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The effectiveness of Pilates for partial anterior cruciate ligament injury

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study explored the effects of Pilates on the muscle strength, function, and instability of patients with partial anterior cruciate ligament (ACL) injuries in situations in which a non-surgical treatment option is preferred.

Methods

Fifty participants 20–45 years of age who were diagnosed with isolated ACL injuries were included in the study. The participants were randomly assigned to either the Pilates exercise group (n = 24) or the control group (n = 26). The subjects in the Pilates exercise group performed basic mat exercises that focused on the muscle strength and flexibility of the lower limbs and core muscles during each class session, which met three times per week for 12 weeks. The control group did not receive any treatment or home exercise programme. All patients were evaluated using the Lysholm Knee Scale, the Cincinnati Knee Rating System, and isokinetic quadriceps and hamstring strength. Patient satisfaction regarding improvement in knee stability was assessed using the Global Rating of Change scale.

Results

The Pilates group experienced significant improvement over the control group as measured by the difference in quadriceps strength at 12 weeks (p = 0.03). Both groups showed some clinical change over time, but the Pilates group improved for all outcome measurements at the 12-week follow-up, and the control group only improved for functional outcomes. Patient satisfaction with the level of knee stability based on the Global Rating of Change scale was higher in the Pilates group than in the control group.

Conclusion

Although both groups exhibited improvements in knee strength and functional outcomes, the results suggest that Pilates is a superior management approach over a control treatment for increasing quadriceps strength in participants with partial ACL injury. Pilates may provide clinicians a novel option when choosing a treatment for a partial ACL injury. Further study is needed to determine whether certain subgroups of individuals might achieve an added benefit with this approach.

Level of evidence

II.

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References

  1. Aladro-Gonzalvo AR, Araya-Vargas GA, Machado-Díaz M, Salazar-Rojas W (2013) Pilates-based exercise for persistent, non-specific low back pain and associated functional disability: a meta-analysis with meta-regression. J Bodyw Mov Ther 17:125–136

    Article  PubMed  Google Scholar 

  2. Barber-Westin SD, Noyes FR, McCloskey JW (1999) Rigorous statistical reliability, validity, and responsiveness testing of the Cincinnati knee rating system in 350 subjects with uninjured, injured, or anterior cruciate ligament-reconstructed knees. Am J Sports Med 27:402–416

    Article  CAS  PubMed  Google Scholar 

  3. Barker AL, Bird ML, Talevski J (2015) Effect of pilates exercise for improving balance in older adults: a systematic review with meta-analysis. Arch Phys Med Rehabil 96:715–723

    Article  PubMed  Google Scholar 

  4. Bliss LS, Teeple P (2005) Core stability: the centerpiece of any training program. Curr Sports Med Rep 4:179–183

    Article  PubMed  Google Scholar 

  5. Briggs KK, Lysholm J, Tegner Y, Rodkey WG, Kocher MS, Steadman JR (2009) The reliability, validity, and responsiveness of the Lysholm score and Tegner activity scale for anterior cruciate ligament injuries of the knee: 25 years later. Am J Sports Med 37:890–897

    Article  PubMed  Google Scholar 

  6. Buckley SL, Barrack RL, Alexander AH (1989) The natural history of conservatively treated partial anterior cruciate ligament tears. Am J Sports Med 17:221–225

    Article  CAS  PubMed  Google Scholar 

  7. Celik D, Coskunsu D, Kilicoglu O (2013) Translation and cultural adaptation of the Turkish Lysholm knee scale: ease of use, validity, and reliability. Clin Orthop Relat Res 471:2602–2610

    Article  PubMed  PubMed Central  Google Scholar 

  8. Dawson AG, Hutchison JD, Sutherland AG (2014) Is anterior cruciate reconstruction superior to conservative treatment? J Knee Surg. doi:10.1055/s-0034-1396017

  9. De Vet HC, Terwee CB, Bouter LM (2003) Current challenges in clinimetrics. J Clin Epidemiol 56:1137–1141

    Article  PubMed  Google Scholar 

  10. Feiring DC, Ellenbecker TS, Derscheid GL (1990) Test–retest reliability of the biodex isokinetic dynamometer. J Orthop Sports Phys Ther 11:298–300

    Article  CAS  PubMed  Google Scholar 

  11. Hewett TE, Liddenfeld TN, Riccobene JV et al (1999) The effect of neuromuscular training on the incidence of knee injury in female athletes. Am J Sports Med 27:699–705

    Article  CAS  PubMed  Google Scholar 

  12. Hewett TE, Myer GD, Ford KR et al (2005) Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med 33:492–501

    Article  PubMed  Google Scholar 

  13. Hewett TE, Zazulak BT, Myer GD, Ford KR (2005) A review of electromyographic activation levels, timing differences, and increased anterior cruciate ligament injury incidence in female athletes. Br J Sports Med 39:347–350

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Kamper SJ, Maher CG, Mackay G (2009) Global rating of change scales: a review of strengths and weaknesses and considerations for design. J Man Manip Ther 17:163–170

