Loaded open-kinetic-chain exercises stretch the anterior cruciate ligament more than closed-kinetic-chain exercises: In-vivo assessment of anterior cruciate ligament length change. 2023

Cong Wang, and Jiayu Qiu, and Yufan Wang, and Changzhao Li, and Willem A Kernkamp, and Xin Xi, and Yan Yu, and Pingyue Li, and Tsung-Yuan Tsai
School of Biomedical Engineering, Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Engineering Research Center of Digital Medicine, Ministry of Education, China; TaoImage Medical Technologies Corporation, Shanghai, China.

Usage of open-kinetic-chain (OKC) or closed-kinetic-chain (CKC) exercises during rehabilitation planning after anterior cruciate ligament (ACL) reconstruction has been debated for decades. However, the ACL elongation pattern during different rehabilitation exercises at different loadings remains unclear. This study aimed to determine the effects of OKC and CKC exercises on the length of ACL anteromedial bundle (AMB) and posterolateral bundle (PLB) to provide biomechanical support for making rehabilitation schedules. Laboratory Descriptive Study. Eighteen healthy volunteers were asked to perform two OKC motions, including non-weight-bearing and 10 kg loaded seated knee extension (OKC-0, OKC-10), as well as two CKC motions, including box squat (BS) and deep single-legged lunge (Lunge). Techniques of 2D-to-3D image registration and 3D ligament simulation were used to quantify length changes of ACL. The motion which led to the least and most ACL elongation were OKC-0 and OKC-10, respectively. The AMB and PLB were significantly longer in OKC-10 than those in OKC-0 during 0-60° and 0-55° of knee flexion (p < 0.01). Compared with reference length, the AMB and PLB were stretched during 0-30° and 0-10° respectively during OKC-10. During CKC exercises, the AMB and PLB were also stretched from 0 to 25°and 0-5°, respectively. Additionally, no significant difference was found in the length change of ACL bundles between BS and lunge. OKC-0 may be safe for the rehabilitation program after ACL reconstruction, and loaded exercises shall be applied when restricted with >30° in early-stage rehabilitation.

UI MeSH Term Description Entries
D007718 Knee Injuries Injuries to the knee or the knee joint. Injuries, Knee,Injury, Knee,Knee Injury
D007719 Knee Joint A synovial hinge connection formed between the bones of the FEMUR; TIBIA; and PATELLA. Superior Tibiofibular Joint,Joint, Knee,Joint, Superior Tibiofibular,Knee Joints,Superior Tibiofibular Joints,Tibiofibular Joint, Superior
D005081 Exercise Therapy A regimen or plan of physical activities designed and prescribed for specific therapeutic goals. Its purpose is to restore normal musculoskeletal function or to reduce pain caused by diseases or injuries. Rehabilitation Exercise,Remedial Exercise,Therapy, Exercise,Exercise Therapies,Exercise, Rehabilitation,Exercise, Remedial,Exercises, Rehabilitation,Exercises, Remedial,Rehabilitation Exercises,Remedial Exercises,Therapies, Exercise
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000070598 Anterior Cruciate Ligament Injuries Sprain or tear injuries to the ANTERIOR CRUCIATE LIGAMENT of the knee. ACL Injuries,ACL Tears,Anterior Cruciate Ligament Injury,Anterior Cruciate Ligament Tear,Anterior Cruciate Ligament Tears,ACL Injury,ACL Tear,Injuries, ACL,Injury, ACL,Tear, ACL,Tears, ACL
D016118 Anterior Cruciate Ligament A strong ligament of the knee that originates from the posteromedial portion of the lateral condyle of the femur, passes anteriorly and inferiorly between the condyles, and attaches to the depression in front of the intercondylar eminence of the tibia. Cruciate Ligament, Anterior,Anterior Cranial Cruciate Ligament,Cranial Cruciate Ligament,Anterior Cruciate Ligaments,Cranial Cruciate Ligaments,Cruciate Ligament, Cranial,Cruciate Ligaments, Anterior,Cruciate Ligaments, Cranial,Ligament, Anterior Cruciate,Ligament, Cranial Cruciate,Ligaments, Anterior Cruciate,Ligaments, Cranial Cruciate

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