Open vs. closed kinetic chain exercises after ACL surgery
Controversy surrounding the use of open kinetic chain (OKC) exercises following anterior cruciate ligament (ACL) reconstruction, especially in the early phases has evolved over many decades.
It is known that the ACL graft is at its most vulnerable during the first 6-12 weeks following surgery, and it has been theorised that OKC exercises lead to increased laxity in the graft, thus placing it at greater risk of of failure.
The current systematic review however, concludes that based upon the current available evidence, there does not appear to be any significant difference in graft laxity, quadriceps strength, patient-report function or physical function.
Overall, based on the current low-medium quality evidence, there does not appear to be any significant difference in graft laxity, quadriceps strength, patient-report function or physical function.
It is important to note that a large proportion of participants was male and therefore the results may not be as applicable to females. Furthermore, higher quality randomised controlled trials in the future would be beneficial to further evaluate this topic.
> From: Perriman et al., J Orthop Sports Phys Ther 48 (2018) 552-566. All rights reserved to Journal of Orthopaedic & Sports Physical Therapy. Click here for the online summary.