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Open kinetic chain exercises after ACL reconstruction

Open-kinetic chain (OKC) and closed-kinetic chain (CKC) exercises may not differ in their effects on the healing response of the anterior cruciate ligament (ACL)-reconstructed knee. Recent biomechanical studies have shown that the peak strains produced on a graft are similar. Clinical studies sugges Background: Recent studies have shown that an early start of open kinetic chain (OKC) exercises for quadriceps strengthening in a full range of motion (ROM) could increase anterior knee laxity after anterior cruciate ligament (ACL) reconstruction with flexor tendons. However, there are no clinical trials that evaluated outcomes of OKC exercises in a restricted ROM for pain, function, muscle. Background and objectives: Controversy exists in the orthopaedic and physiotherapy world regarding the use of open kinetic chain (OKC) exercises during the post-operative rehab of anterior cruciate ligament reconstruction (ACLR). The often-stated reason for avoiding such as exercises is that it will stretch and damage the surgical graft The purpose of the present investigation was to evaluate physical outcome after anterior cruciate ligament (ACL) reconstruction with early versus late initiation of open kinetic chain (OKC) exercises for the quadriceps in patients operated on either patellar tendon or hamstring grafts. Sixty-eight p

Clinical Viewpoint Considerations with Open Kinetic Chain Knee Extension Exercise Following ACL Reconstruction Kevin E Wilk, PT, DPT, FAPTA 1 a, Christopher A Arrigo, MS, PT, ATC 2 , Michael S Bagwell, PT, DPT, OCS, CMPT 3 , Adam N Finck, PT, DPT, SCS, OCS, CSCS 3 1 Champion Sports Medicine; American Sports Medicine Institute, 2 Advanced Rehabilitation, 3 Champion Sports Medicin The Effects of Open versus Closed Kinetic Chain Exercises on Patients with ACL Deficient or Reconstructed Knees: A Systematic Review. N Am J Sports Phys Ther. 2010;5(2):74-84. Jewiss D, Ostman C, Smart N. Open versus Closed Kinetic Chain Exercises following an Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis and The effect of open- versus closed-kinetic-chain exercises on anterior tibial laxity, strength, and function following anterior cruciate ligament reconstruction: a systematic review and meta-analysis

The ACL prevents anterior translation of the tibia on the femur in open kinetic chain. The ACL also prevents posterior translation of the femur on the tibia in closed kinetic chain. Plot twist: This means that you stress the ACL during both OKC and CKC exercise. It is a well-accepted fact in the rehabilitation community that anterior shear. Knee Extension Strengthening Exercises After ACL Reconstruction. On this episode of the #AskMikeReinold show we talk about whether or not we perform knee extension exercises in the open kinetic chain after ACL reconstruction, and if we still limit them from 90 to 40 degrees of flexion We concluded that closed kinetic chain exercises are safe and effective and offer some important advantages over open kinetic chain exercises. As a result of this study, we now use the closed kinetic chain protocol exclusively after anterior cruciate ligament reconstruction [Purpose] To compare outcomes of anterior cruciate ligament (ACL) reconstruction after open kinetic chain (OKC) exercises and closed kinetic chain (CKC) exercises. [Subjects and Methods] The subjects comprised 11 female and 47 male patients who are randomly divided into two groups: which performed a

13. Mikkelsen, C., S. Werner, and E. Eriksson. Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study. Knee Surg. Sports Traumatol. Arthrosc. 8:337-342, 2000 Mikkelsen, C, Werner, S, Eriksson, E. Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadrictif strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study. Knee Surg Sports Traumatol Arthrosc. 2000;8: 337-342 Mikkelsen C, , Werner S, , Eriksson E. and Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study Bynum et al. Open Versus Closed Chain Kinetic Exercises After Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Study. Am J Sports Med. 1995; 23:401-406. ↑ Jewiss D, Ostman C, Smart N. Open versus Closed Kinetic Chain Exercises following an Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis Background . There is no consensus on whether closed kinetic chain (CKC) or open kinetic chain (OKC) exercises should be the intervention of choice following an anterior cruciate ligament (ACL) injury or reconstruction. Methods . A systematic search identified randomized controlled trials of OKC versus CKC exercise training in people who had undergone ACL reconstructive surgery

