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21.02.2017 | Symposium: Improving Care for Patients With ACL Injuries: A Team Approach

Report of the Clinical and Functional Primary Outcomes in Men of the ACL-SPORTS Trial: Similar Outcomes in Men Receiving Secondary Prevention With and Without Perturbation Training 1 and 2 Years After ACL Reconstruction

verfasst von: Amelia J. H. Arundale, PT, DPT, Kathleen Cummer, PT, DPT, Jacob J. Capin, PT, DPT, MS, Ryan Zarzycki, PT, DPT, Lynn Snyder-Mackler, PT, ATC, ScD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 10/2017

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Abstract

Background

Athletes often are cleared to return to activities 6 months after anterior cruciate ligament (ACL) reconstruction; however, knee function measures continue to improve up to 2 years after surgery. Interventions beyond standard care may facilitate successful return to preinjury activities and improve functional outcomes. Perturbation training has been used in nonoperative ACL injury and preoperative ACL reconstruction rehabilitation, but has not been examined in postoperative ACL reconstruction rehabilitation, specifically return to sport rehabilitation.

Questions/Purposes

The purpose of this study was to determine whether there were differences at 1 and 2 years after ACL reconstruction between the male SAP (strengthening, agility, and secondary prevention) and SAP+PERT (SAP protocol with the addition of perturbation training) groups with respect to (1) quadriceps strength and single-legged hop limb symmetry; (2) patient-reported knee outcome scores; (3) the proportion who achieve self-reported normal knee function; and (4) the time from surgery to passing return to sport criteria.

Methods

Forty men who had completed ACL reconstruction rehabilitation and met enrollment criteria (3–9 months after ACL reconstruction, > 80% quadriceps strength limb symmetry, no pain, full ROM, minimal effusion) were randomized into the SAP or SAP+PERT groups of the Anterior Cruciate Ligament-Specialised Post-Operative Return to Sports trial (ACL-SPORTS), a single-blind randomized clinical study of secondary prevention and return to sport. Quadriceps strength, single-legged hopping, the International Knee Documentation Committee (IKDC) 2000 subjective knee form, Knee Injury and Osteoarthritis Outcome Score (KOOS)-sports and recreation, and KOOS-quality-of-life subscales were collected 1 and 2 years after surgery by investigators blind to group. Athletes were categorized as having normal or abnormal knee function at each time point based on IKDC score, and the time until athletes passed strict return-to-sport criteria was also recorded. T-tests, chi square tests, and analyses of variance were used to identify differences between the treatment groups over time.

Results

There were no differences between groups for quadriceps symmetry (1 year: SAP = 101% ± 14%, SAP+PERT = 101% ± 14%; 2 years: SAP = 103% ± 11%, SAP+PERT = 98% ± 14%; mean differences between groups at 1 year: 0.4 [−9.0 to 9.8], 2 years = 4.5 [−4.3 to 13.1]; mean difference between 1 and 2 years: SAP = −1.0 [−8.6 to 6.6], SAP+PERT = 3.0 [−4.3 to 10.3], p = 0.45) or single-legged hop test limb symmetry. There were no clinically meaningful differences for any patient-reported outcome measures. There was no difference in the proportion of athletes in each group who achieved normal knee function at 1 year (SAP 14 of 19, SAP+PERT 18 of 20, odds ratio 0.31 [0.5–19.0]; p = 0.18); however, the SAP+PERT group had fewer athletes with normal knee function at 2 years (SAP 17 of 17, SAP+PERT 14 of 19, p = 0.03). There were no differences between groups in the time to pass return to sport criteria (SAP = 325 ± 199 days, SAP+PERT = 233 ± 77 days; mean difference 92 [−9 to 192], p = 0.09).

Conclusions

This randomized trial found few differences between an ACL rehabilitation program consisting of strengthening, agility, and secondary prevention and one consisting of those elements as well as perturbation training. In the absence of clinically meaningful differences between groups in knee function and self-reported outcomes measures, the results indicate that perturbation training may not contribute additional benefit to the strengthening, agility, and secondary prevention base of the ACL-SPORTS training program.

