Anterior Cruciate Ligament Rehabilitation Research Articles

Cost-Outcome Descriptive Study for Mobile App (UPSCALER) in the Rehabilitation of Anterior Cruciate Ligament (ACL) Injuries After Reconstructive Surgery

Cost-Outcome Descriptive Study for Mobile App (UPSCALER) in the Rehabilitation of Anterior Cruciate Ligament (ACL) Injuries After Reconstructive Surgery

Comparison of Blood Flow Restriction Interventions to Standard Rehabilitation After an Anterior Cruciate Ligament Injury: A Systematic Review.

Blood flow restriction training (BFR-t) data are heterogeneous. It is unclear whether rehabilitation with BFR-t after an anterior cruciate ligament (ACL) injury is more effective in improving muscle strength and muscle size than standard rehabilitation. To review outcomes after an ACL injury and subsequent reconstruction in studies comparing rehabilitation with and without BFR-t. Systematic review. Level of evidence, 3. A search of English-language human clinical studies published in the past 20 years (2002-2022) was carried out in 5 health sciences databases, involving participants aged 18-65 undergoing rehabilitation for an ACL injury. Outcomes associated with muscle strength, muscle size, and knee-specific patient-reported outcome measures (PROMs) were extracted from studies meeting inclusion criteria and compared. The literature search identified 279 studies, of which 5 met the selection criteria. Two studies suggested that BFR-t rehabilitation after an ACL injury improved knee or thigh muscle strength and muscle size compared with rehabilitation consisting of comparable and higher load resistance training, with two studies suggesting the opposite. The single study measuring PROMs showed improvement compared to traditional rehabilitation, with no difference in muscle strength or size. BFR-t after an ACL injury seems to benefit muscle strength, muscle size, and PROM scores compared with standard rehabilitation alone. However, only 1 large study included all these outcomes, which has yet to be replicated in other settings. Further studies utilizing similar methods with a common set of outcome measures are required to confirm the effects of BFR-t on ACL rehabilitation.

Is it time to develop specific return to running criteria for ACL rehabilitation? An international survey of physiotherapists criteria for return to running following ACL injury

ObjectiveTo determine return to running criteria currently used by physiotherapists following anterior cruciate ligament (ACL) injury. DesignSelf-reported online international survey. MethodsAn online survey of physiotherapists across Australia, the Netherlands and France. ResultsA total of 476 respondants participated in the survey across Australia (n = 153), the Netherlands (n = 162), and France (n = 161). For return to running criteria following a non-operative approach, the majority of respondents chose swelling (40.55%, n = 193/476), pain (38.24%, n = 182/476), knee extensor strength (34.34%, n = 163/476), single leg squat (31.93%, n = 152/476) and knee flexor strength (29.83%, n = 142/476). After ACL reconstruction, the highest responses were also swelling (41.18%, n = 196/476), pain (37.18%, n = 177/476), knee extensor strength (37.18%, n = 177/476) and single leg squat (33.19%, n = 158/476). From the identified themes the most common cutoff variables were pain between 0 and 3/10, swelling < grade 1+ and limb symmetry on strength and hop tests >70 %. ConclusionPhysiotherapists in Australia, France, and the Netherlands use many different return to running criteria and most of them use more than one criterion. Despite this, there was little consensus on the cut-off physiotherapists use to apply these criteria.

Effectiveness of Blood Flow Restriction Training on Increasing Strength in Post Surgery Rehabilitation of Anterior Cruciate Ligament (ACL) Compared with Traditional ACL Rehabilitation Protocol

Background: Patients who have anterior cruciate ligament restoration surgery endure a severe loss of strength intheir lower limbs as a result of muscle atrophy and arthrogenic inhibition. A relatively novel method for eitherpreventing muscle atrophy or maybe inducing muscular growth is blood flow restriction (BFR) training.Purpose: The Purpose of the study is to determine effectiveness of blood flow restriction training in post-surgeryrehabilitation of anterior cruciate ligament compared with traditional ACL rehabilitation protocol.Materials and Methods: Total of 50 samples was selected based on inclusion and exclusion criteria. The subjectswere separated as Group A and Group B where group A (n=25) is provided with blood flow restriction trainingand group B (n=25) is provided with strengthening exercise. Results were statistically analysed and tabulated.Result: The study found that there is significant improvement on anterior cruciate ligament surgery in post rehabusing NPRS and Range of motion. The results concluded that the improvement in blood flow restriction trainingwas extremely statistically significant.Conclusion: Blood flow restriction training was found to be more effective than strengthening exercise for thetreatment of post rehabilitation of anterior cruciate ligament surgery.

