Hop tests correlate with IKDC and KOOS at minimum of 2 years after primary ACL reconstruction

Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical School, Nashville, TN, USA.
Knee Surgery Sports Traumatology Arthroscopy (Impact Factor: 3.05). 03/2011; 19(11):1806-16. DOI: 10.1007/s00167-011-1473-5
Source: PubMed


The hypothesis of this study was that single-legged horizontal hop test ratios would correlate with IKDC, KOOS, and Marx activity level scores in patients 2 years after primary ACL reconstruction.
Individual patient-reported outcome tools and hop test ratios on 69 ACL reconstructed patients were compared using correlations and multivariable modeling. Correlations between specific questions on the IKDC and KOOS concerning the ability to jump and hop ratios were also performed.
The triple-hop ratio was moderately but significantly correlated with the IKDC, KOOS Sports and Recreation subscale, and the KOOS Knee Related Quality of Life subscale, as well as with the specific questions related to jumping. Similar but weaker relationship patterns were found for the single-hop ratio and timed hop. No significant correlations were found for the Marx activity level or crossover-hop ratio. Multivariable modeling showed almost no significant additional contribution to predictability of the IKDC or KOOS subscores by gender, BMI, or the number of faults on either leg.
The triple-hop test is most significantly correlated with patient-reported outcome scores. Multivariable modeling indicates that less than a quarter of the variability in outcome scores can be explained by hop test results. This indicates that neither test can serve as a direct proxy for the other; however, assessment of patient physical function by either direct report using validated outcome tools or by the hop test will provide relatively comparable data.

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    • "The KOOS survey has been validated [24] and contains five separate subscales; (i) Pain, (ii) Other Symptoms, (iii) Function in daily living (ADL), (iv) Function in Sport and Recreation (Sport/Rec), and (v) joint related Quality of Life (QOL) [22] [23]. Sport/Rec and QOL were the only KOOS subscales that were analyzed in the present study, since these two subscales are most dominantly affected by ACL-injury [17] [25] and also are the subscales most frequently studied in the research setting [16] [17]. Prior to testing patients performed a standardized warm-up program consisting of two repetitions of 10 toe rises, 10 bilateral squats, 10 unilateral squats (for each leg) and two to three submaximal vertical jumps (Countermovement jumps: CMJ). "
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    ABSTRACT: Background: Associations between objective and subjective measures of knee function may facilitate rehabilitation in ACL-patients. Aim: The aim of this study is to investigate if a test-battery of functional and/or muscle outcomes are associated with Knee osteoarthritis outcome score (KOOS) subscales (Sport/Rec and QOL) in ACL-reconstructed patients. Methods: 23 hamstring auto-graft ACL-reconstructed men (mean age: 27.2 standard deviation 7.5 years, BMI: 25.4 standard deviation 3.2 time since surgery: 27 standard deviation 7 months) completed KOOS-questionnaire and an objective test-battery: (i) one-leg maximal jump for distance (OLJD), isometric maximal voluntary contraction (MVC) for (ii) knee extensors and (iii) flexors, and (iv) maximal counter movement jump (CMJ). Sagittal kinematic data were recorded during CMJ using a 6-camera Vicon MX system. Multilevel linear regression analysis was used to determine the strength of associations between KOOS parameters (Sport/Rec and QOL) that a priori were defined as dependent variables and 4 models of independent outcomes from the test-battery. Results: Moderate associations between OLJD and Sport/Rec (r(2) = 0.26, p < 0.01) and QOL (r(2) = 0.26, p < 0.01) were observed (Model 1). Adding knee extensor or flexor MVC to the analysis (Model 2) increased the strength of the associations (up to r(2) = 0.53, p < 0.01, and r(2) = 0.31, p = 0.02 for Sport/Rec and QOL, respectively). Adding both knee extensor and knee flexor MVC to the analysis (Model 3) did not improve the regression model and only minor increases were observed when including kinematic data of CMJ (Model 4). Conclusion: Moderate-to-large proportion (31-53%) of the variation in KOOS was explained by OLJD and MVC which may add to design effective future rehabilitation interventions for ACL-patients.
    The Knee 10/2014; 21(6). DOI:10.1016/j.knee.2014.09.004 · 1.94 Impact Factor
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    • "Testing exercises are mandatory to evaluate recovery and the competence of the injured or operated limb. There are many functional tests for the knee that have been used [17, 22, 31, 39] and appear to be reliable and valuable tools [40]. After a thorough evaluation of the different tests that have been validated in the literature, we have selected the “single-leg squat”, the “Star Excursion Balance Test” (SEBT), the “drop jump test”, and the “side-hop test”. "
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    ABSTRACT: Patellofemoral instability may occur in a young population as a result of injury during sporting activities. This review focuses on return to sport after one episode of dislocation treated no operatively and as well after surgery for chronic patellofemoral instability. With or without surgery, only two-thirds of patients return to sports at the same level as prior to injury. A high-quality rehabilitation programme using specific exercises is the key for a safe return to sporting activities. To achieve this goal, recovery of muscle strength and dynamic stability of the lower limbs is crucial. The focus should be directed to strengthen the quadriceps muscle and pelvic stabilizers, as well as lateral trunk muscle training. Patient education and regularly performed home exercises are other key factors that can lead to a successful return to sports. The criteria for a safe return to sports include the absence of pain, no effusion, a complete range of motion, almost symmetrical strength, and excellent dynamic stability. Level of evidence IV.
    Knee Surgery Sports Traumatology Arthroscopy 07/2014; 22(10). DOI:10.1007/s00167-014-3172-5 · 3.05 Impact Factor
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    • "The second concern is that, to study recovery after ACL-R, most of the research has compared IL results with the NIL. Side-to-side symmetry is the main goal of rehabilitation after ACL-R (Kvist, 2004); it prevents reinjury and enhance sport performance (Hewett et al., 2005; Newton et al., 2006; Paterno et al., 2007, 2010; Reinke et al., 2011). However, the comparison of IL with NIL does not take into account physiological asymmetries that exist between lower limbs. "
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    ABSTRACT: After anterior cruciate ligament reconstruction (ACL-R), many studies have reported a deficit of performance on the injured leg during multi-joint tasks. However, the total mechanical joint work (WTotal), parameter best related to the vertical displacement of the body mass center during vertical jumping, has not yet been studied. The aim of this research was to compare asymmetries between ACL-R subjects and healthy matched subjects, through the analysis of the kinematics and kinetics during a single-leg squat jump. Asymmetries are defined by the Limb Symmetry Index (LSI). A greater LSI was observed for WTotal in the ACL-R group than in the healthy group. There was no difference in LSI for knee joint work between the two groups, while the LSI for hip and ankle joint work was significantly larger in the ACL-R group. This was explained by greater LSI for the hip and ankle joint range of motion in the ACL-R group than in the healthy group. After ACL-R, patients exhibited greater asymmetries than healthy subjects during single-leg squat jump. Physiotherapists should focus on quality execution of multi-joint movement, especially on hip and ankle joints range of motion in order to reduce asymmetries and to improve vertical jumping performance.
    Scandinavian Journal of Medicine and Science in Sports 04/2014; 24(6). DOI:10.1111/sms.12207 · 2.90 Impact Factor
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