Physical Therapy Korea (한국전문물리치료학회지)

Korean Research Society of Physical Therapy (한국전문물리치료학회)
권호 표지
DOI QR코드

DOI QR Code

Static and Dynamic Balance Comparison Between the Involved and Uninvolved Sides in Patients Who had Anterior Cruciate Ligament Reconstruction: One-year Follow-up Study

  • Kim, Jin-seong (Sports Medical Center, Seoul Paik Hospital, Inje University College of Medicine) ;
  • Choi, Moon-young (Sports Medical Center, Seoul Paik Hospital, Inje University College of Medicine) ;
  • Kong, Doo-hwan (Sports Medical Center, Seoul Paik Hospital, Inje University College of Medicine) ;
  • Chung, Kyu-sung (Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University College of Medicine) ;
  • Hwang, Ui-jae (Department of Physical Therapy, College of Health Science, Yonsei University) ;
  • Kwon, Oh-yun (Department of Physical Therapy, College of Health Science, Yonsei University)
  • Received : 2020.09.18
  • Accepted : 2020.10.22
  • Published : 2020.11.20
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Anterior cruciate ligament reconstruction (ACLR) causes a reduction in the balance of the lower extremities. Static and dynamic balance were evaluated separately to confirm the decrease in balance in patients underwent ACLR. The commonly used methods include the Biodex Balance System (BBS) for static balance and the Y balance test (YBT) for dynamic balance. No study has evaluated whether the static and dynamic balance of the involved side recovers as much as the uninvolved side one year after ACLR. Objects: The purpose of this study was to investigate the recovery of static and dynamic balance between the involved and the uninvolved sides. Methods: The BBS (overall, anteroposterior index, and mediolateral index) and YBT (anterior, posterolateral, and posteromedial) of 58 patients underwent ACLR were measured one year postoperation. Both sides of the BBS and the YBT were compared using the paired t-test. Results: All the index of the BBS showed no difference between the involved and the uninvolved sides, while all the scores of the YBT showed a significant difference in both sides. The YBT anterior result was 54.64 ± 5.62 cm in the involved side and 56.90 ± 5.41 cm in the uninvolved side (p = 0.001). The YBT posterolateral results were 90.12 ± 10.51 cm and 92.34 ± 9.85 cm (p = 0.013). The YBT posteromedial results were 93.72 ± 8.84 cm and 96.14 ± 9.37 cm (p = 0.002). Conclusion: A year after ACLR, the static balance showed no difference, while the dynamic balance showed a significant difference in the involved and the uninvolved sides. The static balance of the involved side recovered as much as the uninvolved side, but the dynamic balance did not. Therefore, dynamic balance training should be considered in the rehabilitation program for patients underwent ACLR.