We conducted a prospective, randomized study of open and closed kinetic chain exercises during accelerated rehabilitation after anterior cruciate ligament recon struction to determine if closed kinetic chain exercises are safe and if they offer any advantages over conven tional rehabilitation Yes. There's a common misconception that knee extensions are the only activity that stretches and strains the ACL graft. This is simply not true, with commonly used closed kinetic chain exercises straining the ACL as much as knee extensions. In a review by Escamilla et al (2012), the authors highlighted that squatting 0-90deg with or without. The open kinetic chain leg extension exercise should be used with cau-tion; research has shown that the greatest amount of anterior tibial translation-hence the greatest stress on the ACL graft-occurs in the final 30° of leg ex tension performed in an open kinetic chain (87), Therefore, open kinetic chain leg extension exercises should be.

Open- or closed-kinetic chain exercises after anterior

  1. KNEE Early versus late start of open kinetic chain quadriceps exercises after ACL reconstruction with patellar tendon or hamstring grafts: a prospective randomized outcome stud
  2. Open-kinetic chain (OKC) and closed-kinetic chain (CKC) exercises may not differ in their effects on the healing response of the anterior cruciate ligament (ACL)-reconstructed knee. Recent biomechanical studies have shown that the peak strains produced on a graft are similar
  3. Mikkelsen C Werner S Eriksson E. Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study. Knee Surg Sports Traumatol Arthrosc. 2000; 8:337-42

Open kinetic chain exercises in a restricted range of

↑ Mikkelsen C, Werner S, Eriksson E. Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction concerning return to sports: a prospective matched follow-up study. Knee Surgery, Sports Traumatology, Arthroscopy. 2000 Nov 1;8(6):337-42 Open-chain exercises are safe to perform after ACL reconstruction! In the acute stages of recovery, only low loads are needed to elicit muscle failure. As with your other strength exercises, increase the resistance to 60-70% of a patient's 1-rep-max and beyond as they progress through their rehabilitation What has been called closed kinetic chain (CKC) exercise has become popular in the last 5 to 10 years for use after anterior cruciate ligament (ACL) reconstructive surgery. Closed kinetic chain exercises appear to have gained popularity over more traditionally used open kinetic chain (OKC) exercises because many clinicians believe that. Rehabilitation following Anterior Cruciate Ligament Reconstruction (ACLR) is an essential part of a full recovery. Open (OKC) and Closed (CKC) Kinetic Chain Exercises There may be too much stress too early if the patient reports pain at the donor site during or after specific exercises Open versus closed chain exercises after ACL reconstruction- Mr Bill Leach of Glasgow Sports Surgery Service www.gsss.co.u

Open & Closed Chain Exercises post ACL reconstruction

Full-range open-chain knee extension. In an open-chain exercise, the end of the limb is free to move in space. In the case of an ACL injury, this is the foot. For example, a standing squat is a closed-chain exercise, because the feet are on the floor, whereas a seated quadriceps extension is an open-chain exercise because the lower leg is free. Many therapists and surgeons refuse to use resisted open-kinetic chain (OKC) knee extensions with patients who have undergone ACL reconstruction (ACLR) for fear of tearing the ACL/increasing laxity. But when you look at the hordes of research on ACL reconstruction, you can absolutely safely and effectively use knee extensions with this patient. Open Kinetic Chain Exercises in a Restricted Range of Motion After Anterior Cruciate Ligament Reconstruction Thiago Yukio Fukuda, PT, PhD , Deborah Fingerhut, PT , Viviane Coimbra Moreira, PT , Paula Maria Ferreira Camarini, PT , Nathalia Folco Scodeller, PT , Aires Duarte, Jr, MD , Mauro Martinelli, MD , and Flavio Fernandes Bryk, P

Early versus late start of open kinetic chain quadriceps

We concluded that closed kinetic chain exercises are safe and effective and offer some important advantages over open kinetic chain ex ercises. As a result of this study, we now use the closed kinetic chain protocol exclusively after anterior cruciate ligament reconstruction ACL Reconstruction and MCL repair occurs after a contact or non-contact knee injury when the ACL and MCL No isotonic resisted hamstring exercises for 8 weeks with hamstring autograft 3. No loaded open kinetic chain knee extension beyond 45 degrees for 8 WEEKS . 4. Meniscus Repair: a. No weight-bearing (WB) therapeutic exercise >90º x 8 WEEK

