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A Journal on Internal Medicine and Pharmacology

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2012 June;171(3):277-85

language: English

Tension on the anterior and posterior cruciate ligament during different kinds of rehabilitation exercises: review of the internal forces acting on the knee in open and closed kinetic-chain exercises

César E. P. 1, 2, Santos T. M. 2, Gomes P. S. C. 2, Silva E. B. 2

1 Antonio Carlos University, Barbacena, MG, Brazil;
2 Gama Filho University, Rio de Janeiro, RJ, Brasil


Aim. The aim of this paper was to review the behavior of different levels of tension on the anterior and posterior cruciate ligaments caused by OKC and CKC exercises in different kinds of muscle actions, critically analyzing the recommendations for rehabilitation programs.
Methods. Randomized clinical trials, prospective studies and controlled laboratory studies, in addition to less direct research, were identified in the PubMed, PEDro, SCIELO and Cochrane databases. Ten studies on anterior cruciate ligament (ACL) tension and seven studies on posterior cruciate ligament (PCL) tension were reviewed.
Results. Tension in the ACL was observed only during OKC exercises, at flexion angles less than 30 degrees, with values that were significantly lower than those tolerated by a healthy ligament. In addition, we found reports of low levels of tension in the ACL during CKC exercises. During dynamic CKC exercises, PCL tension increased proportionally to knee flexion, with a magnitude significantly greater than that found in OKC exercises. In some cases, the type of exercise (OKC or CKC) does not seem to be essential in determining the best ACL and PCL treatments. However, certain factors should be considered including the type of muscular action and overloading. It is important to note that the lack of normative data on the maximum safe tension level for a recuperating structure makes it difficult to reach definitive conclusions on this topic.
Conclusion. Further studies must thus be conducted so that systematic reviews can provide strong conclusions based on solid evidence.

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