Document Detail


Cruciate ligament forces in the human knee during rehabilitation exercises.
MedLine Citation:
PMID:  10656979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the cruciate ligament forces occurring during typical rehabilitation exercises.Design. A combination of non-invasive measurements with mathematical modelling of the lower limb.Background. Direct measurement of ligament forces has not yet been successful in vivo in humans. A promising alternative is to calculate the forces mathematically. METHODS: Sixteen subjects performed isometric and isokinetic or squat exercises while the external forces and limb kinematics were measured. Internal forces were calculated using a geometrical model of the lower limb and the "dynamically determinate one-sided constraint" analysis procedure. RESULTS: During isokinetic/isometric extension, peak anterior cruciate ligament forces, occurring at knee angles of 35-40 degrees, may reach 0.55x body-weight. Peak posterior cruciate ligament forces are lower and occur around 90 degrees. During isokinetic/isometric flexion, peak posterior cruciate forces, which occur around 90 degrees, may exceed 4x body-weight; the anterior cruciate is not loaded. During squats, the anterior cruciate is lightly loaded at knee angles up to 50 degrees, after which the posterior cruciate is loaded. Peak posterior cruciate forces occur near the lowest point of the squat and may reach 3.5x body-weight. CONCLUSIONS: For anterior cruciate injuries, squats should be safer than isokinetic or isometric extension for quadriceps strengthening, though isokinetic or isometric flexion may safely be used for hamstrings strengthening. For posterior cruciate injuries, isokinetic extension at knee angles less than 70 degrees should be safe but isokinetic flexion and deep squats should be avoided until healing is well-advanced. RELEVANCE: Good rehabilitation is vital for a successful outcome to cruciate ligament injuries. Knowledge of ligament forces can aid the physician in the design of improved rehabilitation protocols.
Authors:
D E Toutoungi; T W Lu; A Leardini; F Catani; J J O'Connor
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical biomechanics (Bristol, Avon)     Volume:  15     ISSN:  0268-0033     ISO Abbreviation:  Clin Biomech (Bristol, Avon)     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-03-07     Completed Date:  2000-03-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8611877     Medline TA:  Clin Biomech (Bristol, Avon)     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  176-87     Citation Subset:  IM    
Affiliation:
Cambridge Consultants Ltd., Science Park, Milton Rd, Cambridge, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anterior Cruciate Ligament / injuries,  physiology*
Body Weight
Electromyography
Exercise Therapy*
Humans
Isometric Contraction / physiology
Knee Joint / physiology*
Models, Biological
Muscle Contraction / physiology
Muscle, Skeletal / physiology
Posterior Cruciate Ligament / injuries,  physiology*
Range of Motion, Articular / physiology
Safety
Signal Processing, Computer-Assisted
Stress, Mechanical
Tendons / physiology
Thigh / physiology
Treatment Outcome
Weight-Bearing / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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