From the Lab to the Clinic: Return to Play Outcomes Following ACL-R that Every Clinician Can Use

Morning Sports Rounds_Website

January 24, 2019

From the Lab to the Clinic: Return to Play Outcomes Following ACL-R that Every Clinician Can Use
Terry Grindstaff, PhD, PT, ATC; Meredith Chaput, DPT

Research prioritizing and identifying an appropriate test battery for return to play following anterior cruciate ligament reconstruction is concentrated. The general consensus is that no one test is superior to another and that a battery of tests needs to be completed to well inform RTP decisions. However, despite the current literature to support this, the clinical application and availability of these tests (i.e. isokinetic dynamometry) can be challenging. A recent survey of clinicians published in JOSPT found that 56% percent of PTs that responded used manual muscle testing as their primary measure of strength, 89% utilized functional hop testing as their primary return to play outcome and only 45% of individuals use some form of a self-reported outcome measure in their clinical practice1. The cases presented in this series are meant to challenge the clinician’s understanding of functional outcomes compared to individual muscle testing; and reveal a set of patients who although pass functional measures commonly used in the clinic, may not be ready to return to sport.

Learning Objectives:
1. The attendee will be able to discuss and understand the “gold standard” return to play testing battery used following ACL reconstruction.
2. The attendee will be able to compare and contrast the laboratory clinical measures with the realistic clinical availability of resources.
3. The attendee will be able to list a battery of various outcomes and alternatives to address both functional and isolated muscle strength.

Terry L. Grindstaff, PhD, PT, ATC, is an Associate Professor in the Department of Physical Therapy at Creighton University. Dr. Grindstaff’s research investigates the neuromuscular consequences of lower extremity joint injury and rehabilitative management to address dysfunction. His research has been funded by the National Institutes of Health, National Science Foundation, and several foundations.

Dr. Grindstaff has authored or co-authored over 50 peer-reviewed journal articles and presented at national and international meetings.  Dr. Grindstaff is an Associate Editor for the International Journal of Sports Physical Therapy and was the recipient of the 2014 Eugene Michels New Investigator Award from the American Physical Therapy Association.

Meredith Chaput, DPT is currently the Sports Physical Therapy Resident at Vanderbilt Orthopaedic Institute and Belmont University. She graduated from Creighton University with her Doctorate in Physical Therapy in 2018. Throughout her DPT education, she worked as a graduate research assistant with Dr. Grindstaff in the Creighton Rehab Lab. Her research focused on return to play outcomes commonly used in the clinical setting following ACL reconstruction.