Keywords

References

  1. Barber-Westin SD, Noyes FR. Factors used to determine return to unrestricted sports activities after anterior cruciate ligament reconstruction. Arthroscopy 2011;27(12):1697-705. https://doi.org/10.1016/j.arthro.2011.09.009
  2. Mattacola CG, Perrin DH, Gansneder BM, Gieck JH, Saliba EN, McCue FC 3rd. Strength, functional outcome, and postural stability after anterior cruciate ligament reconstruction. J Athl Train 2002;37(3):262-68.
  3. Chung KS, Ha JK, Ra HJ, Kim SB, Lee GH, Kim JG. Does synovialization after anterior cruciate ligament reconstruction have a positive effect on functional performance, outcomes scores, stability and muscle strength? A 2-year follow-up study after reconstruction. Arch Orthop Trauma Surg 2017;137(12):1725-33. https://doi.org/10.1007/s00402-017-2808-6
  4. Bonfim TR, Jansen Paccola CA, Barela JA. Proprioceptive and behavior impairments in individuals with anterior cruciate ligament reconstructed knees. Arch Phys Med Rehabil 2003;84(8):1217-23. https://doi.org/10.1016/S0003-9993(03)00147-3
  5. Fitzgerald GK, Lephart SM, Hwang JH, Wainner RS. Hop tests as predictors of dynamic knee stability. J Orthop Sports Phys Ther 2001;31(10):588-97. https://doi.org/10.2519/jospt.2001.31.10.588
  6. Risberg MA, Holm I, Myklebust G, Engebretsen L. Neuromuscular training versus strength training during first 6 months after anterior cruciate ligament reconstruction: a randomized clinical trial. Phys Ther 2007;87(6):737-50. https://doi.org/10.2522/ptj.20060041
  7. Almeida GPL, Monteiro IO, Marizeiro DF, Maia LB, de Paula Lima PO. Y balance test has no correlation with the Stability Index of the Biodex Balance System. Musculoskelet Sci Pract 2017;27:1-6. https://doi.org/10.1016/j.msksp.2016.11.008
  8. Chen TH, Chou LW, Tsai MW, Lo MJ, Kao MJ. Effectiveness of a heel cup with an arch support insole on the standing balance of the elderly. Clin Interv Aging 2014;9:351-6.
  9. Akbari A, Ghiasi F, Mir M, Hosseinifar M. The effects of balance training on static and dynamic postural stability indices after acute ACL reconstruction. Glob J Health Sci 2015;8(4):68-81. https://doi.org/10.5539/gjhs.v8n4p68
  10. Alonso AC, Greve JM, Camanho GL. Evaluating the center of gravity of dislocations in soccer players with and without reconstruction of the anterior cruciate ligament using a balance platform. Clinics (Sao Paulo) 2009;64(3):163-70.
  11. Cooper RL, Taylor NF, Feller JA. A randomised controlled trial of proprioceptive and balance training after surgical reconstruction of the anterior cruciate ligament. Res Sports Med 2005;13(3):217-30. https://doi.org/10.1080/15438620500222547
  12. Mohammadirad S, Salavati M, Takamjani IE, Akhbari B, Sherafat S, Mazaheri M, et al. Intra and intersession reliability of a postural control protocol in athletes with and without anterior cruciate ligament reconstruction: a dual-task paradigm. Int J Sports Phys Ther 2012;7(6):627-36.
  13. Overmoyer GV, Reiser RF 2nd. Relationships between lowerextremity flexibility, asymmetries, and the Y balance test. J Strength Cond Res 2015;29(5):1240-7. https://doi.org/10.1519/JSC.0000000000000693
  14. Akhbari B, Salavati M, Mohammadi F, Safavi-Farokhi Z. Intraand inter-session reliability of static and dynamic postural control in participants with and without patellofemoral pain syndrome. Physiother Can 2015;67(3):248-53. https://doi.org/10.3138/ptc.2014-51
  15. Myers H, Christopherson Z, Butler RJ. Relationship between the lower quarter Y-balance test scores and isokinetic strength testing in patients status post ACL reconstruction. Int J Sports Phys Ther 2018;13(2):152-9. https://doi.org/10.26603/ijspt20180152
  16. Yamada RK, Arliani GG, Almeida GP, Venturine AM, Santos CV, Astur DC, et al. The effects of one-half of a soccer match on the postural stability and functional capacity of the lower limbs in young soccer players. Clinics (Sao Paulo) 2012;67(12):1361-4. https://doi.org/10.6061/clinics/2012(12)03
  17. Benis R, Bonato M, La Torre A. Elite female basketball players' body-weight neuromuscular training and performance on the Y-balance test. J Athl Train 2016;51(9):688-95. https://doi.org/10.4085/1062-6050-51.12.03
  18. Linek P, Sikora D, Wolny T, Saulicz E. Reliability and number of trials of Y balance test in adolescent athletes. Musculoskelet Sci Pract 2017;31:72-5. https://doi.org/10.1016/j.msksp.2017.03.011
  19. Arifin N, Abu Osman NA, Wan Abas WA. Intrarater test-retest reliability of static and dynamic stability indexes measurement using the Biodex Stability System during unilateral stance. J Appl Biomech 2014;30(2):300-4. https://doi.org/10.1123/jab.2013-0130
  20. Shaffer SW, Teyhen DS, Lorenson CL, Warren RL, Koreerat CM, Straseske CA, et al. Y-balance test: a reliability study involving multiple raters. Mil Med 2013;178(11):1264-70. https://doi.org/10.7205/MILMED-D-13-00222
  21. Testerman C, Vander Griend R. Evaluation of ankle instability using the Biodex Stability System. Foot Ankle Int 1999;20(5):317-21. https://doi.org/10.1177/107110079902000510
  22. Sherafat S, Salavati M, Ebrahimi Takamjani I, Akhbari B, Mohammadirad S, Mazaheri M, et al. Intrasession and intersession reliability of postural control in participants with and without nonspecific low back pain using the Biodex Balance System. J Manipulative Physiol Ther 2013;36(2):111-8. https://doi.org/10.1016/j.jmpt.2012.12.005
  23. Henriksson M, Ledin T, Good L. Postural control after anterior cruciate ligament reconstruction and functional rehabilitation. Am J Sports Med 2001;29(3):359-66. https://doi.org/10.1177/03635465010290031801
  24. Kim JG, Yang SJ, Lee YS, Shim JC, Ra HJ, Choi JY. The effects of hamstring harvesting on outcomes in anterior cruciate ligament-reconstructed patients: a comparative study between hamstring-harvested and -unharvested patients. Arthroscopy 2011;27(9):1226-34. https://doi.org/10.1016/j.arthro.2011.05.009
  25. Choi JY, Ha JK, Kim YW, Shim JC, Yang SJ, Kim JG. Relationships among tendon regeneration on MRI, flexor strength, and functional performance after anterior cruciate ligament reconstruction with hamstring autograft. Am J Sports Med 2012;40(1):152-62. https://doi.org/10.1177/0363546511424134
  26. Gonell AC, Romero JA, Soler LM. Relationship between the Y balance test scores and soft tissue injury incidence in a soccer team. Int J Sports Phys Ther 2015;10(7):955-66.