Knee Stability and Movement Coordination Impairments: Knee ligament Sprain CPG

Question 1

Knee lig CPG: Diagnosis/classification

Answer 1

A level: use history and physical exam findings: mechanism of injury, passive knee laxity, joint pain, joint effusion, and movement coordination impairments

Question 2

Knee lig CPG: Differential Diagnosis

Answer 2

B level: suspect a serious pathology when the pt’s reported acticity limitations and impairments of body function and structure are not consistent with those presented in the guideline, or when the individual’s symptoms are not resolving with intervention

Question 3

Knee lig CPG: Exam: outcome measures: activity limitations and self reported measures

Answer 3

B level:
symptoms and function:
IKDC 2000
KOOS
Activity level before/after interventions:
Tegner Activity scale
Marx Activity rating scale
Psychological RTS:
ACL-RSI

Question 4

Knee lig CPG: Exam: Physical performance measures

Answer 4

B level: single leg hop tests (single leg hop for distance, crossover hop for distance, triple hop for distance, 6m timed hop)

Question 5

Knee lig CPG: Exam: Phyiscal Impairment measures

Answer 5

B level: knee laxity/stability, lower limb movement coordination, thigh muscle strength, knee effusion, knee joint ROM

Question 6

Knee lig CPG: Interventions: CPM

Answer 6

C level: can use CPG immediately postop to decrease pain after ACLr

Question 7

Knee lig CPG: Interventions: Early WB

Answer 7

C level: can implement early WBAT within 1 wk after surgery

Question 8

Knee lig CPG: Interventions: Knee bracing

Answer 8

C level: use functional knee brace for ACL deficiency
D level: following ACLr utilize pt preference for brace or no brace
F level: can use bracing for PCL, MCL, or PLC injuries

Question 9

Knee lig CPG: Interventions: Immediate vs Delayed Mobilization

Answer 9

B level: within 1wk mobilize after ACLr

Question 10

Knee lig CPG: Interventions: cryotherapy

Answer 10

B level: use cryotherapy immediately after ACLr to reduce post op pain

Question 11

Knee lig CPG: Interventions: Supervised Rehab

Answer 11

B level: use exercises as part of in clinic supervised rehab program and provide HEP.

Question 12

Knee Lig CPG: Interverntions: Therex

Answer 12

A level: use WB and NWB concentric and eccentric exercises within 4-6wks, 2-3x/wk, for 6-10mo.

Question 13

Knee lig CPG: interventions: NMES

Answer 13

A level: use NMES for 6-8wks to augment muscle strengthening exercise for the quad

Question 14

Knee lig CPG: Interventions: NMR

Answer 14

A level: use NMR along with muscle strengthening exercises