Hamstring Co-Contraction in the Early Stage of Rehabilitation After Anterior Cruciate Ligament Reconstruction: A Longitudinal Study

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Abstract

Objective

Hamstring co-contraction may affect recovery from anterior cruciate ligament reconstruction. The aim of the study was to evaluate the changes in hamstring co-contraction during the early postoperative stages.

Design

Twenty-five patients with anterior cruciate ligament reconstruction were followed up for 1–3 mos postoperatively, during which the Lysholm and International Knee Documentation Committee questionnaires were completed and surface electromyograms were assessed during terminal knee extension maximum voluntary contraction and step-up tests. The integrated electromyogram of the tested muscles and co-contraction ratio were analyzed.

Results

Co-contraction ratio during terminal knee extension maximum voluntary contraction at 3 mos postoperatively was significantly less than that at 1 mo postoperatively (P < 0.0083), and it did not significantly differ from that of the uninvolved knee. In contrast, the co-contraction ratio during step-up was significantly higher at 2 and 3 mos postoperatively than that before surgery (P < 0.0167) and for the uninvolved knee (P < 0.05). Moreover, the postoperative hamstring co-contraction ratio in patients with a chronic injury was significantly higher during the step-up test than in patients with an early injury (P = 0.017).

Conclusions

Hamstring co-contraction ratio during terminal knee extension maximum voluntary contraction recovers during the early postoperative stages. However, hamstring co-contraction ratio during step-up, which may be related to knee joint proprioception, remains high, particularly for patients with a chronic injury.

Clinical Trial

ChiCTR-COC-17011167.

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