Quote:
Originally Posted by sharileedahl
Regarding open vs closed chain exercise....I have always gone with the same thoughts as you (WrightDPT) but I'm having a vague memory of reading an article recently regarding the minimal stress to the graft with open-chain exercise which would support the more recent support of quicker ACL rehab protocols.
I'll do a search for those papers and get back to you......
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OK....looked through the journals that I have read at home and done a search of abstracts that I may have reviewed recently and can't find anything about shear stresses with open-chain knee extension.
So... either I'm not looking in the right spot or I made an assumption....
The most recent article re. ACL rehab that I have read goes through a progression for return-to-sport (RTS). Based on functional criteria, the athlete can be progressed much more quickly than with the traditional ACL rehab protocol with successful, early RTS as early as 2-3 months. My assumption may have been that because RTS (in some sports) could include running backward, pivoting, kicking.... then open-chain knee extension must not produce a significant enough amount of shear stress to the ACL to contraindicate the activity. (Again, this is my assumption only.)
There is a contact email address for one of the authors. I am going to send off an email to him to see what their group's thought is on this. I'll get back to you re. what I hear.
The article is....
Myer GD, Paterno MV, Ford KR, Quatman CE, Hewett TE. Rehabilitation after Anterior Cruciate Ligament Reconstruction: Criteria-Based Progression Through the Return-to-Sport Phase. J Orthop Sports Phys Ther, 2006; 36(6): 385-402.