Level of Evidence

Level II, therapeutic study.
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Literatur
1.
Zurück zum Zitat Adams D, Logerstedt D, Hunter-Giordano A, Axe M, Snyder-Mackler L. Current concepts for anterior cruciate ligament reconstruction: a criterion-based rehabilitation progression. J Orthop Sports Phys Ther. 2012;42:601–614.CrossRefPubMedPubMedCentral Adams D, Logerstedt D, Hunter-Giordano A, Axe M, Snyder-Mackler L. Current concepts for anterior cruciate ligament reconstruction: a criterion-based rehabilitation progression. J Orthop Sports Phys Ther. 2012;42:601–614.CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Anderson AF, Irrgang JJ, Kocher MS, Mann BJ, Harrast JJ. The International Knee Documentation Committee subjective knee evaluation form: normative data. Am J Sports Med. 2006;34:128–135.CrossRefPubMed Anderson AF, Irrgang JJ, Kocher MS, Mann BJ, Harrast JJ. The International Knee Documentation Committee subjective knee evaluation form: normative data. Am J Sports Med. 2006;34:128–135.CrossRefPubMed
3.
Zurück zum Zitat Ardern CL, Taylor NF, Feller JA, Webster KE. Fifty-five per cent return to competitive sport following anterior cruciate ligament reconstruction surgery: an updated systematic review and meta-analysis including aspects of physical functioning and contextual factors. Br J Sports Med. 2014;48:1543–1552.CrossRefPubMed Ardern CL, Taylor NF, Feller JA, Webster KE. Fifty-five per cent return to competitive sport following anterior cruciate ligament reconstruction surgery: an updated systematic review and meta-analysis including aspects of physical functioning and contextual factors. Br J Sports Med. 2014;48:1543–1552.CrossRefPubMed
4.
Zurück zum Zitat Ardern CL, Webster KE, Taylor NF, Feller JA. Return to the preinjury level of competitive sport after anterior cruciate ligament reconstruction surgery: two-thirds of patients have not returned by 12 months after surgery. Am J Sports Med. 2011;39:538–543.CrossRefPubMed Ardern CL, Webster KE, Taylor NF, Feller JA. Return to the preinjury level of competitive sport after anterior cruciate ligament reconstruction surgery: two-thirds of patients have not returned by 12 months after surgery. Am J Sports Med. 2011;39:538–543.CrossRefPubMed
5.
Zurück zum Zitat Bizzini M, Hancock D, Impellizzeri F. Suggestions from the field for return to sports participation following anterior cruciate ligament reconstruction: Soccer. J Orthop Sports Phys Ther. 2012;42:304–312.CrossRefPubMed Bizzini M, Hancock D, Impellizzeri F. Suggestions from the field for return to sports participation following anterior cruciate ligament reconstruction: Soccer. J Orthop Sports Phys Ther. 2012;42:304–312.CrossRefPubMed
6.
Zurück zum Zitat Capin J, Zarzycki R, Arundale A, White K, Snyder-Mackler L. Report of the primary outcomes for gait mechanics in men of the ACL-SPORTS trial: secondary prevention with and without perturbation training does not restore gait symmetry in men 1 or 2 years after ACL reconstruction. Clin Orthop Relat Res. 2017. doi:10.1007/s11999-017-5279-8. Capin J, Zarzycki R, Arundale A, White K, Snyder-Mackler L. Report of the primary outcomes for gait mechanics in men of the ACL-SPORTS trial: secondary prevention with and without perturbation training does not restore gait symmetry in men 1 or 2 years after ACL reconstruction. Clin Orthop Relat Res. 2017. doi:10.​1007/​s11999-017-5279-8.
7.
Zurück zum Zitat Chmielewski TL, Hurd WJ, Rudolph KS, Axe MJ, Snyder-Mackler L. Perturbation training improves knee kinematics and reduces muscle co-contraction after complete unilateral anterior cruciate ligament rupture. Phys Ther. 2005;85:740–749.PubMed Chmielewski TL, Hurd WJ, Rudolph KS, Axe MJ, Snyder-Mackler L. Perturbation training improves knee kinematics and reduces muscle co-contraction after complete unilateral anterior cruciate ligament rupture. Phys Ther. 2005;85:740–749.PubMed
8.
