Open Versus Closed Chain Kinetic Exercises After Anterior Cruciate Ligament Reconstruction

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Abstract
We conducted a prospective, randomized study of open and closed kinetic chain exercises during accelerated rehabilitation after anterior cruciate ligament recon struction to determine if closed kinetic chain exercises are safe and if they offer any advantages over conven tional rehabilitation. The closed kinetic chain group used a length of elastic tubing, the Sport Cord, to per form weightbearing exercises and the open kinetic chain group used conventional physical therapy equip ment. Results are reported with a minimum 1-year fol lowup (mean, 19 months). Pre- and postoperative evaluation included the Lysholm knee function scoring scale, Tegner activity rating scale and KT-1000 ar thrometer measurements. Overall, stability was re stored in over 90% of the knees. Preoperative patel lofemoral pain was reduced significantly; 95% of the patients had a full range of motion. The closed kinetic chain group had lower mean KT-1 000 arthrometer side- to-side differences, less patellofemoral pain, was gen erally more satisfied with the end result, and more often thought they returned to normal daily activities and sports sooner than expected. We concluded that closed kinetic chain exercises are safe and effective and offer some important advantages over open kinetic chain ex ercises. As a result of this study, we now use the closed kinetic chain protocol exclusively after anterior cruciate ligament reconstruction.