Doctor of Philosophy (PhD)
Kinesiology and Nutrition Sciences
First Committee Member
Julia Freedman Silvernail
Second Committee Member
Third Committee Member
Fourth Committee Member
Number of Pages
The anterior cruciate ligament (ACL) is commonly injured, especially in individuals under the age of 25. ACL reconstruction (ACLR) is the most common treatment after ACL injury, followed by physical therapy. However, successful surgery and completion of rehabilitation, individuals still demonstrate quadriceps weakness and asymmetries during locomotion. To improve these deficits, an intervention that improves quadriceps strength and lower extremity biomechanics during locomotion is required. First, we aimed to complete a systematic review of the literature to determine the efficacy of resistance training in improving outcomes after ACLR. Second, we aimed to identify if a history of resistance training positively influences limb symmetry in individuals with ACLR during locomotion. We hypothesized that due to the strength adaptations of resistance training, individuals with ACLR who resistance train will move more symmetrically than those who do not. Lastly, we aimed to evaluate the relationship between lower extremity LBM and limb symmetry in individuals with ACLR during locomotion. We hypothesized that lower extremity lean body mass (LBM) would be positively associated with limb symmetry.
From our systematic review, we can conclude that resistance training should be used by clinicians in rehabilitation after ACL reconstruction due to the improvements in muscle size and strength. Secondly, we found that during walking, the resistance trained group demonstrated greater LSI for knee range of motion (d=1.20), peak knee flexion angle (d=1.05), and peak knee extensor moment (d=1.51). We found similar results during running, as the resistance trained group demonstrated greater LSI for knee range of motion (d=1.13), peak knee flexion angle (d=1.32), and peak knee extensor moment (d=1.17). During the sit to stand task, the resistance trained group demonstrated greater LSI for peak vertical GRF (d=1.12) and peak knee extensor moment (d=0.71). Lastly, lower extremity LBM was positively associated with knee range of motion LSI (F1,21= 6.16, p=0.022) during walking. For running, lower extremity LBM was positively associated with knee range of motion LSI (F1,21= 4.726, p=0.042), peak knee flexion angle LSI (F1,21= 9.200, p=0.007) and knee extensor moment LSI (F1,21= 8.124, p=0.020). For the sit to stand task, lower extremity LBM was positively associated peak knee extensor moment LSI (F1,21= 6.673, p=0.018).
Our results demonstrate that resistance training is effective in improving muscle strength after surgery. Additionally, individuals who have had ACLR who resistance train after surgery move more symmetrically than those who do not during functional tasks. An adaptation of resistance training is increased lower extremity LBM, which is positively associated with limb symmetry index during locomotion. Therefore, individuals should resistance train after ACLR to increase the odds of moving symmetrically, which has implications for knee osteoarthritis. Furthermore, clinicians should incorporate resistance training and interventions to improve lower extremity LBM after ACLR. Future aims should prospectively investigate the effects of resistance training after ACLR.
ACL; ACL reconstruction; anterior cruciate ligament; gait; resistance training
University of Nevada, Las Vegas
Choe, Kevin H., "The Influence of Resistance Training on Post Surgical Outcomes in Individuals with Anterior Cruciate Ligament Injury" (2021). UNLV Theses, Dissertations, Professional Papers, and Capstones. 4132.
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