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Measurement of Functional Recovery in Individuals with Acute Anterior Cruciate Ligament Rupture and the effect of rehabilitation using movement feedback

Researchers

  • Kate Button
  • Prof. Patricia Price (Wound Healing Research Unit, School of Medicine, Cardiff University)
  • Dr. Robert van Deursen

The purpose of this study was firstly to evaluate functional recovery following anterior cruciate ligament (ACL) rupture from acute injury over the course of rehabilitation.  Insights from this analysis were then used to integrate movement feedback into rehabilitation to investigate if this resulted in improved functional outcome. 

A prospective repeated measures longitudinal design was used to measure functional recovery from acute injury over time of 63 ACL patients and 61 matched controls, using a 2D video based analysis system.  Time distance variables and kinematics for gait, jog, distance hop and run and stop were analysed monthly. A second exploratory study using a prospective cohort design compared recovery between 115 ACLD individuals randomized into movement feedback (FB) and no feedback (no-FB) rehabilitation.  Functional recovery was found on average to take 3 months for gait and 5 months for hopping.  ACLD non-copers were distinguishable at 40 days post injury due to failure of gait variables to recover to within ‘normal limits’.  In study two 52 ACLD subjects were followed up at 5 months post injury.  No statistically significant differences in functional performance between the FB and no-FB groups were found, for any of the movement variables. 

Functional recovery was successfully modeled and shown to take longer than expected.  This has implications for advising patients on recovery times and length of time for attendance at rehabilitation.  Further clarification is required but failure of simple gait variables to recover by 40 days post injury could direct ACLD management. Incorporating movement feedback into rehabilitation did not result in improved functional outcome. This study demonstrated that the clinically based video analysis system provided detailed insight at all stages of rehabilitation on the speed, timing and completeness of recovery for functional tasks that are directly relevant to the rehabilitation goals.