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Closed-Chain Rehabilitation for Upper and Lower Extremities

Dr. Kibler is Medical Director, Lexington Sports Medicine Center, Lexington, Ky. Mr. Livingston is Clinical Specialist, Lexington Sports Medicine Center.

Reprint requests: Dr. Kibler, Lexington Sports Medicine Center, 1221 South Broadway, Lexington, KY 40504.

Closed-chain exercise protocols are used extensively in rehabilitation of knee injuries and are increasingly used in rehabilitation of shoulder injuries. They are felt to be preferable to other exercise programs in that they simulate normal physiologic and biomechanical functions, create little shear stress across injured or healing joints, and reproduce proprioceptive stimuli. Because of these advantages, they may be used early in rehabilitation and have been integral parts of "accelerated" rehabilitation programs. The authors review the important components of a closed-chain rehabilitation program and provide examples of specific exercises that are used for rehabilitation of knee and shoulder injuries.