{"id":2360,"date":"2018-05-02T12:31:03","date_gmt":"2018-05-02T12:31:03","guid":{"rendered":"https:\/\/andreasphysioblog.com\/?p=2360"},"modified":"2021-06-13T04:56:55","modified_gmt":"2021-06-13T04:56:55","slug":"criteria-for-return-for-running-after-anterior-cruciate-ligament-reconstruction-a-scoping-review","status":"publish","type":"post","link":"https:\/\/andreasphysioblog.com\/?p=2360","title":{"rendered":"Criteria for return for running after anterior cruciate ligament reconstruction: a scoping review"},"content":{"rendered":"<header class=\"entry-header\">\n<h1 class=\"entry-title\">Criteria for return for running after anterior cruciate ligament reconstruction: a scoping\u00a0review<\/h1>\n<\/header>\n<div class=\"entry-body\">\n<div class=\"entry-meta\"><\/div>\n<div class=\"entry-content\">\n<p><img decoding=\"async\" class=\"alignnone size-full wp-image-13887\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-02-16.png?w=825\" sizes=\"(max-width: 825px) 100vw, 825px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-02-16.png?w=825 825w, https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-02-16.png?w=150 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-02-16.png?w=300 300w, https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-02-16.png?w=768 768w, https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-02-16.png?w=1024 1024w, https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-02-16.png 1096w\" alt=\"Sk\u00e6rmbillede 2018-05-02 kl. 21.02.16.png\" data-attachment-id=\"13887\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2018\/05\/02\/criteria-for-return-for-running-after-anterior-cruciate-ligament-reconstruction-a-scoping-review\/skaermbillede-2018-05-02-kl-21-02-16\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-02-16.png\" data-orig-size=\"1096,256\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2018-05-02 kl. 21.02.16\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-02-16.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-02-16.png?w=825\" \/><\/p>\n<div class=\"highwire-cite-authors\"><a href=\"http:\/\/bjsm.bmj.com\/content\/early\/2018\/05\/02\/bjsports-2017-098602.info\"><span class=\"highwire-citation-authors\"><span class=\"highwire-citation-author first\"><span class=\"nlm-surname\">Rambaud<\/span>\u00a0AJM<\/span>,\u00a0<span class=\"highwire-citation-author\"><span class=\"nlm-surname\">Ardern<\/span>\u00a0CL<\/span>,\u00a0<span class=\"highwire-citation-author\"><span class=\"nlm-surname\">Thoreux<\/span>\u00a0P<\/span><\/span><span class=\"citation-et\">, et al\u00a0<\/span>Criteria for return for running after anterior cruciate ligament reconstruction: a scoping review<\/a><\/div>\n<div class=\"highwire-cite-metadata bmjj-citation-metadata\"><a href=\"http:\/\/bjsm.bmj.com\/content\/early\/2018\/05\/02\/bjsports-2017-098602.info\"><span class=\"highwire-cite-metadata-journal highwire-cite-metadata\">Br J Sports Med\u00a0<\/span><span class=\"highwire-cite-metadata-date highwire-cite-metadata\"><span class=\"label\">Published Online First:<\/span>\u00a002 May 2018.\u00a0<\/span><span class=\"highwire-cite-metadata-doi highwire-cite-metadata\"><span class=\"label\">doi:<\/span>\u00a010.1136\/bjsports-2017-098602<\/span><\/a><\/div>\n<div><\/div>\n<div>After ACL reconstruction an important milestone is returning to running (RTR), however there is a lack of information regarding when the patient can RTR following ACL reconstruction..<\/div>\n<h2>The authors research question was: \u2018Which criteria are used to determine when the patient can return to running following primary ACL reconstruction?\u2019<\/h2>\n<p><img decoding=\"async\" class=\"alignnone size-full wp-image-13888\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-08-28.png?w=825\" sizes=\"(max-width: 616px) 100vw, 616px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-08-28.png 616w, https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-08-28.png?w=115 115w, https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-08-28.png?w=230 230w\" alt=\"Sk\u00e6rmbillede 2018-05-02 kl. 21.08.28.png\" data-attachment-id=\"13888\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2018\/05\/02\/criteria-for-return-for-running-after-anterior-cruciate-ligament-reconstruction-a-scoping-review\/skaermbillede-2018-05-02-kl-21-08-28\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-08-28.png\" data-orig-size=\"616,802\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2018-05-02 kl. 21.08.28\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-08-28.png?w=230\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2018\/05\/skc3a6rmbillede-2018-05-02-kl-21-08-28.png?w=616\" \/><\/p>\n<p>Discussion In this scoping review that included 201 articles, time was the most frequently reported criterion for clearing patients to RTR after primary ACL reconstruction. The median time for clearance to RTR was 12 postoperative weeks (IQR=3.3, range 5\u201339 weeks). The time criterion for RTR has changed over the years mirroring changes in rehabilitation approaches. Fewer than one in five studies reported clinical, strength or performance-based criteria for RTR, the most frequently reported being: full knee RoM or &gt;95% of the non-injured knee; pain &lt;2 on visual analogue scale; isometric lower limb strength LSI&gt;70%; isokinetic quadriceps and hamstring strength LSI&gt;70%; and hop test LSI&gt;70%.