Zurück zum Zitat Daniel DM, Stone ML, Dobson BE, Fithian DC, Rossman DJ, Kaufman KR. Fate of the ACL-injured patient: a prospective outcome study. Am J Sports Med. 1994;22:632–644.CrossRefPubMed Daniel DM, Stone ML, Dobson BE, Fithian DC, Rossman DJ, Kaufman KR. Fate of the ACL-injured patient: a prospective outcome study. Am J Sports Med. 1994;22:632–644.CrossRefPubMed
9.
Zurück zum Zitat Di Stasi SL, Myer GD, Hewett TE. Neuromuscular training to target deficits associated with second anterior cruciate ligament injury. J Orthop Sports Phys Ther. 2013;43:777-A711.CrossRef Di Stasi SL, Myer GD, Hewett TE. Neuromuscular training to target deficits associated with second anterior cruciate ligament injury. J Orthop Sports Phys Ther. 2013;43:777-A711.CrossRef
10.
Zurück zum Zitat Di Stasi SL, Snyder-Mackler L. The effects of neuromuscular training on the gait patterns of ACL-deficient men and women. Clin Biomech. 2012;27:360–365.CrossRef Di Stasi SL, Snyder-Mackler L. The effects of neuromuscular training on the gait patterns of ACL-deficient men and women. Clin Biomech. 2012;27:360–365.CrossRef
11.
Zurück zum Zitat Failla MJ, Logerstedt DS, Grindem H, Axe MJ, Risberg MA, Engebretsen L, Huston LJ, Spindler KP, Snyder-Mackler L. Does extended preoperative rehabilitation influence outcomes 2 years after acl reconstruction? A comparative effectiveness study between the moon and delaware-oslo acl cohorts. Am J Sports Med. 2016;44:2608–2614.CrossRefPubMed Failla MJ, Logerstedt DS, Grindem H, Axe MJ, Risberg MA, Engebretsen L, Huston LJ, Spindler KP, Snyder-Mackler L. Does extended preoperative rehabilitation influence outcomes 2 years after acl reconstruction? A comparative effectiveness study between the moon and delaware-oslo acl cohorts. Am J Sports Med. 2016;44:2608–2614.CrossRefPubMed
12.
Zurück zum Zitat Faul F, Erdfelder E, Lang A-G, Buchner A. G* power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–191.CrossRefPubMed Faul F, Erdfelder E, Lang A-G, Buchner A. G* power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–191.CrossRefPubMed
13.
Zurück zum Zitat Fitzgerald GK, Axe MJ, Snyder-Mackler L. The efficacy of perturbation training in nonoperative anterior cruciate ligament rehabilitation programs for physically active individuals. Phys Ther. 2000;80:128–140.PubMed Fitzgerald GK, Axe MJ, Snyder-Mackler L. The efficacy of perturbation training in nonoperative anterior cruciate ligament rehabilitation programs for physically active individuals. Phys Ther. 2000;80:128–140.PubMed
14.
Zurück zum Zitat Gobbi A, Francisco R. Factors affecting return to sports after anterior cruciate ligament reconstruction with patellar tendon and hamstring graft: a prospective clinical investigation. Knee Surg Sports Traumatol Arthrosc. 2006;14:1021–1028.CrossRefPubMed Gobbi A, Francisco R. Factors affecting return to sports after anterior cruciate ligament reconstruction with patellar tendon and hamstring graft: a prospective clinical investigation. Knee Surg Sports Traumatol Arthrosc. 2006;14:1021–1028.CrossRefPubMed
15.
Zurück zum Zitat Granan L-P, Bahr R, Steindal K, Furnes O, Engebretsen L. Development of a national cruciate ligament surgery registry: the Norwegian National Knee Ligament Registry. Am J Sports Med. 2008;36:308–315.CrossRefPubMed Granan L-P, Bahr R, Steindal K, Furnes O, Engebretsen L. Development of a national cruciate ligament surgery registry: the Norwegian National Knee Ligament Registry. Am J Sports Med. 2008;36:308–315.CrossRefPubMed
16.
