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  • Author: Eduardo L. Cadore x
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Igor Setuain, Mikel Izquierdo, Fernando Idoate, Eder Bikandi, Esteban M. Gorostiaga, Per Aagaard, Eduardo L. Cadore and Jesús Alfaro-Adrián

Context:

The muscular function restoration related to the type of physical rehabilitation followed after anterior cruciate ligament reconstruction (ACLR) using autologous hamstring tendon graft in terms of strength and cross-sectional area (CSA) remain controversial.

Objective:

To analyze the CSA and force output of quadriceps and hamstring muscles in subjects following either an Objective Criteria-Based Rehabilitation (OCBR) algorithm or the usual care (UCR) for ACL rehabilitation in Spain, before and 1 year after undergoing an ACLR.

Design:

Longitudinal clinical double-blinded randomized controlled trial.

Setting:

Sports-medicine research center.

Patients:

40 recreational athletes (30 male, 10 female [24 ± 6.9 y, 176.55 ± 6.6 cm, 73.58 ± 12.3 kg]).

Intervention:

Both groups conducted differentiated rehabilitation procedures after ACLR. Those belonging to OCBR group were guided in their recovery according to the current evidence-based principles. UCR group followed the national conventional approach for ACL rehabilitation.

Main Outcome Measures:

Concentric isokinetic knee joint flexor-extension torque assessments at 180°/s and Magnetic Resonance Imaging (MRI) evaluations were performed before and 12 months after ACLR. Anatomical muscle CSA (mm2) was assessed, in Quadriceps, Biceps femoris, Semitendinous, Semimembranosus, and Gracilis muscles at 50% and 70% femur length.

Results:

Reduced muscle CSA was observed in both treatment groups for Semitendinosus and Gracilis 1 year after ACLR. At 1-year follow-up, subjects allocated to the OCBR demonstrated greater knee flexor and extensor peak torque values in their reconstructed limbs in comparison with patients treated by UCR.

Conclusions:

Objective atrophy of Semitendinosus and Gracilis muscles related to surgical ACLR was found to persist in both rehabilitation groups. However, OCBR after ACLR lead to substantial gains on maximal knee flexor strength and ensured more symmetrical anterior-posterior laxity levels at the knee joint.

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Rodrigo Ramírez-Campillo, Cristian Martínez, Carlos I. de La Fuente, Eduardo L. Cadore, Mário C. Marques, Fabio Y. Nakamura, Irineu Loturco, Alexis Caniuqueo, Rodrigo Cañas and Mikel Izquierdo

Older women participated in a 12-week high-speed resistance training program under two supervisor-to-subject ratio methods (i.e., high versus low supervision) to assess its effects on muscle strength, power, functional performance, and quality of life assessed before (T1) and after (T2) intervention. Women were divided into either the control group (CG, n = 15), high supervision group (HSG, n = 30), or low supervision group (LSG, n = 28). The training program included exercises requiring high-speed concentric muscle actions. No differences were observed among groups at T1. Between T1 and T2, the HSG showed a higher (p < .05) improvement in muscle strength (ES = 0.36–1.26), power (ES = 0.5–0.88), functional performance (ES = 0.52–0.78), and quality of life (ES = 0.44–0.82) compared with LSG and CG. High-speed resistance training under closer supervision is more effective for improving muscle strength, power, functional performance, and quality of life in older women.