An evaluation of patients with anterior cruciate ligament reconstruction with an accelerometer and the step-up-and-over test
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Evaluating patient knee function after anterior cruciate ligament reconstruction (ACLR) can be difficult. With current evaluation methods, some patients are unable to return to their previous level of physical activity and if they do, they have a high risk of re-injury. One reason for these poor outcomes could be a lack of evaluation options in the clinic. Clinical evaluations require inexpensive and objective tests that have low physical demand. One objective and low demand test is the step-up-and-over (SUAO). Presently, the test uses a force plate, an expensive device. Replacing the force plate with an accelerometer could make the SUAO test an inexpensive evaluation tool of ACLR patients. Therefore, this thesis had three objectives. First, to discover if an accelerometer is a valid alternative to a force plate for the SUAO test. Second, to determine if the accelerometer-modified SUAO test is performed differently by ACL-intact individual and ACLR patients. Third and final, to determine if a relationship exists between SUAO test performance and subjective knee function. Two studies were completed for this thesis. In the first study, 17 ACL-intact individuals completed the SUAO test while being measured with a force plate and an accelerometer. In the second study, 26 ACL-intact individuals and 25 ACLR patients completed questionnaires on subjective knee function and fear of re-injury, then were measured with an accelerometer during the SUAO test. Results showed that the force plate and accelerometer measures were strongly correlated. Results also showed that the SUAO test, was performed differently by ACL-intact individuals and ACLR patients, and that the test performance was correlated to subjective knee function. Together, these results demonstrate that the SUAO test, with an accelerometer, is a clinically viable option on which normal and abnormal knees perform differently, and that the performance is related to the person’s opinion of their knee’s function.