Abstract

When pain and effusion have been minimized and patients assume appropriate knee posture at rest and during exercise, the extent of postinjury or postoperative quadriceps femoris neuromuscular inhibition and avoidance during locomotion is reduced. Restoring normal lower-extremity ROM and musculotendinous extensibility (with consideration for biarticular muscles) is foundational to the implementation of an exercise program that integrates the trunk, hip, and ankle muscles into dynamic knee-stabilization challenges while addressing isolated quadriceps femoris deficiencies. Cardiovascular conditioning should be addressed as early as feasible. Although programs generally address anaerobic and aerobic energy systems, increasing patients' fatigue resistance, as evidenced by prolonged maintenance of appropriate functional exercise techniques and body control without verbalized discomfort or observed movement-avoidance patterns, ensures therapists that neuromuscular responsiveness for dynamic knee stabilization is improving.

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