Differences in athletic identity, sport participation, and psychosocial factors following anterior cruciate ligament rehabilitation in youth athletes.

While youth sports benefits the developing athlete, athletes may also be subject to injury and subsequent return-to-sport protocols. The current return-to-sport criteria emphasize physical measures; however, psychological measures may also be valuable to inform providers of an athlete's readiness. One such measure is athletic identity defined as the degree to which an individual identifies with the athlete role. To better understand athletic identity in return-to-sport, this study aimed to identify relationships and trends between the Athletic Identity Measurement Scale (AIMS), demographic variables, sport participation measures, and the Athletic Coping Skills Inventory-28 (ACSI-28) in youth athletes during rehabilitation following anterior cruciate ligament reconstruction (ACLR). A retrospective review was completed of patients who underwent ACLR at a sports medicine clinic between October 2019 and May 2021. Patients responded to a series of patient reported outcomes (PROs) regarding physical and psychological function at a pre-surgical baseline and after 1 year of rehabilitation. Patients were then divided into groups of high/low AIMS and an increased/decreased AIMS between 1 year and baseline for comparison. Independent samples t-tests and ANOVAs were performed as appropriate with a 95% confidence interval. In the final sample, 87 patients (15.3 ± 1.8 years) were included, with 51.7% being females. Total AIMS scores decreased from 50.3 to 47.5 over rehabilitation (p = 0.019). Furthermore, results indicated that nearly all AIMS scores decreased during rehabilitation, with none showing an increase; however, not all domains were significant. Conversely, all sport participation and coping ability PROs increased over time points except for ACSI-Confidence and Achievement Motivation. Generally, those in the groups with high AIMS and an increase in AIMS also had higher scores in physical function and coping ability PROs, with the groups separated by high/low AIMS exhibiting more frequent statistical significance. Given these results, it appears that athletes may lose identification with the athlete role after ACLR and struggle even 1 year for rehabilitation, but those who recover athletic identity the best may also be those able to cope most effectively with the stressors induced by injury.

Effect of Virtual Reality and Augmented Reality Training for Injury Prevention and Accelerating Rehabilitation of Anterior Cruciate Ligament Injury in Athletes: A Scoping Review

Context: Recently, the use of Virtual reality (VR) and Augmented reality (AR) tools for assessing athletes’ performance in returning to sports and neuromuscular training has experienced significant growth across all age groups. Through this technology, by utilizing laboratory facilities and creating a three-dimensional simulated sports environment that closely resembles the reality and conditions of each sports discipline, athletes can train and undergo evaluation under controlled conditions. The VR and AR systems have been used recently to prevent and rehabilitate Anterior Cruciate Ligament (ACL) injuries and assess the motor control of injured individuals. This scoping review aimed to investigate the impact of VR and AR exercises on ACL injury prevention, ACL rehabilitation, and expediting the return to sports process. Evidence Acquisition: The scoping review follows the reporting system of systematic and meta-analysis studies (PRISMA-ScR) and utilizes the guidelines provided by the Joanna Briggs Institute for conducting various stages of work and data extraction. This study was registered in the PROSPERO database with code CRD42023446354. The search for English articles was conducted in electronic databases, including PubMed, Embase, Web of Science, SPORT Discuss, PsycINFO, CINAHL, and Cochrane, using keywords such as virtual reality, rehabilitation, injury prevention, simulation, augmented reality, ACL, and anterior cruciate ligament until the end of June 2022. Inclusion criteria encompassed any primary research involving both athletes and non-athletes across all levels (from beginners to professional) and all ages and genders (male and female) who have experienced unilateral anterior cruciate ligament injury and have undergone any type and degree of sports or therapeutic intervention using VR and AR systems. Results: Twenty-six out of 204 comprehensive studies were reviewed based on the inclusion and exclusion criteria. The results showed that biomechanical parameters related to ACL injury were measured using various methods such as real-time biofeedback, virtual reality, and augmented reality. The factors investigated showed significant changes after exercise in VR and AR environments. Conclusions: Anterior cruciate ligament injury (or any other sports injury) cannot be summarized in a single musculoskeletal dimension involving mechanical or movement dysfunction. The failure of current approaches to prevent ACL injuries, rehabilitation, and risk assessment is due to the neglect of cognitive and neurological aspects of the injury. New methods such as augmented neuromuscular training (aNMT), multidimensional rehabilitation approaches, and the utilization of virtual reality technology and novel training strategies based on the strengths of VR and AR systems (such as optimal strategy) can compensate for this scientific and practical gap.

