed 3 trials on each leg of the SUO test.
Test results for each participant were collected and data was entered into the SPSS Version 11.0 software system. Comparisons were made between data components using a one-sample t-test for the parametric test, a Mann-Whitney U test for the nonparametric test, and by qualitative analysis.
Due to significant differences found in this study, the overall results show that there are some knee deficits following an ACLR. Deficits were found in the involved leg versus the uninvolved leg and patellar grafts versus hamstring grafts in weight bearing, movement time, and impact index in the WBS and SUO tests. Lysholm Knee Rating Scale scores indicated good scores (87.73/100) for participants less than and equal to 18 months and excellent scores (91.00/100) for participants greater than 18 months post ACLR.
This study showed variable significant differences throughout test results due to several probable factors. Some limitations that may have hindered this study on balance and weight bearing were individual variability, age, vision, functional status, strength, proprioception, and the presence of other pathologies.
This study indicates that there is a need for further investigation to evaluate the effects an ACLR has on function. Recommendations such as a larger sample size, consistent testing times, shorter and variable time frames post-op, and utilizing multiple and repetitive tests may improve results. Hopefully, this will lead to better decision making on rehabilitation for ACLR's and improve the ability to solve increasingly complex problems resulting in efficient cost-effective care. Findings could possibly be used for guidelines on rehabilitation programs in patients with post ACLR's
Broadway, Kim; Grise, Carrie; Yamamoto, Nicky; and Yuen, Franz, "Examination of Balance and Weightbearing in Post Anterior Cruciate Ligament Reconstruction Utilizing the Weight Bearing and Step Up/Over Tests on the Neurocom Balance Master" (2004). Physical Therapy Scholarly Projects. 71.