Rehabilitation of Athletic Injuries

1
Rehabilitation of Athletic Injuries

• Open versus Closed Kinetic
• Chain Exercises

2
What is OPEN and CLOSED Kinetic Chain????

• Was first proposed in 1970 and was referred to as
  the link system by mechanical engineers.
• Called chain because of the series of
  overlapping segments.

3
Open and Closed Kinetic Chain

• KINETIC CHAIN The term is used in
  engineering to indicate combinations of several
  segments linked together by interposing
  joints. Kinetic Movement

4
Open and Closed Kinetic Chain Activities

• OPEN Distal segment of the extremity is not
  fixed or stabilized.

• CLOSED Distal segment of the extremity is
  fixed or stabilized.

5
Why is Closed better than OPEN??????

• From a biomechanical perspective, Closed chain
  exercises are safer and produce stresses and
  forces that are potentially less of a threat to
  healing of structures.

6
AND...

• Lower Extremity Closed chain activities generally
  are more functional than open-kinetic chain
  exercises because they involve weight bearing
  activities.

7
in addition...

• Closed-kinetic chain exercises can be used in
  lower and upper extremity rehabilitation programs.

8
OPEN Kinetic Chain Exercises

• Movement usually occurs in an isolated joint
  movement
• Usually only one axis or one joint is used for
  the movement
• There is more mobility of both the proximal and
  distal joints

9
OPEN Kinetic Chain Exercises

• One part of the extremity that forms the joint is
  stabilized (to some degree) and one part of the
  extremity is always mobile
• Movement is unpredictable at the distal extremity

10
AND .

• Movement of the moving part of the extremity
  occurs in a single plane
• (Upper extremity) open-kinetic chain activities
  better simulate functional sports activities

11
On the other hand, Closed Kinetic Activities.

• Movement patterns occur with multiple joint
  movements.
• Movement occurs at the joint above and below the
  injured joint.
• Movement is done in a predictable fashion.

12
AND .

• The primary axis (of the injured joint) is
  translatory because there are several joints
  (axis) being used.
• Proximal and distal components of the extremity
  that form the (injured) joint are moving at the
  same time.

13
AND Also..

• (Lower extremity) closed-kinetic chain exercises
  better simulate functional sports activities.
• Closed-kinetic chain exercises increase joint
  stability.

14
Forces that occur in Open and Closed Kinetic Chain

• COMPRESSION forces
• SHEAR forces Shear forces are reduced using
  closed kinetic chain exercises, while compression
  forces are increased.

15
Forces that occur in Open and Closed Kinetic Chain

• For example closed-kinetic chain activities in
  the lower extremity decrease shear forces,
  reducing anterior tibial translation, and
  increase compressive forces, which increases
  stability around the knee joint.

16
Forces that Occur in Open and Closed-Kinetic
Chain Activities

• A shear force can place stress on a newly
  attached ACL.
• Compressive forces stabilize the knee, thus
  reducing re-injury

17
Functional Advantages of Closed-Kinetic Chain
Activities

• Reduced shear forces
• Increased compression force
• Functional activities such as walking, climbing
  steps etc.. involve the foot being stabilized,
  WHICH means these exercises are more sport
  specific..

18
Functional Advantages of Closed-Kinetic Chain
Activities

• Depending on the activity, variable speeds can be
  used.
• Proprioceptive training can occur.
• Uses combinations of isometric-concentric and
  eccentric contractions.

19
Reading Assignment

• Read Chapter 11 in your Prentice text.