Closed kinetic chain and open kinetic chain exercises seem to have similar outcomes on knee laxity, knee pain, and function and therefore can both be used during the rehabilitation of a patient with ACL deficiency or post ACL reconstruction OPEN CHAIN EXERCISES: If patient has full painless ROM and is progressing on schedule, begin with five pounds max. HEP of 10 sets of 10 per day. When patient can perform ten sets of ten without quad fatigue, then advance 5 lbs. Continue to advance up to 25 lbs. DO NOT exceed 25 lbs open chain Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study. Knee Surg Sports Traumatol Arthrosc. 2000;8(6):337-42. Mikkelsen C1, Werner S, Eriksson E. From the study: Abstract Rehabilitation after A safe rehabilitation exercise for anterior cruciate ligament (ACL) injuries needs to be compatible with the normal knee arthrokinematics to avoid abnormal loading on the joint structures. The objective of this study was to measure the amount of the anterior tibial translation (ATT) of the ACL-deficient knees during selective open and closed kinetic chain exercises

Two examples of open kinetic chain exercises performed

For example, in the setting of rehabilitation after anterior cruciate ligament reconstruction, Bynum and colleagues 25 performed a randomized prospective trial comparing open and closed kinetic chain rehabilitation. The closed kinetic chain group had lower mean KT-1000 arthrometer side-to-side differences, less patellofemoral pain, was. Image: Knee extensions are a safe exercise to perform during ACL rehabilitation (at the right time and with the correct technique) A recent systematic review showed that OKC exercises (when prescribed after 6 weeks in a reduced ROM of 45-90deg) did not increase ACL laxity at any follow-up time point (Perriman, Leahy, & Semciw, 2018)

Quadriceps strengthening exercises are often referred to as occurring in the open kinetic chain (OKC) or closed kinetic chain (CKC). Currently, there is little agreement in the literature as to whether only CKC exercises or a combination of OKC and CKC exercise should be performed after ACL reconstruction to strengthen the quadriceps Rehabilitation following Anterior Cruciate Ligament Reconstruction (ACLR) is an essential After an ACL injury, deficits occur in strength Kinetic Chain Exercises OKC exercises have previously been contraindicated in ACLR patients for 6 months up to a year post-operatively, although the concern about the safety of OKC training in th These exercises are typically referred to as either closed kinetic chain (CKC) or open kinetic chain (OKC). During CKC exercises, the foot is fixed to a platform or surface, the motion at the knee joint is accompanied by predictable motions at the hip and ankle joints, and the entire limb is loaded such as during a leg press or squat Rehabilitate Your ACL With These Exercises Best www.verywellhealth.com The next two weeks, you will continue to increase your range of motion, increase quadriceps strength, and perform easy balance exercises Mikkelsen C, Werner S, Eriksson E. Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sport, a prospective matched follow-up study

The term open kinetic chain describes an exercise in which the foot is not in contact with a solid surface, whereas closed kinetic chain describes an exercise in which the The Effect of Open- Versus Closed- Kinetic-Chain Exercises on Anterior Tibial Laxity, Strength, and Function Following Anterior Cruciate Ligament Reconstruction: A Systematic. Rehabilitation after anterior cruciate ligament (ACL) reconstruction has focused over the past decade on closed kinetic chain (CKC) exercises due to presumably less strain on the graft than with isokinetic open kinetic chain exercises (OKC); however, recent reports suggest that there are only minor differences in ACL strain values between some CKC and OKC exercises Open kinetic chain knee exercises are continued during this phase. Both isotonic workloads and isokinetic training sessions are helpful. Care must be taken to protect the healing graft and to avoid patellofemoral joint irritation. Early knee motion after open and arthroscopic anterior cruciate ligament reconstruction. Am J Sports Med. 1984.