Zurück zum Zitat Granan L-P, Forssblad M, Lind M, Engebretsen L. The Scandinavian ACL registries 2004–2007: baseline epidemiology. Acta Orthop. 2009;80:563–567.CrossRefPubMedPubMedCentral Granan L-P, Forssblad M, Lind M, Engebretsen L. The Scandinavian ACL registries 2004–2007: baseline epidemiology. Acta Orthop. 2009;80:563–567.CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Grindem H, Snyder-Mackler L, Moksnes H, Engebretsen L, Risberg MA. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL Cohort Study. Br J Sports Med. 2016;50:804–808.CrossRefPubMedPubMedCentral Grindem H, Snyder-Mackler L, Moksnes H, Engebretsen L, Risberg MA. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL Cohort Study. Br J Sports Med. 2016;50:804–808.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Hartigan E, Axe MJ, Snyder-Mackler L. Perturbation training prior to ACL reconstruction improves gait asymmetries in non-copers. J Orthop Res. 2009;27:724–729.CrossRefPubMedPubMedCentral Hartigan E, Axe MJ, Snyder-Mackler L. Perturbation training prior to ACL reconstruction improves gait asymmetries in non-copers. J Orthop Res. 2009;27:724–729.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Hartigan EH, Axe MJ, Snyder-Mackler L. Time line for noncopers to pass return-to-sports criteria after anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther. 2010;40:141–154.CrossRefPubMedPubMedCentral Hartigan EH, Axe MJ, Snyder-Mackler L. Time line for noncopers to pass return-to-sports criteria after anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther. 2010;40:141–154.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Hewett T, Lindenfeld T, Riccobene J, Noyes F. The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study. Am J Sports Med. 1999;27:699–706.CrossRefPubMed Hewett T, Lindenfeld T, Riccobene J, Noyes F. The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study. Am J Sports Med. 1999;27:699–706.CrossRefPubMed
21.
Zurück zum Zitat Hewett T, Stroupe A, Nance T, Noyes F. Plyometric training in female athletes. Decreased impact forces and increased hamstring torques. Am J Sports Med. 1996;24:765–773.CrossRefPubMed Hewett T, Stroupe A, Nance T, Noyes F. Plyometric training in female athletes. Decreased impact forces and increased hamstring torques. Am J Sports Med. 1996;24:765–773.CrossRefPubMed
22.
Zurück zum Zitat Hurd W, Chmielewski T, Snyder-Mackler L. Perturbation-enhanced neuromuscular training alters muscle activity in female athletes. Knee Surg Sports Traumatol Arthrosc. 2006;14:60–69.CrossRefPubMed Hurd W, Chmielewski T, Snyder-Mackler L. Perturbation-enhanced neuromuscular training alters muscle activity in female athletes. Knee Surg Sports Traumatol Arthrosc. 2006;14:60–69.CrossRefPubMed
23.
Zurück zum Zitat Irrgang JJ, Anderson AF, Boland AL, Harner CD, Kurosaka M, Neyret P, Richmond JC, Shelborne KD. Development and validation of the International Knee Documentation Committee subjective knee form. Am J Sports Med. 2001;29:600–613.CrossRefPubMed Irrgang JJ, Anderson AF, Boland AL, Harner CD, Kurosaka M, Neyret P, Richmond JC, Shelborne KD. Development and validation of the International Knee Documentation Committee subjective knee form. Am J Sports Med. 2001;29:600–613.CrossRefPubMed
24.
Zurück zum Zitat Irrgang JJ, Anderson AF, Boland AL, Harner CD, Neyret P, Richmond JC, Shelbourne KD. Responsiveness of the International Knee Documentation Committee subjective knee form. Am J Sports Med. 2006;34:1567–1573.CrossRefPubMed Irrgang JJ, Anderson AF, Boland AL, Harner CD, Neyret P, Richmond JC, Shelbourne KD. Responsiveness of the International Knee Documentation Committee subjective knee form. Am J Sports Med. 2006;34:1567–1573.CrossRefPubMed
25.
Zurück zum Zitat Logerstedt D, Grindem H, Lynch A, Eitzen I, Engebretsen L, Risberg MA, Axe MJ, Snyder-Mackler L. Single-legged hop tests as predictors of self-reported knee function after anterior cruciate ligament reconstruction: the Delaware-Oslo ACL cohort study. Am J Sports Med. 2012;40:2348–2356.CrossRefPubMedPubMedCentral Logerstedt D, Grindem H, Lynch A, Eitzen I, Engebretsen L, Risberg MA, Axe MJ, Snyder-Mackler L. Single-legged hop tests as predictors of self-reported knee function after anterior cruciate ligament reconstruction: the Delaware-Oslo ACL cohort study. Am J Sports Med. 2012;40:2348–2356.CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Logerstedt D, Lynch A, Axe MJ, Snyder-Mackler L. Symmetry restoration and functional recovery before and after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2013;21:859–868.CrossRefPubMed Logerstedt D, Lynch A, Axe MJ, Snyder-Mackler L. Symmetry restoration and functional recovery before and after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2013;21:859–868.CrossRefPubMed
