Qualitative and quantitative assessment of functional performance before and after reconstruction of anterior cruciate ligament in people from non-elite/professional sporting background

Reconstruction surgery is a very common management option following rupture of an anterior cruciate ligament (ACL). There is currently no study assessing ACL patients following surgery in Egypt (or other Arabic countries) or in people who are not from competitive sports background. The aims of this thesis were to evaluate the quantity and quality of functional performance, postural stability and rehabilitative outcomes of non-high competitive sports patients following ACL reconstruction in Egypt. To accomplish these research aims, five separate studies were performed; Study one: A systematic scoping review of the ACL reconstructed patients’ outcomes and the measures used to evaluate them following the surgery including functional performance testing and patient reported questionnaires. The findings of this review suggested a more extensive series of tests to measure both the quantitative and qualitative aspects of functional performance and control stability for people participating in non competitive sports and who had the ACL reconstruction. Also The KOOS and the IKDC questionnaires are both measures that are increasingly being used for ACL reconstruction throughout the last decade; Study two: One hundred and twenty nine Egyptian patients were included to assess the reliability and validity of an Arabic version of the Knee KOOS. The results demonstrated acceptable psychometric characteristics of the Arabic version of KOOS with similar qualities to the original American-English language version among the Egyptian population. Study three: Four subjects and four assessors were involved in this preliminary study to assess the test retest (inter- intra tester) reliability of a qualitative scoring system of limb alignment during single leg squat (QASLS). The results indicated that the qualitative evaluation method may allow clinicians and researcher to standardize the categorization of functional movements of singe-leg loading such as the SLS regardless of the equipment, time and a venue. Study four: An observational and prospective study with repeated measurements of eighty nine ACL reconstructed Egyptian patients were included and functionally evaluated before surgery and three, six and twelve months following surgery. All functional performance testing and self- reported outcomes are improved at six and twelve months postoperatively compared with preoperatively data and regardless of rehabilitation achieved. Finally, study five: A retrospective study of a twenty four patients were collected from private clinics in the UK and evaluated in the period between six and nine months following their ACL reconstructions, then matched with similar group of patients from study four to identify the relation between the prospective and the retrospective study by comparing their results