Regarding the Application of Open and Closed Chains in Rehabilitation
In orthopedic rehabilitation, treatment requires not only the therapist's technique but also the patient's self-muscle strength training. Prolonged restriction leads to muscle atrophy, and the muscle strength exerted during walking and activities of daily living is only 10-12. This requires self-training to strengthen muscles and restore functional movement.
The human body's various parts are connected in sequence through joints, which is called a movement chain. The movement chain is divided into open chain and closed chain. Today, let's explore open and closed chains.
Open Chain
Remote limb movement in space
Single joint movement
Activate single joint muscles and mainly active muscles
Non-weight bearing posture
Resistance applied to the action's remote end
Closed Chain
Remote limb maintains contact and fixation with the support surface
Multi-joint movement
Activate multiple joint muscle groups
Executed in a loaded posture
Using axial load
Open and Closed Chains
Studies have shown that open chain exercise helps to strengthen individual muscle training, thereby strengthening the control of individual joints. Closed chain exercise, on the other hand, aims to strengthen the stability control of multiple joints, increase proprioception, improve neuromuscular control and balance, coordination, and improve function and prevent injury.
Research shows that in the early rehabilitation of patients after anterior cruciate ligament reconstruction of the knee joint, compared with open and closed chains, closed chain exercise is linear and does not increase the shear force of the joint, which provides a protective effect, and is closer to functional rehabilitation. Therefore, closed chain exercise is safer, more reliable, and more effective in the early rehabilitation of the knee joint after anterior cruciate ligament reconstruction. Furthermore, appropriate knee flexion semi-squat closed chain exercises are more effective than sitting leg raises in open chain exercises to stimulate the inner thigh muscles and establish the balance of the quadriceps muscles.
Muscle strength training in rehabilitation requires taking care of individual muscles, but also taking care of joint movement and coordination between muscles. Although closed chain exercise has good efficacy, the muscle training process also needs the help of open chain exercise.
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