Evidence map›Paper›PMID 30182287›Full record

Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019

Cross-education does not improve early and late-phase rehabilitation outcomes after ACL reconstruction: a randomized controlled clinical trial.

Tjerk Zult, Alli Gokeler, Jos J A M van Raay, Reinoud W Brouwer, Inge Zijdewind, Jonathan P Farthing, Tibor Hortobágyi

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Trial
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  7. Review
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  13. Tibial slope and medial meniscectomy significantly influence short-term knee laxity following ACL reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Tjerk ZultCenter for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. tjerk.zult@anglia.ac.uk.
Alli GokelerCenter for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Jos J A M van RaayDepartment of Orthopedic Surgery, Martini Hospital, Groningen, The Netherlands.
Reinoud W BrouwerDepartment of Orthopedic Surgery, Martini Hospital, Groningen, The Netherlands.
Inge ZijdewindDepartment of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Jonathan P FarthingCollege of Kinesiology, University of Saskatchewan, Saskatoon, Canada.
Tibor HortobágyiCenter for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Funding

Start-up fund from the University Medical Center Groningen 653013
6 · The paper itself

Abstract

purposeLimited evidence suggests that cross-education affords clinical benefits in the initial 8 weeks after anterior cruciate ligament (ACL) reconstruction, but it is unknown if such cross-education effects are reproducible and still present in later phases of rehabilitation. We examined whether cross-education, as an adjuvant to standard therapy, would accelerate the rehabilitation up to 26 weeks after ACL reconstruction by attenuating quadriceps weakness.

methodsACL-reconstructed patients were randomized into experimental (n = 22) and control groups (n = 21). Both groups received standard care after ACL reconstruction. In addition, the experimental group strength trained the quadriceps of the non-operated leg during weeks 1-12 after surgery (i.e., cross-education). Self-reported knee function was assessed with the Hughston Clinic Knee score as the primary outcome. Secondary outcomes were maximal quadriceps and hamstring strength and single leg hop distance. All outcomes were measured 29 ± 23 days prior to surgery, as a reference, and at 5-week, 12-week, and 26-week post-surgery.

resultsBoth groups scored 12% worse on self-reported knee function 5-week post-surgery (95% CI 7-17) and showed 15% improvement 26-week post-surgery (95% CI - 20 to - 10). No cross-education effect was found. Interestingly, males scored 8-10% worse than females at each time point post-surgery. None of 33 secondary outcomes showed a cross-education effect. At 26-week post-surgery, both legs improved maximal quadriceps (5-14%) and hamstring strength (7-18%), and the non-injured leg improved 2% in hop distance. The ACL recovery was not affected by limb dominance and age.

conclusion26 weeks of standard care improved self-reported knee function and maximal leg strength relative to pre-surgery and adding cross-education did not further accelerate ACL recovery. LEVEL OF EVIDENCE: I. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION: This randomized controlled clinical trial is registered at the Dutch trial register ( http://www.trialregister.nl ) under NTR4395.

Indexed as

Muscle StrengthAdolescentAdultAnterior Cruciate LigamentAnterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionFemaleHamstring MusclesHumansKneeKnee InjuriesMaleQuadriceps MuscleRecovery of FunctionResistance TrainingSelf ReportAnterior cruciate ligament reconstructionHughston Clinic Knee scoreLimb symmetry indexMaximal voluntary forceResistance training

Identifiers

PMID30182287

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.