Open versus closed kinetic chain exercise: Issues in rehabilitation after anterior cruciate ligament reconstructive surgery

被引:65
作者
Fitzgerald, GK [1 ]
机构
[1] Allegheny Univ Hlth Sci, Dept Phys Therapy, Philadelphia, PA 19102 USA
来源
PHYSICAL THERAPY | 1997年 / 77卷 / 12期
关键词
exercise; general; ligaments; rehabilitation; surgery;
D O I
10.1093/ptj/77.12.1747
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
What has been called "closed kinetic chain" (CKC) exercise has become popular in the last 5 to 10 years for use after anterior cruciate ligament (ACL) reconstructive surgery. Closed kinetic chain exercises appear to have gained popularity over more traditionally used open kinetic chain (OKC) exercises because many clinicians believe that CKC exercises are safer and more functional. These clinicians also contend that CKC exercise is equally effective as OKC exercise in restoring quadriceps femoris muscle force production following ACL reconstructive surgery. The purpose of this clinical perspective is to examine the evidence concerning OKC and CKC training after ACL reconstructive surgery with regard to these issues and discuss how physical therapists can best apply this knowledge in clinical practice. Based on the review of data, it does not appear that clinicians should completely abandon more traditional OKC exercises and replace them with CKC exercises in postoperative ACL reconstruction rehabilitation programs. Both types of exercise apparently can be modified to minimize (I) the risk of applying excessive strain on the ACL graft and (2) the risk of excessive patellofemoral joint stress. Depending on the functional goals of the patient, both OKC and CKC exercises may be appropriate for simulating functional activities. When improvement in quadriceps femoris muscle function is an essential treatment goal, therapists may need to combine OKC exercises with CKC exercises to provide optimal training stimuli. Suggestions for further research are discussed.
引用
收藏
页码:1747 / 1754
页数:8
相关论文
共 21 条
[1]
ARMS SW, 1984, AM J SPORT MED, V12, P8, DOI 10.1177/036354658401200102
[2]
ANTERIOR CRUCIATE LIGAMENT STRAIN BEHAVIOR DURING REHABILITATION EXERCISES IN-VIVO [J].
BEYNNON, BD ;
FLEMING, BC ;
JOHNSON, RJ ;
NICHOLS, CE ;
RENSTROM, PA ;
POPE, MH .
AMERICAN JOURNAL OF SPORTS MEDICINE, 1995, 23 (01) :24-34
[3]
BEYNNON BD, 1993, T 36 ANN M ORTH RES, P308
[4]
OPEN VERSUS CLOSED CHAIN KINETIC EXERCISES AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION - A PROSPECTIVE RANDOMIZED STUDY [J].
BYNUM, EB ;
BARRACK, RL ;
ALEXANDER, AH .
AMERICAN JOURNAL OF SPORTS MEDICINE, 1995, 23 (04) :401-406
[5]
EINHORN AR, 1993, REHABILITATION KNEE, P245
[6]
FLEMING BC, 1995, T 41 ANN M ORTH RES, P631
[7]
BIOMECHANICS OF THE KNEE-EXTENSION EXERCISE - EFFECT OF CUTTING THE ANTERIOR CRUCIATE LIGAMENT [J].
GROOD, ES ;
SUNTAY, WJ ;
NOYES, FR ;
BUTLER, DL .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1984, 66A (05) :725-733
[8]
AN INVIVO STRAIN-GAUGE STUDY OF ELONGATION OF THE ANTERIOR CRUCIATE LIGAMENT [J].
HENNING, CE ;
LYNCH, MA ;
GLICK, KR .
AMERICAN JOURNAL OF SPORTS MEDICINE, 1985, 13 (01) :22-26
[9]
HUNGERFORD DS, 1983, ORTHOP CLIN N AM, V14, P397
[10]
NORKIN CC, 1992, JOINT STRUCTURE FUNC, P485