Abstract

BackgroundRehabilitation following anterior cruciate ligament (ACL) reconstructions is based mainly on comprehensive progressive exercise programmes using a multi-dimensional approach. Elastic knee sleeves may be useful adjuncts to rehabilitation. The aim of this study was to determine the immediate and 6-week effects of wearing a knee sleeve on person-reported outcomes and function in participants who had undergone an ACL reconstruction and who had residual self-reported functional limitations.MethodsIndividuals with ACL reconstruction in the previous 6 months to 5 years were recruited. Immediate effects of a commercially-available elastic knee sleeve on single-leg horizontal hop distance were explored using a cross-over design. Following this first session, participants were randomised into a Control Group and a Sleeve Group who wore the sleeve for 6 weeks, at least 1 h daily. Outcome measures for the randomised clinical trial (RCT) were the International Knee Documentation Classification Subjective Knee Form (IKDC-SKF) score, the single-leg horizontal hop distance, and isokinetic quadriceps and hamstring peak torque. Linear mixed models were used to determine random effects. Where both limbs were measured at multiple time points, a random measurement occasion effect nested within participant was used.ResultsThirty-four individuals (16 women) with ACL reconstruction completed the cross-over trial. Hop distance for the injured side during the sleeve condition increased by 3.6 % (95 % CI 0.4–6.8 %, p = 0.025). There was no evidence of differential changes between groups for the IKDC-SKF (Sleeve Group n = 15; Control Group n = 16; p = 0.327), or relative improvement in the injured side compared to the uninjured side for the physical performance measures (Sleeve Group n = 12, Control Group n = 12; three-way interaction p = 0.533 [hop distance], 0.381 [quadriceps isokinetic peak torque], and 0.592 [hamstring isokinetic peak torque]).ConclusionsSingle-leg hop distance of the ACL reconstructed side improved when wearing a knee sleeve. Wearing the knee sleeve over 6 weeks did not lead to enhanced improvements in self-reported knee function, hop distance and thigh muscle strength compared to the control group.Trial registrationThe trial was prospectively registered with the Australia New Zealand Clinical Trials Registry No: ACTRN12618001083280, 28 June 2018.

Highlights

  • Rehabilitation following anterior cruciate ligament (ACL) reconstructions is based mainly on comprehensive progressive exercise programmes using a multi-dimensional approach

  • A further eight participants were affected by the COVID-19 lockdown in New Zealand in March/April 2020: one control participant withdrew from the randomised clinical trial (RCT); seven (Sleeve Group n = 3; Control Group n = 4) continued and completed their physical activity diaries during lockdown

  • There was no evidence of differences between participants of the Sleeve Group and Control Group in terms of relative improvement in the injured side compared to the uninjured side for the physical performance measures (Table 3)

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Summary

Introduction

Rehabilitation following anterior cruciate ligament (ACL) reconstructions is based mainly on comprehensive progressive exercise programmes using a multi-dimensional approach. The aim of this study was to determine the immediate and 6-week effects of wearing a knee sleeve on person-reported outcomes and function in participants who had undergone an ACL reconstruction and who had residual self-reported functional limitations. Anterior cruciate ligament (ACL) ruptures are debilitating knee injuries, potentially with devastating short-term and long-term consequences. Surgical ACL reconstruction and rehabilitation remains the primary approach for active individuals with such ruptures [1]. Different procedures and grafts have been described for the surgical ACL reconstruction. In New Zealand, hamstring tendon grafts account for 71 % of all primary ACL reconstructions, followed by patellar tendon grafts (24 %), and quadriceps tendon grafts (3 %), with allografts used infrequently [6]. Over 50 % of individuals develop symptoms of knee osteoarthritis within 15 years of reconstruction [8]

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