27.
Zurück zum Zitat Logerstedt D, Stasi SD, Grindem H, Lynch A, Eitzen I, Engebretsen L, Risberg MA, Axe MJ, Snyder-Mackler L. Self-reported knee function can identify athletes who fail return-to-activity criteria up to 1 year after anterior cruciate ligament reconstruction: a Delaware-Oslo ACL cohort study. J Orthop Sports Phys Ther. 2014;44:914–923.CrossRefPubMedPubMedCentral Logerstedt D, Stasi SD, Grindem H, Lynch A, Eitzen I, Engebretsen L, Risberg MA, Axe MJ, Snyder-Mackler L. Self-reported knee function can identify athletes who fail return-to-activity criteria up to 1 year after anterior cruciate ligament reconstruction: a Delaware-Oslo ACL cohort study. J Orthop Sports Phys Ther. 2014;44:914–923.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Mccullough KA, Phelps KD, Spindler KP, Matava MJ, Dunn WR, Parker RD, Reinke EK, MOON Group. Return to high school and college level football following ACL reconstruction: a MOON cohort study. Am J Sports Med. 2012;40:2523.CrossRefPubMedPubMedCentral Mccullough KA, Phelps KD, Spindler KP, Matava MJ, Dunn WR, Parker RD, Reinke EK, MOON Group. Return to high school and college level football following ACL reconstruction: a MOON cohort study. Am J Sports Med. 2012;40:2523.CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Myer G, Paterno MV, Ford KR, Quatman CE, Hewett TE. Rehabilitation after anterior cruciate ligament reconstruction: criteria-based progression through the return-to-sport phase. J Orthop Sports Phys Ther. 2006;36:385–402.CrossRefPubMed Myer G, Paterno MV, Ford KR, Quatman CE, Hewett TE. Rehabilitation after anterior cruciate ligament reconstruction: criteria-based progression through the return-to-sport phase. J Orthop Sports Phys Ther. 2006;36:385–402.CrossRefPubMed
30.
Zurück zum Zitat Myer GD, Ford KR, Hewett TE. Methodological approaches and rationale for training to prevent anterior cruciate ligament injuries in female athletes. Scand J Med Sci Sports. 2004;14:275–285.CrossRefPubMed Myer GD, Ford KR, Hewett TE. Methodological approaches and rationale for training to prevent anterior cruciate ligament injuries in female athletes. Scand J Med Sci Sports. 2004;14:275–285.CrossRefPubMed
31.
Zurück zum Zitat Nagelli CV, Hewett TE. Should return to sport be delayed until 2 years after anterior cruciate ligament reconstruction? Biological and functional considerations. Sports Med. 2017;47:221–232.CrossRefPubMed Nagelli CV, Hewett TE. Should return to sport be delayed until 2 years after anterior cruciate ligament reconstruction? Biological and functional considerations. Sports Med. 2017;47:221–232.CrossRefPubMed
32.
Zurück zum Zitat Noyes FR, Barber SD, Mangine RE. Abnormal lower limb symmetry determined by function hop tests after anterior cruciate ligament rupture. Am J Sports Med. 1991;19:513–518.CrossRefPubMed Noyes FR, Barber SD, Mangine RE. Abnormal lower limb symmetry determined by function hop tests after anterior cruciate ligament rupture. Am J Sports Med. 1991;19:513–518.CrossRefPubMed
33.
Zurück zum Zitat Paterno MV, Rauh MJ, Schmitt LC, Ford KR, Hewett TE. Incidence of contralateral and ipsilateral anterior cruciate ligament (ACL) injury after primary ACL reconstruction and return to sport. Clin J Sport Med. 2012;22:116–121.CrossRefPubMedPubMedCentral Paterno MV, Rauh MJ, Schmitt LC, Ford KR, Hewett TE. Incidence of contralateral and ipsilateral anterior cruciate ligament (ACL) injury after primary ACL reconstruction and return to sport. Clin J Sport Med. 2012;22:116–121.CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Pauzenberger L, Syré S, Schurz M. ‘Ligamentization’ in hamstring tendon grafts after anterior cruciate ligament reconstruction: a systematic review of the literature and a glimpse into the future. Arthroscopy. 2013;29:1712–1721.CrossRefPubMed Pauzenberger L, Syré S, Schurz M. ‘Ligamentization’ in hamstring tendon grafts after anterior cruciate ligament reconstruction: a systematic review of the literature and a glimpse into the future. Arthroscopy. 2013;29:1712–1721.CrossRefPubMed
