The relationship between performance on the modified star excursion balance test and the knee muscle strength before and after anterior cruciate ligament reconstruction

Objectives: The objective of this study was to evaluate the dynamic balance of the injured and uninjured limb before and after the anterior cruciate ligament (ACL) reconstruction and compare with the control group. Study design: Prospective longitudinal. Setting: Biomechanics laboratory. Participants: Participants are 24 males (mean age, 27.5 years) with unilateral ACL injury (ACLG) and 24 male healthy volunteers (CG). Main outcomes measures: The modified star excursion balance test (SEBT) and isokinetic knee extensor and flexor strength were applied in the ACLG preoperatively and after surgery. The dominant limb of CG was evaluated at a single time. Results: There was no difference between the injured and the uninjured limb of the ACLG (P> 0.05) before and after surgery. Preoperatively, both ACLG limbs had a significantly lower reach distance in posteromedial (PM) and posterolateral (PL) directions and in composite reach (CR) score compared to the control group (P < 0.001). Postoperatively, no significant differences were found between ACLG and CG (P > 0.05). There was a positive correlation between preoperative PL (0.59) and CR (0.51), postoperative PM (0.36), PL (0.36) and CR (0.46) with flexor strength at 12 months after surgery. Conclusion: Patients with ACL injury presented a worse performance in the SEBT in the preoperative period compared to the control group. After ligament reconstruction, the performance in the SEBT became equivalent to that of the control group. The strong correlation between flexor strength and posterior directions of the injured limb demonstrates the importance of the knee flexor muscles in the neuromuscular control of patients submitted to ACL reconstruction. (C) 2018 Elsevier B.V. All rights reserved.