A focus on exercise prescription and assessment for a safe return to sport participation following a patellar tendon reconstruction in a soccer player

Abstract

Purpose: The aim of this study was to analyse a 6-month kinesiological intervention after patellar tendon reconstruction. The kinetics, kinematics, and neuromuscular differences between operated (OL) and non-operated limbs (N-OL) were examined over time in a soccer player. Methods: The assessment took place at three months (T0) and nine months (T1) after the reconstruction. This comprised an assessment of the range of motion (ROM), gait analysis through angle-angle diagrams, postural control, neuromuscular assessment during whole-body vibration (WBV), and unilateral-bilateral maximal voluntary isometric contractions (MVICs) synchronised with surface electromyography (sEMG). Results: The angle-angle diagrams at T1 show that the area and perimeter of the N-OL and OL diagrams increased, especially the area and perimeter of the knee-ankle diagram in OL. Furthermore, the postural control at T1 indicated an increase in different conditions. The root mean square (RMS) of sEMGRMS obtained during WBV revealed a significant alteration in the neuromuscular patterns in the OL at T1. The increase in the vastus lateralis (VL) and lateral gastrocnemius (LG) activities was accompanied by a decrease in the biceps femoris (BF) and tibialis anterior (TA). The peak of force and the rate of force development during MVICs showed a slight difference between OL and N-OL at T1. Furthermore, sEMGRMS activity synchronised with MVICs showed a slight difference between the OL and N-OL in the extensors (VL, VM, and RF) and flexors (BF) muscles at T1. Conclusions: The kinetic, kinematic, and neuromuscular variables have shown improvements at T1 compared to T0. Anyway, a 6-month individualised kinesiological intervention, following a patellar tendon reconstruction, reveals that minor alterations in the neuromuscular pattern remain in the OL. These results help kinesiologists manage the functional recovery after patellar tendon reconstruction.