Patient-reported Outcomes and Muscle Strength after a Physiotherapy-led Exercise and Support Brace Intervention in Patients with Acute Injury of the Posterior Cruciate Ligament: A Two-year Follow-up Study

Randi Gram Rasmussen, Julie Sandell Jacobsen, Birgitte Blaabjerg, Torsten Gronbech Nielsen, Martin Lind

Publikation: Bidrag til tidsskriftTidsskriftsartikelForskningpeer review

Abstract

Background
While outcomes of Posterior Cruciate Ligament (PCL) injuries treated surgically are well described, prospective studies reporting outcomes of exercise interventions are lacking.

Purpose
We aimed to investigate changes in patient-reported outcomes of a physiotherapy-led exercise and support brace intervention in patients with acute injury of the PCL over a two-year follow-up period. Furthermore, we sought to investigate changes in isometric knee muscle strength over an eight-month follow-up period, and finally to report conversion to surgical reconstruction over a two-year follow-up period.
Study design
Case series study, prospective

Methods
Fifty patients with an acute injury of the PCL were treated with a brace and a physiotherapy-led exercise intervention and followed prospectively. Changes in patient-reported outcomes were measured with the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) and the Knee injury and Osteoarthritis Outcome Score (KOOS) from baseline (diagnosis) to two-year follow-up. Furthermore, changes in isometric knee flexion and extension strength were measured with a static strength dynamometer from 16 weeks after diagnosis to one-year follow-up. Conversion to surgery was prospectively extracted from medical records. Mean changes were analyzed with a mixed effects model with time as a fixed factor.

Results
The IKDC-SKF score improved 28 (95%CI 24-33) IKDC points from baseline to two-year follow-up. Isometric knee flexion strength of the injured knee increased 0.18 (95%CI 0.11-0.25) Nm/kg from 16 weeks after diagnosis to one-year follow-up, corresponding to an increase of 16%. In contrast, isometric knee extension strength of the injured knee did not change (0.12 (95%CI 0.00-0.24) Nm/kg, p=0.042). Over two years, seven patients converted to PCL surgical reconstruction. One and two-year follow-up were completed by 46 and 31 patients, respectively.

Conclusions
The physiotherapy-led exercise and support brace intervention demonstrated clinically relevant improvements in patient-reported outcomes and knee flexion strength, and the risk of PCL surgical reconstruction was considered low within the first two years.
Level of evidence: 4
OriginalsprogEngelsk
TidsskriftInternational Journal of Sports Physical Therapy
Vol/bind18
Udgave nummer4
Sider (fra-til)807-819
Antal sider12
ISSN2159-2896
DOI
StatusUdgivet - 8 aug. 2023

Emneord

  • Sygdom, sundhedsvidenskab og sygepleje
  • Exercise
  • Knee strength
  • PCL
  • Physiotherapy
  • posterior cruciate ligament

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