35.
Zurück zum Zitat Roewer BD, Di Stasi SL, Snyder-Mackler L. Quadriceps strength and weight acceptance strategies continue to improve two years after anterior cruciate ligament reconstruction. J Biomech. 2011;44:1948–1953.CrossRefPubMedPubMedCentral Roewer BD, Di Stasi SL, Snyder-Mackler L. Quadriceps strength and weight acceptance strategies continue to improve two years after anterior cruciate ligament reconstruction. J Biomech. 2011;44:1948–1953.CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998;28:88–96.CrossRefPubMed Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998;28:88–96.CrossRefPubMed
37.
Zurück zum Zitat Spindler KP, Huston LJ, Wright RW, Kaeding CC, Marx RG, Amendola A, Parker RD, Andrish JT, Reinke EK, Harrell FE, MOON Group, Dunn WR. The prognosis and predictors of sports function and activity at minimum 6 years after anterior cruciate ligament reconstruction: a population cohort study. Am J Sports Med. 2011;39:348–359. Spindler KP, Huston LJ, Wright RW, Kaeding CC, Marx RG, Amendola A, Parker RD, Andrish JT, Reinke EK, Harrell FE, MOON Group, Dunn WR. The prognosis and predictors of sports function and activity at minimum 6 years after anterior cruciate ligament reconstruction: a population cohort study. Am J Sports Med. 2011;39:348–359.
39.
Zurück zum Zitat Sugimoto D, Myer GD, Foss KDB, Hewett TE. Specific exercise effects of preventive neuromuscular training intervention on anterior cruciate ligament injury risk reduction in young females: meta-analysis and subgroup analysis. Br J Sports Med. 2015;49:282.CrossRefPubMed Sugimoto D, Myer GD, Foss KDB, Hewett TE. Specific exercise effects of preventive neuromuscular training intervention on anterior cruciate ligament injury risk reduction in young females: meta-analysis and subgroup analysis. Br J Sports Med. 2015;49:282.CrossRefPubMed
40.
Zurück zum Zitat White K, Di Stasi S, Smith A, Snyder-Mackler L. Anterior cruciate ligament-specialized post-operative return-to-sports (ACL-sports) training: a randomized control trial. BMC Musculoskelet Disord. 2013;14:108.CrossRefPubMedPubMedCentral White K, Di Stasi S, Smith A, Snyder-Mackler L. Anterior cruciate ligament-specialized post-operative return-to-sports (ACL-sports) training: a randomized control trial. BMC Musculoskelet Disord. 2013;14:108.CrossRefPubMedPubMedCentral
41.
Zurück zum Zitat Wright RW, Haas AK, Anderson J, Calabrese G, Cavanaugh J, Hewett TE, Lorring D, Mckenzie C, Preston E, Williams G. Anterior cruciate ligament reconstruction rehabilitation. Sports Health. 2015;7:239–243.CrossRefPubMedPubMedCentral Wright RW, Haas AK, Anderson J, Calabrese G, Cavanaugh J, Hewett TE, Lorring D, Mckenzie C, Preston E, Williams G. Anterior cruciate ligament reconstruction rehabilitation. Sports Health. 2015;7:239–243.CrossRefPubMedPubMedCentral
Metadaten
Titel
Report of the Clinical and Functional Primary Outcomes in Men of the ACL-SPORTS Trial: Similar Outcomes in Men Receiving Secondary Prevention With and Without Perturbation Training 1 and 2 Years After ACL Reconstruction
verfasst von
Amelia J. H. Arundale, PT, DPT
Kathleen Cummer, PT, DPT
Jacob J. Capin, PT, DPT, MS
Ryan Zarzycki, PT, DPT
Lynn Snyder-Mackler, PT, ATC, ScD
Publikationsdatum
21.02.2017
Verlag
Springer US
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 10/2017
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-017-5280-2

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