Anterior cruciate ligament (ACL) injuries are common among a young, active population. While some individuals can maintain knee stability during daily and sporting activities following ACL rupture (copers), the majority of patients experience knee instability (non-copers). With our early work, we have shown that we can identify those individuals with the potential for dynamic knee stability (potential copers) early after injury. Our work of the past 5 years has also demonstrated that different levels of dynamic knee stability result in changes in movement and muscle patterns, which appear early after injury. Our previous work has demonstrated a rehabilitation program that includes purposeful perturbation of support surfaces (perturbation training) results in superior short-term return to functional activity and improved movement and muscle patterns in potential copers compared to a treatment consisting of standard rehabilitation techniques. Several questions remain that impact the development of effective rehabilitation programs for patients after ACL rupture. How do different levels of dynamic knee stability impact the outcomes over time among active patients with ACL rupture? Are the strategies stable? And how does perturbation training affect movement patterns and recovery of potential copers who eventually undergo surgery? The overall goal of this work is to identify those with better dynamic stability of the knee after anterior cruciate ligament rupture, enhance these patterns with rehabilitation and improve outcomes after reconstructive surgery.
The specific aims of this study are to compare clinical and functional outcomes, and the movement and muscle patterns of patients with different levels of dynamic knee stability after participating in perturbation enhanced rehabilitation. Comparisons will be made between potential copers and non-copers before and after training. Patient comparisons after surgery will be performed at the University of Delaware. Patients will not undergo surgery in Norway, allowing us to study the long-term non-operative management of patients with different levels of dynamic knee stability. Results from this study will allow us extend our previous findings and will provide information that is needed to identify and treat individuals with ACL rupture across the spectrum of compensation strategies. ? ? ? ?

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD037985-06
Application #
7284380
Study Section
Special Emphasis Panel (ZRG1-MOSS-L (02))
Program Officer
Shinowara, Nancy
Project Start
2001-02-08
Project End
2011-06-30
Budget Start
2007-07-01
Budget End
2008-06-30
Support Year
6
Fiscal Year
2007
Total Cost
$298,418
Indirect Cost
Name
University of Delaware
Department
Other Health Professions
Type
Schools of Allied Health Profes
DUNS #
059007500
City
Newark
State
DE
Country
United States
Zip Code
19716
Failla, Mathew J; Logerstedt, David S; Grindem, Hege et al. (2016) 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 44:2608-2614
Lynch, Andrew D; Logerstedt, David S; Grindem, Hege et al. (2015) Consensus criteria for defining 'successful outcome' after ACL injury and reconstruction: a Delaware-Oslo ACL cohort investigation. Br J Sports Med 49:335-42
Grindem, Hege; Eitzen, Ingrid; Snyder-Mackler, Lynn et al. (2014) Online registration of monthly sports participation after anterior cruciate ligament injury: a reliability and validity study. Br J Sports Med 48:748-53
Logerstedt, David; Lynch, Andrew; Axe, Michael J et al. (2013) Symmetry restoration and functional recovery before and after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 21:859-68
Logerstedt, David; Lynch, Andrew; Axe, Michael J et al. (2013) Pre-operative quadriceps strength predicts IKDC2000 scores 6 months after anterior cruciate ligament reconstruction. Knee 20:208-12
Hartigan, Erin H; Lynch, Andrew D; Logerstedt, David S et al. (2013) Kinesiophobia after anterior cruciate ligament rupture and reconstruction: noncopers versus potential copers. J Orthop Sports Phys Ther 43:821-32
Lynch, Andrew D; Logerstedt, David S; Axe, Michael J et al. (2012) Quadriceps activation failure after anterior cruciate ligament rupture is not mediated by knee joint effusion. J Orthop Sports Phys Ther 42:502-10
Logerstedt, David; Grindem, Hege; Lynch, Andrew et al. (2012) 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 40:2348-56
Grindem, Hege; Eitzen, Ingrid; Moksnes, Håvard et al. (2012) A pair-matched comparison of return to pivoting sports at 1 year in anterior cruciate ligament-injured patients after a nonoperative versus an operative treatment course. Am J Sports Med 40:2509-16
Grindem, Hege; Logerstedt, David; Eitzen, Ingrid et al. (2011) Single-legged hop tests as predictors of self-reported knee function in nonoperatively treated individuals with anterior cruciate ligament injury. Am J Sports Med 39:2347-54

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