Motor performance in different dynamic tests in knee rehabilitation

Functional dynamic tests are increasingly used in rehabilitation after injuries of the lower extremities. In these tests quantitative measures (e.g. time, height, distance) are mainly used as parameters, whereas the quality of the neuromuscular performance is poorly evaluated. In the present study the neuromuscular performance of leg muscles in different motor tasks was investigated 10-16 months after ACL-reconstruction. In 39 subjects with arthroscopically assisted ACL-reconstruction and 20 controls, isometric knee extensor strength, thigh circumference, knee stability, subjective knee function and the neuromuscular performance (by kinematic data and EMG) during three dynamic tests (stair descending, one-legged drop jump, one-legged cyclic hops) were measured. During the strength measurements a superimposed twitch technique was used for the detection of neuromuscular inhibition. The results demonstrate a significantly reduced Lysholm-Score and a distinct strength deficit, but no neuromuscular inhibition and no differences in knee stability in the operated leg. Besides reduced motor abilities of the injured leg, significant differences of the neuromuscular performance could be detected. It was evident that different test conditions revealed different persisting changes of the neuromuscular performance, which could not be detected by kinematic parameters alone.