<\/p>\n<h2>Clinical criteria are important indicators of adequate loading when returning to running<\/h2>\n<p>We suggest that these clinical criteria: pain &lt;2 on visual analogue scale, 95%knee flexion RoM\u00a0(side to side difference), full extension RoM (0\u00b0 knee extension), no effusion\/trace of effusion, should be used as \u2018non-negotiable\u2019 clinical milestones for RTR\u2014patients must fulfil these criteria before RTR as a way to ensure adequate loading.<\/p>\n<p>We propose the term return-to-running activities to describe the phase of RTR at a slow speed (8\u201310km\/ hour), but it may be relevant to establish consensus on the definition of the term \u2018running\u2019. Since authors report general criteria that governed rehabilitation progression, our analysis of the time-based criteria reflects a general time frame, instead of the precise time each patient was permitted to RTR in each study.<\/p>\n<h2>What are the new findings?<\/h2>\n<p>\u25ba Only one in five studies reported clinical, strength or performance-based criteria for return to running (RTR).<\/p>\n<p>\u25ba The most cited time-based criterion for RTR was 12 postoperative weeks.<\/p>\n<p>\u25ba An approach combining assessment goal-based criteria with time-based criteria is a reasonable approach for RTR after ACL reconstruction.<\/p>\n<h1>How is your return to running criteria and protocol?<\/h1>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Criteria for return for running after anterior cruciate ligament reconstruction: a scoping\u00a0review Rambaud\u00a0AJM,\u00a0Ardern\u00a0CL,\u00a0Thoreux\u00a0P, et al\u00a0Criteria for return for running after anterior cruciate ligament reconstruction: a scoping review Br J Sports Med\u00a0Published Online First:\u00a002 May 2018.\u00a0doi:\u00a010.1136\/bjsports-2017-098602 After ACL reconstruction an important milestone is returning to running (RTR), however there is a lack of information regarding when the patient can RTR following ACL reconstruction.. The authors research question was: \u2018Which criteria are used to determine when the patient can return to running following primary ACL reconstruction?\u2019 Discussion In this scoping review that included 201 articles, time was the most frequently reported criterion for clearing patients to RTR after primary ACL reconstruction. The median time for clearance to RTR was 12 postoperative weeks (IQR=3.3, range 5\u201339 weeks). The time criterion for RTR has changed over the years mirroring changes in rehabilitation approaches. Fewer than one in five studies reported clinical, strength or performance-based criteria for RTR, the most frequently reported being: full knee RoM or &gt;95% of the non-injured knee; pain &lt;2 on visual analogue scale; isometric lower limb strength LSI&gt;70%; isokinetic quadriceps and hamstring strength LSI&gt;70%; and hop test LSI&gt;70%. Clinical criteria are important indicators of adequate loading when returning to running We suggest that these clinical criteria: pain &lt;2 on visual analogue scale, 95%knee flexion RoM\u00a0(side to side difference), full extension RoM (0\u00b0 knee extension), no effusion\/trace of effusion, should be used as \u2018non-negotiable\u2019 clinical milestones for RTR\u2014patients must fulfil these criteria before RTR as a way to ensure adequate loading. We propose the term return-to-running activities to describe the phase of RTR at a slow speed (8\u201310km\/ hour), but it may be relevant to establish consensus on the definition of the term \u2018running\u2019. Since authors report general criteria that governed rehabilitation progression, our analysis of the time-based criteria reflects a general time frame, instead of the precise time each patient was permitted to RTR in each study. What are the new findings? \u25ba Only one in five studies reported clinical, strength or performance-based criteria for return to running (RTR). \u25ba The most cited time-based criterion for RTR was 12 postoperative weeks. \u25ba An approach combining assessment goal-based criteria with time-based criteria is a reasonable approach for RTR after ACL reconstruction. How is your return to running criteria and protocol?<\/p>\n","protected":false},"author":1,"featured_media":2362,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"postBodyCss":"","postBodyMargin":[],"postBodyPadding":[],"postBodyBackground":{"backgroundType":"classic","gradient":""},"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[155,4,190,193],"tags":[156,37,185],"class_list":["post-2360","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-acl","category-knee-injuries","category-publications","category-running","tag-acl","tag-knee","tag-running"],"blocksy_meta":{"styles_descriptor":{"styles":{"desktop":"","tablet":"","mobile":""},"google_fonts":[],"version":7}},"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- 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