    Article  PubMed  PubMed Central  Google Scholar 

  15. Levine B, Kaplanek B, Jaffe WL (2009) Pilates training for use in rehabilitation after total hip and knee arthroplasty: a preliminary report. Clin Orthop Relat Res 467:1468–1475

    Article  PubMed  PubMed Central  Google Scholar 

  16. Lorenz S, Imhoff AB (2014) Reconstruction of partial anterior cruciate ligament tears. Oper Orthop Traumatol 26:56–62

    Article  CAS  PubMed  Google Scholar 

  17. Muaidi QI, Nicholson LL, Refshauge KM, Herbert RD, Maher CG (2007) Prognosis of conservatively managed anterior cruciate ligament injury: a systematic review. Sports Med 37:703–716

    Article  PubMed  Google Scholar 

  18. Newell D, Shead V, Lwine Sloane L (2012) Changes in gait and balance parameters in elderly subjects attending an 8-week supervised Pilates programme. J Bodyw Mov Ther 16:549–554

    Article  CAS  PubMed  Google Scholar 

  19. Norman GR, Stratford P, Regehr G (1997) Methodological problems in the retrospective computation of responsiveness to change: the lesson of Cronbach. J Clin Epidemiol 50:869–879

    Article  CAS  PubMed  Google Scholar 

  20. Odensten M, Lysholm J, Gillquist J (1985) The course of partial anterior cruciate ligament ruptures. Am J Sports Med 13:183–186

    Article  CAS  PubMed  Google Scholar 

  21. Queiroz BC, Cagliari MF, Amorim CF, Sacco IC (2010) Muscle activation during four pilatescore stability exercises in quadruped position. Arch Phys Med Rehabil 324(91):86–92

    Article  Google Scholar 

  22. Patti A, Bianco A, Paoli A, Messina G, Montalto MA, Bellafiore M, Battaglia G, Iovane A, Palma A (2015) Effects of Pilates exercise programs in people with chronic low back pain: a systematic review. Med (Baltimore) J94:e383

    Article  Google Scholar 

  23. Pujol N, Colombet P, Cucurulo T, Graveleau N, Hulet C, Panisset JC, Potel JF, Servien E, Sonnery-Cottet B, Trojani C, Djian P (2012) French Arthroscopy Society (SFA). Natural history of partial anterior cruciate ligament tears: a systematic literature review. Orthop Traumatol Surg Res 98:160–164

    Article  Google Scholar 

  24. Rosene JM, Fogarty TD, Mahaffey BL (2001) Isokinetic hamstrings: quadriceps ratios in intercollegiate athletes. J Athl Train 36:378–383

    PubMed  PubMed Central  Google Scholar 

  25. Shi DL, Li JL, Zhai H, Wang HF et al (2012) Specialized core stability exercise: a neglected component of anterior cruciate ligament rehabilitation programs. J Back Musculoskelet Rehabil 25:291–297

    Article  PubMed  Google Scholar 

  26. Sommerlath K, Odensten M, Lysholm J (1992) The late course of acute partial anterior cruciate ligament tears. A nine to 15 year follow-up evaluation. Clin Orthop Relat Res 281:152–158

    Google Scholar 

  27. Sonnery-Cottet B, Panisset JC, Colombet P, Cucurulo T, Graveleau N, Hulet C et al (2012) Partial A. C. L. reconstruction with preservation of the posterolateral bundle. Orthop Traumatol Surg Res 98:165–170

    Article  Google Scholar 

  28. Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49

    Google Scholar 

  29. Temponi EF, Carvalho Júnior HL, Sonnery-Cottet B, Chambat P (2015) Partial tearing of the anterior cruciate ligament: diagnosis and treatment. Rev Bras Ortop 50:9–15

    Article  PubMed  PubMed Central  Google Scholar 

  30. Tjoumakaris FP, Donegan DJ, Sekiya JK (2011) Partial tears of the anterior cruciate ligament: diagnosis and treatment. Am J Orthop (Belle Mead NJ) 40:92–97

    Google Scholar 

  31. Wells C, Kolt GS, Bialocerkowski A (2012) Defining Pilates exercise: a systematic review. Complement Ther Med 20:253–262

    Article  PubMed  Google Scholar 

  32. Zazulak BT, Hewett TE, Reeves NP, Goldberg B, Cholewicki J (2007) Deficits in neuromuscular control of the trunk predict knee injury risk: a prospective biomechanical-epidemiologic study. Am J Sports Med 35:1123–1130

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank Hilal Cil for the assessment of the participants and collection of the data.

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Corresponding author

Correspondence to Derya Çelik.

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Conflict of interest

The authors declare no conflicts of interest in preparing this article.

Appendix 1

Appendix 1

See Table 4.

Table 4 Pilates exercise programme given to the participants

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Çelik, D., Turkel, N. The effectiveness of Pilates for partial anterior cruciate ligament injury. Knee Surg Sports Traumatol Arthrosc 25, 2357–2364 (2017). https://doi.org/10.1007/s00167-015-3718-1

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