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Isometric hamstring contractions at 60 degrees of knee flexion
49%
1665/3410
Isolated quadriceps contractions with the knee at 30 degrees of flexion
10%
341/3410
Simultaneous quadricep and hamstring contractions at 15 degrees of knee flexion
25%
854/3410
Isolated quadriceps contractions with the knee at 15 degrees of flexion
11%
384/3410
Active resisted knee motion from terminal extension to 30 degrees of flexion
4%
133/3410
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Isometric hamstring contractions at 60 degrees of knee flexion will produce the lowest strain in this patient's ACL graft. Straight leg raises are also commonly used in post-ACL rehabilitation protocols as this exercise places little stress on an ACL graft. The other exercises mentioned have been shown to result in increased graft strain in patients with a reconstructed ACL. Beynnon et al measured the strain behavior of the ACL during rehabilitation activities in vivo. They found that exercises that produce low or unstrained ligament values, and would not endanger a properly implanted graft, are either dominated by the hamstrings muscle (isometric hamstring contractions at any angle), involve quadriceps muscle activity with the knee flexed at 60 degrees or greater (isometric quadriceps, simultaneous quadriceps and hamstrings contraction), or involve active knee motion between 35 degrees and 90 degrees of flexion. A bar graph from their study representing their findings is shown and explained in Illustration A.
2.9
(34)
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