In-vivo tibiofemoral kinematics of the normal knee during closed and open kinetic chain exercises: A comparative study of box squat and seated knee extension

A rehabilitation program after anterior cruciate ligament reconstruction is of great importance to obtain a satisfactory prognosis after surgery. However, there is still an onging debate over whether closed kinetic chain or open kinetic chain exercises should be chosen. Our study was designed to compare the in vivo tibiofemoral kinematics during closed kinetic chain and open kinetic chain exercises. Eighteen healthy volunteers were asked to perform box squat and unloaded/10 kg-loaded seated knee extension. In vivo 3-dimensional analysis of tibiofemoral kinematics of different motions were determined using a dual fluoroscopic imaging system. The study found significantly more tibial anterior displacement during loaded seated knee extension than during unloaded seated knee extension from 25 degrees-50 degrees of knee flexion (p < 0.031). The knees exhibited significantly more internal tibial rotation and lateral tibial translation during the box squat than both seated knee extensions during mid-flexion. In addition, the knees showed less internal-external (IE) range of motion (ROM) from 20 degrees- 75 degrees of flexion (p < 0.001) and medial-lateral (ML) ROM from 75 degrees to full extension (p < 0.006) during box squat than both extensions. This knowledge may help optimize rehabilitation plans for patients post ACL reconstruction