TY - GEN
T1 - Evaluation of the need for delayed anterior cruciate ligament reconstruction: Predictors and validation of Knee Outcome Survey and ForceFrame
AU - Arp, Kamilla
PY - 2024/9/17
Y1 - 2024/9/17
N2 - Injury to the anterior cruciate ligament (ACL) injury is a devastating injury
that typically occurs in young and active patients. Muscle weakness, risk of
instability and poor knee function are often consequences of an ACL injury.
These impairments are typically present in the short term but can persist
long term. Rehabilitation as the first line of treatment after an ACL injury
has become common practice, at least in parts of the world. Some patients
will still need ACL reconstruction (ACLR), but it is unclear how these
patients can be identified. Moreover, it is important to assess patients' own
perspectives on their knee using a patient-reported outcome measure
(PROM) and ensuring that loss of muscle strength is re-established after the
injury. These issues may also be important when considering the need for
ACLR.The overall aim of this thesis was to evaluate the necessity for ACLR in
patients with ACL injury after initial treatment with rehabilitation, including
the validation of measurement tools for assessing knee function.Study I was a scoping review that described predictors for ACLR in patients
who were initially treated with rehabilitation. The findings showed that only
two predictors described patients having ACLR; lower age and preinjury
activity level. Study II was a study that translated, culturally adapted and evaluated
measurement properties of Knee Outcome Survey – Activities of Daily
Living Scale (KOS-ADLS) in a Danish ACL-injured population. The findings
showed that the Danish version of KOS-ADLS was valid, reliable and
responsive for assessing symptoms and functional limitations in patients
with ACL injury, but that it has some minor limitations in regard to its
construct validity.Study III was a reproducibility study in which we evaluated validity,
reliability and agreement of the novel dynamometer ForceFrame for
assessing knee extension and flexion strength in patients with ACL injury.
The findings showed that ForceFrame can obtain valid and reliable results
to assess MVIC of knee extension. However, absolute results may be
considered an underestimation of actual MVIC. Positioning patients in a
seated test position when assessing knee flexion using the ForceFrame does
not appear to be optimal, and different test positions may be considered.
AB - Injury to the anterior cruciate ligament (ACL) injury is a devastating injury
that typically occurs in young and active patients. Muscle weakness, risk of
instability and poor knee function are often consequences of an ACL injury.
These impairments are typically present in the short term but can persist
long term. Rehabilitation as the first line of treatment after an ACL injury
has become common practice, at least in parts of the world. Some patients
will still need ACL reconstruction (ACLR), but it is unclear how these
patients can be identified. Moreover, it is important to assess patients' own
perspectives on their knee using a patient-reported outcome measure
(PROM) and ensuring that loss of muscle strength is re-established after the
injury. These issues may also be important when considering the need for
ACLR.The overall aim of this thesis was to evaluate the necessity for ACLR in
patients with ACL injury after initial treatment with rehabilitation, including
the validation of measurement tools for assessing knee function.Study I was a scoping review that described predictors for ACLR in patients
who were initially treated with rehabilitation. The findings showed that only
two predictors described patients having ACLR; lower age and preinjury
activity level. Study II was a study that translated, culturally adapted and evaluated
measurement properties of Knee Outcome Survey – Activities of Daily
Living Scale (KOS-ADLS) in a Danish ACL-injured population. The findings
showed that the Danish version of KOS-ADLS was valid, reliable and
responsive for assessing symptoms and functional limitations in patients
with ACL injury, but that it has some minor limitations in regard to its
construct validity.Study III was a reproducibility study in which we evaluated validity,
reliability and agreement of the novel dynamometer ForceFrame for
assessing knee extension and flexion strength in patients with ACL injury.
The findings showed that ForceFrame can obtain valid and reliable results
to assess MVIC of knee extension. However, absolute results may be
considered an underestimation of actual MVIC. Positioning patients in a
seated test position when assessing knee flexion using the ForceFrame does
not appear to be optimal, and different test positions may be considered.
U2 - 10.21996/vd9q-7g43
DO - 10.21996/vd9q-7g43
M3 - Ph.D. thesis
PB - Syddansk Universitet. Det Sundhedsvidenskabelige Fakultet
ER -