Quadriceps muscle function after rehabilitation with cryotherapy in patients with anterior cruciate ligament reconstruction

Joseph M. Hart, Christopher M. Kuenze, David R. Diduch, Christopher D. Ingersoll

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Context: Persistent muscle weakness after anterior cruciate ligament (ACL) reconstruction may be due to underlying activation failure and arthrogenic muscle inhibition (AMI). Knee-joint cryotherapy has been shown to improve quadriceps function transiently in those with AMI, thereby providing an opportunity to improve quadriceps muscle activation and strength in patients with a reconstructed ACL. Objective: To compare quadriceps muscle function in patients with a reconstructed ACL who completed a 2-week intervention including daily cryotherapy (ice bag), daily exercises, or both. Design: Cross-sectional study. Setting: Laboratory. Patients or Other Participants: A total of 30 patients with reconstructed ACLs who were at least 6 months post-index surgery and had measurable quadriceps AMI. Intervention(s): The patients attended 4 supervised visits over a 2-week period. They were randomly assigned to receive 20 minutes of knee-joint cryotherapy, 1 hour of therapeutic rehabilitation exercises, or cryotherapy followed by exercises. Main Outcome Measure(s): We measured quadriceps Hoffmann reflex, normalized maximal voluntary isometric contraction torque, central activation ratio using the superim-posed-burst technique, and patient-reported outcomes before and after the intervention period. Results: After the 2-week intervention period, patients who performed rehabilitation exercises immediately after cryotherapy had higher normalized maximal voluntary isometric contraction torques (P = .002, Cohen d effect size = 1.4) compared with those who received cryotherapy alone (P = .16, d = 0.58) or performed exercise alone (P = .16, d = 0.30). Conclusions: After ACL reconstruction, patients with AMI who performed rehabilitation exercises immediately after cryotherapy experienced greater strength gains than those who performed cryotherapy or exercises alone.

Original languageEnglish (US)
Pages (from-to)733-739
Number of pages7
JournalJournal of Athletic Training
Volume49
Issue number6
DOIs
StatePublished - Nov 1 2014
Externally publishedYes

Keywords

  • Arthrogenic muscle inhibition
  • Disinhibition
  • Knee
  • Therapeutic exercises

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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