A tear of the anterior cruciate ligament (ACL) represents a significant injury for an athlete that requires substantial time away from sport, and significant rehabilitation after reconstruction, which creates anxiety for an athlete regarding the potential for return to sport at the previous competitive level.
The physical therapist is responsible to determine when a patient is capable of tolerating the physical demands of daily activities and to attempt to prevent re-injury.
Determining an individual’s ability to participate in sporting events requires careful evaluation of the rigors and demands on the athlete within his/her designated sport. One mechanism used to evaluate an athlete’s ability to safely return to sport post ACL reconstruction is the use of physical or functional performance tests (FPTs). FPTs are designed to evaluate a variety of skills that are necessary to participate in higher level functions such as sport or recreation. Functional performance testing requires a combination of ability to move through up to three planes of movement (vertical, horizontal, and lateral movement by 1 or both Lower Extremities).
Physical or functional performance tests (FPTs) are one mechanism used to evaluate the athlete’s physical skills and capabilities prior to returning to sports participation. Functional performance testing should examine athletes under conditions that imitate the necessary functional demands of their sports. Functional performance tests use dynamic skills or tasks to assess multiple components of function, including muscular strength, neuromuscular control/coordination, and joint stability.
Probably the most important requirement for successful sport performance is a series of highly developed motor control strategies to allow speed and agility during performance. If an LE reach, jump, hop, or agility test could be used to objectively screen athletes’ neuromuscular performance and suggest intervention before either sport participation or return to sport, that functional performance test would be valuable for preventing injury or decreasing the likelihood of reinjury.
Some of the identified FPTs pertaining to the knee following ACL injury and reconstruction include the single-leg hop test, the single leg squat, the active straight leg raise, the in-line lunge, and the deep squat. Others, such as the shuttle run, side-step, resisted knee extension, resisted knee flexion, and leg press, may be used in combination as a test battery to include a variety of constructs that when combined resemble function.