**3.2 Subjective assessment of the effects of rehabilitation (Lysholm i IKDC 2000 questionnaires)**

The patient was asked to evaluate the functioning of the knee joint twice: immediately after the completion of the fourth stage of rehabilitation (study 1) and then after 18 months (study 2). Two scales were used for the assessment: the knee joint assessment scale according to Lysholm and the IKDC 2000 knee assessment questionnaire (The International Knee Documentation Committee 2000). Both contain information about knee joint ailments and their impact on the functioning of the patient in daily life.

## *3.2.1 Lysholm knee scoring scale*

The Lysholm scale contains eight points concerning pain and activity. In each point, the examined person is supposed to choose and check one of the statements which matches his or her pain or functions, each answer is a specific number of points. Maximal total score is 100 points, which means the highest subjective functional status possible (perfect level–over 90 points). The following functional levels are good: 84–90 points, satisfactory: 65–83 points and insufficient: below 65 points) [18].

### *3.2.2 IKDC 2000 questionnaire*

The IKDC 2000 subjective knee evaluation form is composed of three blocks, which concern: pain, physical activity, and function during activity of daily living (ADL). Similar to filling the Lysholm form, the patient is expected to choose and check one of the statements that matches his or her complaints and abilities. For each answer, a certain number of points is assigned according to the principle that

**41**

**Table 5.**

*The results of the questionnaires.*

**4. Results**

*Knee Dislocation: Comprehensive Rehabilitation Program after Two-Stage Ligament…*

*3.2.3 Evaluation of the peak power and rate of power development*

Leg Curl/Leg Extension system was used for the examination.

One-minute recovery break was used before the tests.

The results of the questionnaires are presented in **Table 5**.

result of the two attempts performed during the test.

**Scale Points**

Lysholm 85 95 IKDC 2000 78.2 81.6

examination was repeated for the other limb.

0 means the greatest ailments or the most limited function. Highest final score that

The questionnaires with the instructions concerning the method of scoring and interpretation of the result were collected from the website of the American Orthopedics Society for Sports Medicine [http://www.sportsmed.org/research/

The examinations were performed in the laboratory of the Academy of Physical Education in Katowice, 18 months following the last stage of rehabilitation. Peak power (Ppeak) of the knee flexors and extensors of operated limb was evaluated and the results were compared with the measurement for the healthy limb. Keiser A-300

The methodology consisted in maximal flexion and extension in the position that allowed for examination of only knee joint movements, that is, isolated work of the hamstrings in the case of flexion and quadriceps femoris muscles (more specifically, vastus muscles, excluding the rectus femoris) in flexion. The second limb rested relaxed on the device and was not stabilized. The examination was preceded by a short warm-up and several repetitions of the movement without load. Healthy leg was examined first. After receiving detailed instruction, the patient was asked to repeat the test of maximal knee flexion at the load of 10 kg twice at 5 s intervals. Next, the test was repeated with the load increasing to 20–30 kg. The tests were repeated in order to evaluate strength of knee joint extensors using the same loads.

Rate of power development was measured by means of the force platform Accu Power. The measurement was preceded with accurate measurement of body mass and body composition analysis. After stepping on the platform, the patient adopted the test position: standing on one leg (the healthy leg was examined first) and then, at the signal of the test supervisor, the patient jumped up. After landing, the patient left the platform and repeated the procedure twice in consecutive tests. Next, the

In the power tests, differences in peak power of quadriceps femoris muscle were found between the operated and nonoperated limbs. With the increasing load, the differences in power in knee extension were 32, 17, and 61% (**Table 6**). Examination of the power in the hamstrings also revealed smaller differences at lower levels of load between the legs. The use of maximal tolerable load of 30 kg confirmed greater difference in power at the level of 15% (**Table 6**). **Tables 6** and **7** include better

**Test number 1 Test number 2**

*DOI: http://dx.doi.org/10.5772/intechopen.89649*

can be achieved being also 100 points.

IKDC\_forms/].

### *Knee Dislocation: Comprehensive Rehabilitation Program after Two-Stage Ligament… DOI: http://dx.doi.org/10.5772/intechopen.89649*

0 means the greatest ailments or the most limited function. Highest final score that can be achieved being also 100 points.

The questionnaires with the instructions concerning the method of scoring and interpretation of the result were collected from the website of the American Orthopedics Society for Sports Medicine [http://www.sportsmed.org/research/ IKDC\_forms/].

## *3.2.3 Evaluation of the peak power and rate of power development*

The examinations were performed in the laboratory of the Academy of Physical Education in Katowice, 18 months following the last stage of rehabilitation. Peak power (Ppeak) of the knee flexors and extensors of operated limb was evaluated and the results were compared with the measurement for the healthy limb. Keiser A-300 Leg Curl/Leg Extension system was used for the examination.

The methodology consisted in maximal flexion and extension in the position that allowed for examination of only knee joint movements, that is, isolated work of the hamstrings in the case of flexion and quadriceps femoris muscles (more specifically, vastus muscles, excluding the rectus femoris) in flexion. The second limb rested relaxed on the device and was not stabilized. The examination was preceded by a short warm-up and several repetitions of the movement without load. Healthy leg was examined first. After receiving detailed instruction, the patient was asked to repeat the test of maximal knee flexion at the load of 10 kg twice at 5 s intervals. Next, the test was repeated with the load increasing to 20–30 kg. The tests were repeated in order to evaluate strength of knee joint extensors using the same loads. One-minute recovery break was used before the tests.

Rate of power development was measured by means of the force platform Accu Power. The measurement was preceded with accurate measurement of body mass and body composition analysis. After stepping on the platform, the patient adopted the test position: standing on one leg (the healthy leg was examined first) and then, at the signal of the test supervisor, the patient jumped up. After landing, the patient left the platform and repeated the procedure twice in consecutive tests. Next, the examination was repeated for the other limb.
