Thigh-Muscle and Patient-Reported Function Early After Anterior Cruciate Ligament Reconstruction: Clinical Cutoffs Unique to Graft Type and Age
| Autor: | Curtis Bush, Grant E. Norte, James M. Bothwell, Christopher Kuenze, Craig Garrison, Thomas Birchmeier, David A. Sherman, Joseph Hannon |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Anterior cruciate ligament reconstruction Adolescent Knee Joint Anterior cruciate ligament medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation Context (language use) Hamstring Muscles Logistic regression Quadriceps Muscle 03 medical and health sciences 0302 clinical medicine medicine Cutoff Humans Orthopedics and Sports Medicine Knee Muscle Strength Patient Reported Outcome Measures Orthodontics 030222 orthopedics Receiver operating characteristic Anterior Cruciate Ligament Reconstruction business.industry Anterior Cruciate Ligament Injuries Retrospective cohort study 030229 sport sciences General Medicine Odds ratio Recovery of Function Exercise Therapy medicine.anatomical_structure Cross-Sectional Studies Treatment Outcome Thigh Female business |
| Zdroj: | J Athl Train |
| ISSN: | 1938-162X |
| Popis: | Context Patient-reported function is an important outcome in anterior cruciate ligament rehabilitation. Identifying which metrics of thigh-muscle function are indicators of normal patient-reported function can help guide treatment. Objective To identify which metrics of thigh-muscle function discriminate between patients who meet and patients who fail to meet age- and sex-matched normative values for patient-reported knee function in the first 9 months after anterior cruciate ligament reconstruction (ACLR) and establish cutoffs for these metrics by covariate subgroups. Design Cross-sectional retrospective study. Setting Laboratory. Patients or Other Participants A total of 256 patients (129 females, 128 males; age = 17.1 ± 3.0 years, height = 1.7 ± 0.1 m, mass = 74.1 ± 17.9 kg, months since surgery = 6.4 ± 1.4), 3 to 9 months after primary unilateral ACLR. Main Outcome Measure(s) We stratified the sample into dichotomous groups by the International Knee Documentation Committee (IKDC) score (IKDCMET, IKDCNOT MET) using sex- and age-matched normative values. We measured quadriceps and hamstrings isokinetic (60°/s) torque and power bilaterally. Normalized quadriceps and hamstrings peak torque (Nm/kg) and power (W/kg), limb symmetry indices (LSI, %), and hamstrings : quadriceps ratios were calculated. Logistic regression indicated which of these metrics could predict IKDC classification while controlling for age, graft type, and sex. Receiver operating characteristic curves established cutoffs for explanatory variables for both total cohort and covariate subgroups. Odds ratios (OR) determined the utility of each cutoff to discriminate IKDC status. Results Quadriceps torque LSI (≥69.4%, OR = 3.6), hamstrings torque (≥1.11 Nm/kg, OR = 2.1), and quadriceps power LSI (≥71.4%, OR = 2.0) discriminated between IKDC classification in the total cohort. Quadriceps torque LSI discriminated between IKDC classification in the patellar-tendon graft (≥61.6%, OR = 5.3), hamstrings-tendon graft (≥71.8%, OR = 10.5), and age Conclusions Quadriceps torque LSI, hamstrings torque, and quadriceps power LSI were the most useful metrics for predicting normal patient-reported knee function early after ACLR. Further, cutoff values that best predicted normal patient-reported function differed by graft type and age. |
| Databáze: | OpenAIRE |
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