Heterogeneity Clinical heterogeneity was expected given that the data were obtained from patients represented in the included trials.
OKC, step-ups, squats, calf exercises Permitted, but not controlled: Please reference the corresponding article for further description Okc versus ckc dissertations interventions and progression of exercises. Knee extensors kinetic chain training in anterior cruciate ligament deficiency.
Knee Surg Sports Traumatol Arthrosc. The purpose of this randomized, single-blind clinical trial was to compare the effects of OKC and CKC exercises on knee laxity and knee function in patients with ACL deficiency.
The trial examined 64 patients, 49 males and 15 females. Inclusion and exclusion criteria for this study were that subjects were deemed suitable if they had no previous history of pathology requiring medical attention in the contralateral lower extremity within the past 6 months, did not have a concurrent posterior cruciate ligament PCL injury, and their ACL diagnosis had to be confirmed by the use of an MRI or other clinical test.
After informed consent was received, the patients went through a series of tests and measures conducted by physical therapists that were blinded to the subjects group assignments; including knee laxity testing with a ligament arthrometer, measurement of function based on the Hughston Clinic knee self-assessment questionnaire, and testing of the maximum effort during a single leg jump test.
Each of the above named tests were measured at baseline and then again following 6 weeks of intervention, during which patients attended therapy 3 times per week.
The jump test methods used single-leg horizontal hop and the vertical jump have both been found to be reliable and valid. Aside from the test and measures, the researchers instructed the subjects to keep a diary, which allowed them to record the details of the therapy they received as well as activities they were participating in outside of treatment.
At the conclusion of this study the researchers were unable to reject their null hypotheses regarding all study variables. The researchers were not able to find a Okc versus ckc dissertations difference in the knee laxity measurements between groups from baseline when compared to the end of the intervention program.
The subjects demonstrated a statistically significant difference between groups in the vertical jump test, which was greater in the OKC group at post-test.
However, even with this finding, inferences can not be made for the other jump test because of the differences in muscular torques and motor performance variations that are required with each of the tests. A comprehensive rehabilitation program with quadriceps strengthening in closed versus open kinetic chain exercise in patients with anterior cruciate ligament deficiency: A randomized clinical trial evaluating dynamic tibial translation and muscle function.
Am J Sports Med. This randomized controlled trial aimed to define the differences between a comprehensive rehabilitation program which used either additional quadriceps strengthening using CKC exercises or additional quadriceps strengthening using OKC exercises.
The trial included subjects between the ages of 15 and Inclusion criterion was that subjects had to have a unilateral ACL rupture that was no more than 14 weeks old. Subjects were exluded if they had an additional injury or previous surgery to the lower extremities, except for minor meniscal or collateral ligament injury, and if the diagnosis of the ACL injury was not identified by an MRI.
The following information was gathered on the injured lower extremity at baseline and after 4 months of intervention: In order to determine differences from baseline to post-intervention, the researchers used the following statistical tests: A significantly greater difference was found in quadriceps strength of the injured leg after intervention in the OKC group as compared to the CKC group.
Results showed that a treatment program complemented with OKC quadriceps exercises led to significantly greater quadriceps strength over one with CKC quadriceps exercises only. The authors of this article stated that their results support the use of OKC exercises to regain proper muscle torque around an ACL deficient knee.
Of the 6 articles, 4 articles investigated the differences within a population of patients who underwent ACL reconstruction and the other 2 investigated subjects who had ACL deficiency. Five of the 6 articles studied the effects of these exercises on knee laxity, examining both static and dynamic anterior tibial translation.
Four of the 6 articles utilized measurements including knee girth, PROM of knee flexion and extension, muscle strength testing and biomechanical analysis of knee function during walking and stair use.
Three studies 345 utilized the Hughston clinic questionnaire to address patient self-assessment and two of these studies 45 also used a pre-test general questionnaire to describe injury and surgery dates, activity difficulties, and any current sporting activities.
One study used a post-test questionnaire addressing knee function and satisfaction as well as physical activity. Tagesson et al 6 stated that their results supported the use of OKC exercises to regain proper muscle torque around an ACL deficient knee.
Strengthening of the quadriceps through a treatment program using OKC quadriceps exercises with exclusion of CKC exercises led to significantly greater quadriceps strength over using CKC quadriceps exercises alone.
This combined exercise method improved muscle torque about the knee and returned patients to activity earlier than the use of CKC exercises in isolation. Both of the studies by Perry et al 45 commented on the reliability and validity of various elements of their research design.
Reliability of the therapists measuring laxity compared well with other published data, having significant difference values for knee laxity between 3. For example, Mikkelsen et al 7 used a questionnaire that assessed knee function and satisfaction.
Subjects believed their knee function was greater and reported earlier return to sports than those who received CKC exercises alone.
A weakness among some of the studies was a lack of statistical power due to inadequate subject numbers. For example, Morrissey et al 10 conducted an analysis which reported the need of 60 subjects for statistical power.OKC and CKC exercises have been used by other investigators as a rehabilitation protocol, 2,4,5,7,12,23,34,38,39 but no long-term follow-up has been undertaken to compared the results of OKC versus CKC exercises.
Start studying Ther Ex: OKC vs CKC. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Start studying Ther Ex: OKC vs CKC. Learn vocabulary, terms, and more with flashcards, games, and other study tools. By conducting a systematic review of the literature, data can be compared from past studies to examine whether the evidence or lack thereof offers insight on the appropriateness of OKC versus CKC exercises when dealing with patients who have ACL pathology.
Controversies Between Open and Closed Chain Exercises after ACL Reconstruction Megan Bechtold, DPT, OCS, CMPT. to determine if CKC only versus CKC plus OKC training generates better outcomes after with OKC vs CKC exercise.
By conducting a systematic review of the literature, data can be compared from past studies to examine whether the evidence or lack thereof offers insight on the appropriateness of OKC versus CKC exercises when dealing with patients who have ACL pathology.