The Case for Open Kinetic Chain Exercises in ACLR Rehab

Open kinetic chain exercises in a restricted range of motion after anterior cruciate ligament reconstruction: a randomized controlled clinical trial. Thiago Yukio Fukuda Santa Casa de São Paulo, Setor de Fisioterapia, Rua Dr Cesário Motta 112, 01221-020, São Paulo-SP, Brazil Open kinetic chain exercises in a restricted range of motion after anterior cruciate ligament reconstruction: a randomized controlled clinical trial Am J Sports Med , 41 ( 4 ) ( 2013 ) , pp. 788 - 79 Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study. AU Mikkelsen C, Werner S, Eriksson E SO Knee Surg Sports Traumatol Arthrosc. 2000;8(6):337 Thirty-seven patients who had undergone anterior cruciate ligament reconstruction were tested in a gait analysis laboratory at 2 and 6 weeks after surgery. Between test sessions, patients were randomly assigned to a course of either closed or open kinetic chain resistance exercises (3 sessions per week for 4 weeks). Gait analysis consisted of bilateral calculations of knee joint angle, moment.

Open versus closed chain kinetic exercises after anterior cruciate ligament reconstruction Am J Sports Med , 23 ( 1995 ) , pp. 401 - 406 CrossRef View Record in Scopus Google Schola Open versus closed chain kinetic exercises after anterior cruciate ligament reconstruction. A prospective randomized study. Am J Sports Med. 1995 Aug;23(4):401-6. ↑ Uçar M, Koca I, Eroglu M, Eroglu S, Sarp U, Arik HO, et al. Evaluation of Open and Closed Kinetic Chain Exercises in Rehabilitation Following Anterior Cruciate Ligament. Shelbourne, KD & Nitz, P. Accelerated rehabilitation after anterior cruciate ligament reconstruction. The American Journal of Sports Medicine, 18(3): 292-299, 1990; Escamilla, et al. Biomechanics of the knee during closed kinetic chain and open kinetic chain exercises Conservative Treatment for ACL Rupture. The rehab program consisted of single- and multiple-joint exercises; open and closed kinetic chain exercises; and concentric, eccentric, and isometric exercises with 3 to 4 sets and 6 to 8 repetitions per exercise. Plyometric exercises were gradually progressed

Who's Afraid of the Big Bad Wolf? Open-Chain Exercises

Vol. 41, No. 4, 2013 Open Kinetic Chain Exercises After ACL Reconstruction 789 Downloaded from ajs.sagepub.com at UNIV OF SOUTHERN CALIFORNIA on April 29, 2013 of all tests and questionnaires at 12 weeks, 19 weeks, 2 [Purpose] The purpose of this study was to compare the strength and endurance between open and closed kinematic chain exercises after anterior cruciate ligament reconstruction. [Subjects] Sixty-two subjects ac-tively participating in rehabilitation for anterior cruciate ligament reconstruction for the last 3 month were chosen

- Comparison of closed and open kinetic chain exercises in the anterior cruciate ligament deficient knee. - Intra-articular cruciate reconstruction. I: Perspectives on graft strength, vascularization, and immediate motion after replacement After ACL Reconstruction Philosophy of Rehabilitation Rehabilitation, as it applies to the recovery period from were designed for open surgery using patella tendon grafts. Firstly, with open surgery, there is a need to Kinetic Chain Exercises These come in 2 varieties, closed and open. The difference is that, in closed a kinetic chain. Avoid open kinetic chain knee extension machine. inue to stress functional training exercises and endurance activities• Cont • May begin retro ambulation on treadmill ion and educate patients regarding the revascularization of the ACL graft from weeks • Cau

Are Open Kinetic Chain Exercises Really OK for ACL Rehab

The Effects of Open versus Closed Kinetic Chain Exercises on Patients with ACL Deficient or Reconstructed Knees: A Systematic Review.North American Journal of Sports Physical Therapy : NAJSPT. 2010;5(2):74-84. • Hinckel B, Demange M, Gobbi R, J, Camanho G. The Effect of Mechanical Varus on Anterior Cruciate Ligament and Lateral Collatera chain exercises (CKC) and Open kinetic chain exercises (OKC) play an important role in regaining muscle (quadriceps, hamstrings) Gaining good functional stability and strength and knee stability. Reaching the best possible functional level and decrease the risk for re-injury. A consistent approach to rehabilitation after ACL reconstruction can. versions of both open kinetic chain (OKC) and closed kinetic chain (CKC) exercises must now be used for safe, effective and thorough rehabilitation of all types of knee injury. The purpose of this course is to present you with advanced concepts in OKC and CKC exercise in knee rehabilitation for ACL, PCL, MCL, LCL, and meniscus injury an

