Which Tests Predict 6-Month Isokinetic Quadriceps Strength After ACL Reconstruction? An Examination of Isometric Quadriceps Strength and Functional Tests at 3 Months
# Background Restoration of quadriceps strength after anterior ligament reconstruction (ACLR) is a persistent challenge for patients and clinicians. Inadequate recovery of quadriceps strength has been linked to increase risk of re-injury. Developing methods of early identification of strength defic...
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| Format: | Article |
| Language: | English |
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North American Sports Medicine Institute
2023-12-01
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| Series: | International Journal of Sports Physical Therapy |
| Online Access: | https://doi.org/10.26603/001c.89263 |
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| author | Nicholas Giampetruzzi Adam P Weaver Dylan P Roman Joshua A Cleland Brandon M Ness |
| author_facet | Nicholas Giampetruzzi Adam P Weaver Dylan P Roman Joshua A Cleland Brandon M Ness |
| author_sort | Nicholas Giampetruzzi |
| collection | DOAJ |
| description | # Background
Restoration of quadriceps strength after anterior ligament reconstruction (ACLR) is a persistent challenge for patients and clinicians. Inadequate recovery of quadriceps strength has been linked to increase risk of re-injury. Developing methods of early identification of strength deficits is essential to allow clinicians to provide more individualized interventions early in the rehabilitation process.
# Purpose
To determine whether 3-month isometric quadriceps strength, the Y-Balance Test (YBT), and the anterior step-down test are predictive of isokinetic quadriceps strength at six months in adolescents after ACLR.
# Design
Retrospective cohort
# Methods
Thirty-six adolescent patients with primary ACLR (58% female, 36% with concomitant meniscal repair, age: 15.7 ± 1.6 years). At three months post-operative, isometric quadriceps strength via isokinetic dynamometer, YBT-Lower Quarter, and anterior step-down tests were completed. At six months post-operative, an isokinetic knee strength assessment was completed. Regression analysis was used to evaluate the predictive relationship between 3-month isometric tests and 6-month isokinetic knee extension tests.
# Results
Three-month post operative isometric quadriceps peak torque predicted isokinetic quadriceps peak torque at 6 months, F(1,34) = 19.61, p \<0.001. Three-month isometric quadriceps peak torque accounted for 36.6% of the variance in normalized isokinetic quadriceps peak torque at 6 months with adjusted R^2^ = 34.7%. Including YBT anterior reach (β = 0.157, p = 0.318) in regression added 1.9% of variance when predicting 6-month isokinetic quadriceps peak torque, F (2,33) = 10.32, p \<0.001, R^2^ = 0.385, ΔR^2^ = 0.019.
# Conclusion
At three months post-ACLR, isometric strength testing appears more optimal than other functional tests in predicting isokinetic quadriceps peak torque in later stages of rehabilitation for adolescents. Clinicians should use tests at three months that measure quadriceps strength if aiming to predict isokinetic quadriceps peak torque at six months post-ACLR, rather than using functional tests such as the YBT-LQ or anterior step-down.
# Level of Evidence
Level 3 |
| format | Article |
| id | doaj-art-f4c958420517464885e969c16c0c22aa |
| institution | Kabale University |
| issn | 2159-2896 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | North American Sports Medicine Institute |
| record_format | Article |
| series | International Journal of Sports Physical Therapy |
| spelling | doaj-art-f4c958420517464885e969c16c0c22aa2025-02-11T20:27:48ZengNorth American Sports Medicine InstituteInternational Journal of Sports Physical Therapy2159-28962023-12-01186Which Tests Predict 6-Month Isokinetic Quadriceps Strength After ACL Reconstruction? An Examination of Isometric Quadriceps Strength and Functional Tests at 3 MonthsNicholas GiampetruzziAdam P WeaverDylan P RomanJoshua A ClelandBrandon M Ness# Background Restoration of quadriceps strength after anterior ligament reconstruction (ACLR) is a persistent challenge for patients and clinicians. Inadequate recovery of quadriceps strength has been linked to increase risk of re-injury. Developing methods of early identification of strength deficits is essential to allow clinicians to provide more individualized interventions early in the rehabilitation process. # Purpose To determine whether 3-month isometric quadriceps strength, the Y-Balance Test (YBT), and the anterior step-down test are predictive of isokinetic quadriceps strength at six months in adolescents after ACLR. # Design Retrospective cohort # Methods Thirty-six adolescent patients with primary ACLR (58% female, 36% with concomitant meniscal repair, age: 15.7 ± 1.6 years). At three months post-operative, isometric quadriceps strength via isokinetic dynamometer, YBT-Lower Quarter, and anterior step-down tests were completed. At six months post-operative, an isokinetic knee strength assessment was completed. Regression analysis was used to evaluate the predictive relationship between 3-month isometric tests and 6-month isokinetic knee extension tests. # Results Three-month post operative isometric quadriceps peak torque predicted isokinetic quadriceps peak torque at 6 months, F(1,34) = 19.61, p \<0.001. Three-month isometric quadriceps peak torque accounted for 36.6% of the variance in normalized isokinetic quadriceps peak torque at 6 months with adjusted R^2^ = 34.7%. Including YBT anterior reach (β = 0.157, p = 0.318) in regression added 1.9% of variance when predicting 6-month isokinetic quadriceps peak torque, F (2,33) = 10.32, p \<0.001, R^2^ = 0.385, ΔR^2^ = 0.019. # Conclusion At three months post-ACLR, isometric strength testing appears more optimal than other functional tests in predicting isokinetic quadriceps peak torque in later stages of rehabilitation for adolescents. Clinicians should use tests at three months that measure quadriceps strength if aiming to predict isokinetic quadriceps peak torque at six months post-ACLR, rather than using functional tests such as the YBT-LQ or anterior step-down. # Level of Evidence Level 3https://doi.org/10.26603/001c.89263 |
| spellingShingle | Nicholas Giampetruzzi Adam P Weaver Dylan P Roman Joshua A Cleland Brandon M Ness Which Tests Predict 6-Month Isokinetic Quadriceps Strength After ACL Reconstruction? An Examination of Isometric Quadriceps Strength and Functional Tests at 3 Months International Journal of Sports Physical Therapy |
| title | Which Tests Predict 6-Month Isokinetic Quadriceps Strength After ACL Reconstruction? An Examination of Isometric Quadriceps Strength and Functional Tests at 3 Months |
| title_full | Which Tests Predict 6-Month Isokinetic Quadriceps Strength After ACL Reconstruction? An Examination of Isometric Quadriceps Strength and Functional Tests at 3 Months |
| title_fullStr | Which Tests Predict 6-Month Isokinetic Quadriceps Strength After ACL Reconstruction? An Examination of Isometric Quadriceps Strength and Functional Tests at 3 Months |
| title_full_unstemmed | Which Tests Predict 6-Month Isokinetic Quadriceps Strength After ACL Reconstruction? An Examination of Isometric Quadriceps Strength and Functional Tests at 3 Months |
| title_short | Which Tests Predict 6-Month Isokinetic Quadriceps Strength After ACL Reconstruction? An Examination of Isometric Quadriceps Strength and Functional Tests at 3 Months |
| title_sort | which tests predict 6 month isokinetic quadriceps strength after acl reconstruction an examination of isometric quadriceps strength and functional tests at 3 months |
| url | https://doi.org/10.26603/001c.89263 |
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