康复学报 (Dec 2023)
Treatment Efficacy of Open Kinetic Chain Combined with Closed Kinetic Chain Exercise Training on Patients after Anterior Cruciate Ligament Reconstruction
Abstract
ObjectiveTo observe the effect of open kinetic chain (OKC) combined with closed kinetic chain (CKC) exercise training on motor function of knee or lower limb, balance function, quadriceps isokinetic muscle strength and atrophy degree after anterior cruciate ligament (ACL) reconstruction.MethodsA total of 84 patients who underwent knee ACL reconstruction in the Jinan Zhangqiu District People's Hospital from January 2020 to October 2021 were randomly divided into OKC group, CKC group, equal combination group and adjusted combination group, with 21 cases in each group. The OKC group received OKC training, the CKC group received CKC training, the equal combination group received equal amount of OKC training and CKC training, and the adjusted combination group received OKC training and CKC training of different proportions. All four groups were trained for 12 weeks. Before and after intervention, Lysholm score and the international knee documentation committee (IKDC) score were used to evaluate the function of the affected knee, the KT-1000 score of the knee ligament and the differences of bilateral active range and passive range of motions; the ratio of jump distance between the affected side and the healthy side during one foot jump and cross foot jump were used to evaluate the lower limb motor function; Fugl-Meyer balance scale and Berg balance scale (BBS) were used to evaluate the balance function; isokinetic muscle strength testing system was used to analyze peak torque (PT), average power (AP), total power (TW) and atrophy index of quadriceps femoris on the affected side.Results(1) Knee motor function: compared with that before intervention, Lysholm and IKDC scores in four groups after intervention increased significantly, and KT-1000 score, bilateral active and passive joint motion differences decreased significantly (P<0.05). Compared with the OKC group, the Lysholm score in the CKC group after intervention was significantly higher, the IKDC scores were significantly higher in the CKC group and adjusted combination group after intervention, and the KT-1000 score, bilateral active and passive joint motion differences were significantly lower (P<0.05); the difference of bilateral active joint motion in the equal combination group significantly decreased (P<0.05). (2) Balance function: compared with that before intervention, Fugl-Meyer score and BBS score in four groups after intervention were significantly higher (P<0.05); there were no significant differences in Fugl-Meyer score and BBS score in four groups after intervention (P>0.05). (3) Lower limb motor function: compared with that before intervention, the ratio of jump distance between the affected side and the healthy side during one foot jump and cross foot jump in four groups after intervention significantly increased (P<0.05); compared with the OKC group, the ratio of jump distance between the affected side and the healthy side during one foot jump and cross foot jump in the CKC group and the adjusted combination group after intervention significantly increased (P<0.05). (4) Quadriceps isokinetic muscle strength and atrophy index: compared with that before intervention, PT, AP and TW scores in four groups after intervention were significantly higher and atrophy index was significantly lower (P<0.05). Compared with the OKC group, PT, AP and TW scores in the CKC group after intervention were significantly lower and the atrophy index was significantly higher (P<0.05); compared with the CKC group, PT and TW in the equal combination group and the adjusted combination group after intervention were significantly higher and the atrophy index was significantly lower (P<0.05).ConclusionOKC combined with CKC exercise training can effectively improve motor function of the knee joint and lower limb, improve the muscle strength of quadriceps femoris, and reduce the muscle atrophy in patients after ACL reconstruction, and the effect of equivalent combination mode is similar to that of adjusted combination mode.