Open- or Closed-Kinetic Chain Exercises After ACLACL Injury Prevention Program

Knee Extension Strengthening Exercises After ACL

ACL Reconstruction Guideline • May initiate open kinetic chain knee extension strengthening exercises at 4 weeks post-op from 90 degrees-45 degrees challenges with balance exercises Goals of Phase: 1. Prevention of post-operative complications 2. Reducing fear with regaining ROM Is knee laxity change after ACL injury and surgery related to open kinetic chain knee extensor training load? Am J Phys Med Rehabil. 2009 May;88(5):369-75. Morrissey MC, Perry MC, King JB. From the study: OBJECTIVE: The purpose of this study was to evaluate whether knee anterior laxity changes after anterio

Open versus closed chain kinetic exercises after anterior

[Purpose] To compare outcomes of anterior cruciate ligament (ACL) reconstruction after open kinetic chain (OKC) exercises and closed kinetic chain (CKC) exercises. [Subjects and Methods] The subjects comprised 11 female and 47 male patients who are randomly divided into two groups: which performed a CKC exercise program Group I and Group II. Reasons why open kinetic chain (OKC) exercises (ie: leg extensions especially with weight) are contraindicated after ACL reconstruction: When the quadricep muscle contracts with the above exercises, the lower leg (tibia) is pulled forward (shears) in relation to the upper leg (femur). This shear directly stresses the reconstructed ACL graft Continue focus on closed kinetic chain quadriceps strength with Leg press, squats, step -up/downs, lateral stepping, multi Focus on avoidance of knee valgus Progress closed kinetic strength hamstring to open kinetic chain as able Blood flow restriction training Continue 2-3 times per week utilizing 3-5 exercises In efforts to restore optimal lower limb function after anterior cruciate ligament (ACL) reconstructive surgery, a variety of exercise protocols have evolved. In the 1990s, most often advocated were nonweightbearing or open kinetic chain knee extensor resistive exercises introduced only afte

Closed chain knee extension to step - YouTube

Evaluation of open and closed kinetic chain exercises in

Closed kinetic chain (CKC) exercises should be performed in the protected range of 0-45° of flexion and open kinetic chain (OKC) knee extension exercises should stay in the protected range of 90-60° of flexion. Post-Op ACL Reconstruction Return to Sport Test REHABILITATION FOLLOWING ACL RECONSTRUCTION For Dr. Crockett and Dr. May Use of ROM brace locked out at zero degrees extension for ambulation for six weeks No running for four months after surgery No Biodex or KT testing for four-six months after surgery No resisted open chain knee extension exercises 0-2 week I. Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study. Mikkelsen C, Werner S, Eriksson E Knee Surg, Sports Traumatol, Arthrosc 2000; 8: 337-342 II

Open- or Closed-Kinetic Chain Exercises After Anterior

Open Kinetic Chain Exercises in a Restricted Range of

The following anterior cruciate ligament (ACL) reconstruction rehabilitation protocol is specific to patients with a quadriceps tendon autograft. If a hamstring autograft was used, please refer to the Anterior Cruciate Ligament (ACL) Reconstruction: Hamstring Autograft protocol on the Ohio State Sports Medicine website Therapeutic Exercises: {Reminder: ACL reconstruction performed with meniscal repair or transplant: follow the ACL protocol with avoidance of open kinetic hamstring strengthening for 6 weeks} • Initiate active-assisted leg curls; progress to active range of motion when pain free • Heel slides • Quad sets • Patellar mobilizatio Open-kinetic chain (OKC) and closed-kinetic chain (CKC) exercises may not differ in their effects on the healing response of the anterior cruciate ligament (ACL)-reconstructed knee. Recent biomechanical studies have shown that the peak strains produced on a graft are similar. Clinical studies suggest that both play a beneficial role in the early rehabilitation of the reconstructed knee

