Morgan DiSipio

Tech & Assess.

Dr. Stephen Cone

17 November 2015

Assessment Project

Problem

  1. The purpose of the rating scale is to measurerecovery of ACL reconstruction after six months post-surgery as compared to the knee pre-injury.

Refining the Problem

  1. This scale is designed for any athlete going through ACL reconstruction. It can be used for any age level, sex, or expertise level to determine if they are physically ready to return to play.
  2. “The incidence of a second injury to the anterior cruciate ligament (ACL) within the first 12 months after ACL reconstruction and return to sport in a young, active population has been reported to be 15 times greater than a previously uninjured cohort.” (Porucznik). Could a possible reason for this reinjured knee be the return to sport before an athlete is truly ready? This scale would be used to test if participants are actually back to 100% at the six month mark of ACL reconstruction. Baseline data would be collected at the beginning of the season in each of the five components for both the right and left legs. If an athlete experiences ACL tear, they will be retested of the same five components six months after surgery. By comparing the data, researchers would be able to identify a participant’s readiness to return to play.
  3. This scale contains five different components both will be measured before the injury for a baseline and then again six months after the injury. The five components are range of motion (ROM), balance, strength, time able to run without pain, and sensation. All of these components are essential to being able to participate effectively in sport. If a person is lacking any single component, they could be more susceptible to knee injury. If range of motion is not fully recovered, the person can risk being pushed passed their ROM and retearinn the ACL. If they cannot balance correctly, they risk falling which again which can retear the ACL. If their knee is weaker or pain is caused with action, this is a sign that the knee is not fully recovered and risks being reinjured, and finally, if an athlete is lacking sensation in their knee, they may not feel certain things that can be injuring their ACL.

Instrumentation and Methodology

  1. This scale runs on a pass/fail basis. The athlete must be sufficient in each of the five components to pass (return to play). If an athlete is lacking in just one of these components, their risk for knee re-injury is greater. This athlete would “fail” and not be permitted to return to play until they are retested and pass.
  2. It is important a facilitator is correctly measuring the components to see if a participant is able to return to play. The facilitator should be a health professional (ie. Doctor, physical/occupational therapist, or athletic trainer) and should be experienced in using the following tools. In order to measure range of motion, the facilitator would use a goniometer to measure to angle of extension of the knee (straight) and the maximum angle of flexion of the knee (bent). If the post-surgery results are within 5 degrees of the original measurement, the participant may pass this category. To measure balance in both pre and post assessment, the athlete is to stand on the injured leg (measure both legs in pre-assessment), the participant closes their eyes. The facilitator times (seconds) how long the participant can stand like this before coming unstable and wobbling. If the time exceeds 2 minutes, you may stop. If the post test results fall within 10 seconds of the pre test, the participant may pass this category. To measure strength, an athlete will need to use a leg press machine. In pretest, the facilitator will measure each leg by its self, in the post test the facilitator will measure on the injured knee alone. Measure the maximum weight a participant can do for 10 reps. if the post test results are within 10 pounds of the original results, the participant passes. To measure time running without pain, the participant runs on a treadmill at a comfortable pace for as long as they can without knee pain or up to 1 mile for the pre test.In the post test, make sure the participant in running at the same speed as the pre test. Measure the amount of time before the experienced knee pain. If this measurement falls within 30 seconds of the original, the participant may pass. Finally, for sensation using tools with different textures (about 5 levels hard-soft) rub the knee, record the lightest texture the participant can feel. For post test, do the same on the injured knee, if the participant can feel the at least one level above the pretest results, they pass this test.

Analysis of Results

  1. The results of this test are important to determining if a participant may return to play on not. If participants do not pass the exam, they can be retested again in two weeks. This cycle will continue until passing scores are met.

References:

Porucznik, Mary. "Athletes Risk Second ACL Injury After ACL Reconstruction." American Academy of Orthopaedic Surgeons. 1 Aug. 2013. Web. 17 Nov. 2015. <