Document Title: Kvist-AJSM-Jan01

Article Title: Sagittal plane knee translation and electromyographic activity during closed and open kinetic chain exercises in anterior cruciate ligament-deficient patients and control subjects

Author: Joanna Kvist, Jan Gillquist.

Publication: The American Journal of Sports Medicine

ISSN: 03635465

Date: January-February 2001.

(Figures included. Reference-denoting numbers appear in the same point size as document text.)

Volume: 29

Issue: 1

Pages: 72-82

Key Words: Knee, physiotherapy, ACL, kinetics, exercises.

 

Kvist notes that for ACL-deficient knees, closed-kinetic-chain exercises are preferable to open-kinetic-chain exercises. This is also true for nascent-ACL-harbouring knees. (Closed-kinetic-chain exercises are characterized by the foot bearing weight throughout the entire exercise.)

 

ABSTRACT

 

Using electrogoniometry and electromyography, we measured tibial translation and muscle activation in 12 patients with unilateral anterior cruciate ligament injury and in 12 control subjects. Measurements were made during an active extension exercise with 0-, 4-, and 8-kg weights and during squats on two legs and on one leg where the projection of the center of gravity was placed over, behind, and in front of the feet. In the uninjured subjects, tibial translation increased with increasing load except during the squat with the center of gravity behind the feet, which produced the smallest translation. For the active extension exercises, translation was greater during eccentric activity. In the anterior cruciate ligament-injured knees, all squats resulted in similar translation, which was smaller than that during the active extension exercise. The highest muscle activation was seen during squats. Hamstring muscle activity was low. Increased static laxity in the anterior cruciate ligament-deficient knee can be controlled during closed but not during open kinetic chain exercises. Coactivation of the quadriceps and gastrocnemius muscles seems to be important for knee stability, whereas hamstring muscle coactivation was insignificant. To minimize sagittal translation during nonoperative management of anterior cruciate ligament-deficient knees, closed kinetic chain exercises are preferable to open kinetic chain exercises, and importance should be attached to the spontaneous coactivation of the quadriceps and gastrocnemius muscles.

 

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