Anterior Cruciate Ligament (ACL) Rehabilitation - Physiopedia

The Effect of Open- Versus Closed-Kinetic-Chain Exercises

2. No open chain hamstring strengthening or isolated hamstring exercises Initiate submaximal leg extension 90-45 degrees Initiate knee AROM 90-0 degrees (modify if painful) 3. No hamstring stretching 4. Avoid dynamic knee valgus with all interventions, including warm-up and endurance activities 5. ACL graft at its weakest at 8-10 week 3-4 weeks - initially hamstring strengthening is achieved via co-contraction (closed kinetic chain). It is important to concentrate on hamstring stretches and increase resistance gradually to prevent recurrent injury. 4-6 weeks - open kinetic chain hamstring strengthening may begin but care must be taken to avoid strain injury as it impedes. • For ACL reconstruction performed with meniscal repair or transplant, defer to ROM Exercises: • Active-assisted leg curls 0-1 week. Progress to active as tolerated after 1 week. Delay • Initiate open kinetic chain leg extension (90o-30o), progress to eccentrics as tolerate This study try to present a comparative evaluation between open kinetic chain(OKC) and closed kinetic chain(CKC) in rehabilitation the stability of knee, after ACL reconstruction, using the role of proprioceptive system of knee, because we want to obtain an early return to sport activity. Key words: kinetic chain, rehabilitation, ACL In open kinetic chain exercise, the leg is free to move in various directions. In closed kinetic chain exercise, the leg is fixed to a surface as the joints closer to the body work. Recent evidence has suggested that closed chain exercises are safer and have better results after ACL reconstruction. But very little research has been done to.

Anterior Cruciate Ligament (ACL) Rehabilitation - Physiopedi

Because the deadlift is considered a closed kinetic chain exercise (23), it can also be employed in knee rehabilitation programs, such as after anterior cruciate ligament (ACL) reconstruction. Numerous studies have already shown that the squat is an effective exercise during ACL rehabilitation (11,15,20,22,25,26,29) (47) Heijne A, Werner S. Early versus late start of open kinetic chain quadriceps exercises after ACL reconstruction with patellar tendon or hamstring grafts: a prospective randomized outcome study. Knee Surg Sports Traumatol Arthrosc 2007;15:402-414. (54) Isberg J, Faxen E, Brandsson S, Eriksson BI, Karrholm J, Karlsson J The next two weeks, you will continue to increase your range of motion, increase quadriceps strength, and perform easy balance exercises. Build a range of motion from 0 to 110 degrees Veja grátis o arquivo Open kinetic chain exercises in a restricted rangeof motion after ACL reconstruction (AJSM 2013) enviado para a disciplina de Fisioterapia das Disfunções Neuro-músculo-esqueléticas III Categoria: Outro - 2 - 397606

Open versus Closed Kinetic Chain Exercises following an

Heijne A., Werner S. Early versus late start of open kinetic chain quadriceps exercises after ACL reconstruction with patellar tendon or hamstring grafts: a prospective randomized outcome study. Knee Surg Sport Traumatol Arthrosc. 2007; 15:472-473. [Google Scholar Mikkelsen C, Werner S, Eriksson E (2000) Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study

In open kinetic chain exercises, the segment furthest away from the body — known as the distal aspect, usually the hand or foot — is free and not fixed to an object. In a closed chain exercise. What has been called closed kinetic chain (CKC) exercise has become popular in the last 5 to 10 years for use after anterior cruciate ligament (ACL) reconstructive surgery. Closed kinetic chain exercises appear to have gained popularity over more traditionally used open kinetic chain (OKC) exercises because many clinicians believe that CKC. Open versus Closed Kinetic Chain Exercises following an Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis DanielJewiss,1 CeciliaOstman,1 andNeilSmart2 1SchoolofRuralMedicine,UniversityofNewEngland,Armidale,NSW2351,Australia 2SchoolofScienceandTechnology,UniversityofNewEngland,Armidale,NSW2351,Australi Background There is no consensus on whether closed kinetic chain (CKC) or open kinetic chain (OKC) exercises should be the intervention of choice following an anterior cruciate ligament (ACL) injury or reconstruction. Methods A systematic search identified randomized controlled trials of OKC versus CKC exercise training in people who had undergone ACL reconstructive surgery Early full weight-bearing exercises, early open and closed kinetic-chain exercises, cryotherapy and neuromuscular electrostimulation may be used according individual circumstances. The CPGs recommend against continuous passive motion and functional bracing. Conclusion The quality of the CPGs in ACL postoperative rehabilitation was good, but all.