ReviewSports medicine - open2025
Criteria-Based Decision Making for Introducing Open Kinetic Chain Exercise after-ACL Reconstruction: A Scoping Review.
Review in Sports medicine - open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Eccentric Hamstring Force Asymmetry After Anterior Cruciate Ligament Reconstruction: A Cross-Sectional Comparison of Independent 12- and 24-Month Postoperative Cohorts.Diagnostics (Basel, Switzerland) · 2026Article
- The Effectiveness of Psychological Interventions for Patients Undergoing Anterior Cruciate Ligament Reconstruction: A Meta-Analysis and Systematic Review.Journal of clinical medicine · 2026Review
- Dual-Task Single-Leg Hop Performance Exposes Persistent Asymmetry and Movement Deficits After Anterior Cruciate Ligament Reconstruction: A Randomised Crossover Experimental Study.Translational sports medicine · 2026Article
- Intra-Session Reliability of Eccentric Countermovement Jump Kinetics in Individuals Six Months After Anterior Cruciate Ligament Reconstruction.International journal of sports physical therapy · 2026Article
- Think Outside the Block: Rehabilitation Continuum After ACL Reconstruction with Adaptive Macro-Blocks-A Narrative Review.Healthcare (Basel, Switzerland) · 2025Review
- Early Open Kinetic Chain Hamstring Exercise After ACL Reconstruction: A Retrospective Safety and Efficacy Study.Journal of clinical medicine · 2025Article
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAfter an anterior cruciate ligament reconstruction (ACLR), mounting evidence suggests that open kinetic chain (OKC) strengthening is safe, reduces the risk of anterior knee pain, and significantly improves the quadriceps strength. However, clinicians are reluctant to use OKC knee strengthening exercises mainly due to the strong beliefs that they might increase graft laxity. The objective of this scoping review is to identify the key criteria employed in the scientific literature for the safe introduction of OKC quadriceps strengthening following ACLR.
methodsA scoping review of the literature was conducted on the online databases MEDLINE (PubMed), ScienceDirect, Embase and CINAHL Library online. Data regarding time-based criteria and/or clinical based criteria allowing OKC exercises introduction following ACLR were searched for. Only studies involving patients who performed quadriceps strengthening using any type of OKC exercises were included, regardless of the type, resistance location, load magnitude, type of muscle contraction, knee range of motion, or duration of the strengthening protocol.
resultsTwenty-six studies met the inclusion criteria. Twenty-one employed time-based criteria for the introduction of OKC exercise. The median time from when OKC was permitted was 15 postoperative days (range 1-270 days), while the mean time was 31.6 ± 56.7 postoperative days. In 30.7% of the studies additional clinical examination components were used. These components included range of motion (0-100°), numeric pain scale score < 2 or 3, absence of joint effusion (assess by the stroke test), full knee active extension (assess by the straight leg raise), and walking without crutches for the decision-making regarding OKC exercise introduction.
conclusionLess than one study in 3 reported clinical criteria for the introduction of OKC exercise. This highlights the absence of consensus among surgeons and physiotherapists, thereby hindering their ability to make informed decisions based on scientific evidence. Although the use of OKC exercise appears to be safe, precautions to maintain the integrity of the surgical repair need to be implemented. The establishment of valid criteria is crucial to support evidence-based decision-making.
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