Progressive submaximal effort hamstring muscle endurance is reduced after reconstruction of the anterior cruciate ligament

BackgroundEndurance capability in the muscles controlling the knee is poorly understood post anterior cruciate ligament (ACL) reconstruction, despite many sporting activities requiring notable muscle endurance. The hamstring muscles, when active, provide important anatomical support to protect the reconstructed graft. In the absence of good hamstring endurance, fatigue may predispose individuals to re-injury. ObjectiveTo assess whether ACL reconstruction (ACLR) with a hamstring graft leads to reduced hamstring endurance 9–13 months post-surgery. Study designA cross-sectional inter-limb comparison study was undertaken with participants 9–13 months after an ACLR with a hamstring graft, and a group of age, sex, and activity-matched controls. There were 22 participants in each group. MethodSubmaximal hamstring endurance was measured using a progressive fatigue test on an isokinetic dynamometer at a joint angular velocity of 120°/second. The dependant variable was the maximum number of repetitions performed. Statistical comparisons were made across injured, uninjured and control group limbs. ResultsThere was a significant (p < 0.05) deficit in hamstring endurance observed between the injured leg (mean: 111 repetitions, SD 49) and uninjured leg (mean: 136 repetitions, SD 67) of the ACL group, but not between the uninjured and control group legs (mean: 124 repetitions, SD 50). ConclusionThe 18% deficit in submaximal hamstring endurance across the ACL-reconstructed individual's limbs is indicative of a notable loss in muscle performance at 9–13 months post-surgery. These results provide initial evidence for supporting further research examining the inclusion of hamstring endurance training in ACL rehabilitation programmes post-surgery.

The Interval Kicking Program (IKP) as a Reprogramming Technique for the Soccer Player in an Anterior Cruciate Ligament (ACL) Rehabilitation: A Technical Report

The Interval Kicking Program (IKP) as a Reprogramming Technique for the Soccer Player in an Anterior Cruciate Ligament (ACL) Rehabilitation: A Technical Report

Analyzing the Quality, Reliability, and Educational Value of ACL Rehabilitation Exercises on TikTok: A Cross-Sectional Study.

Videos relating to rehabilitation exercises for common injuries relevant to younger populations such as anterior cruciate ligament (ACL) tear receive high view counts on social media platforms such as TikTok. The purpose of this study was to analyze the quality, reliability, and educational value of TikTok videos among the patient population for ACL injury. It was hypothesized that TikTok videos related to ACL rehabilitation exercises would lack quality, reliability, and educational value. Cross-sectional study. TikTok was queried for relevant videos using the hashtags "#ACLrehab" and "#ACLexercises." For each included video, the type of uploader (general user or health care professional) was identified. In addition, the number of views, likes, shares, comments, and favorites for each included video was recorded, and the content of each video was graded using the DISCERN (a well-validated informational analysis tool) and the ACL exercise education score (ACLEES - a custom-designed tool for the evaluation of ACL-related exercises). A total of 111 videos with 5,520,660 cumulative views were included; the median number of views per video was 9801.0 (interquartile range [IQR], 3583.0-28,000.0). Of these videos, 84 and 27 were created by the general public and health care professionals, respectively. The videos collectively received 335,577 likes, 2969 comments, 22,856 favorites, and 6142 shares, with a median of 439 (IQR, 111-1374), 10 (IQR, 2.5-25.5), 54 (IQR, 18-172.5), and 12 (IQR, 2-36), respectively. The tabulated scores for the DISCERN and ACLEES between general users and health care professionals were all statistically nonsignificant. Health care professionals had a higher percentage of videos with a "very poor" DISCERN score in comparison with the general public (66.67% vs 53.57%, respectively). The overall educational value of the TikTok videos related to ACL rehabilitation exercises was very poor. Health care professionals should be aware of the broad distribution of ACL rehabilitation exercise videos that are accessible on TikTok and raise awareness of the deficiencies of the platform as a medium for educational medical-related information.

A Comparative Study of Anterior Cruciate Ligament Reconstruction Versus Conservative Treatment.

Background The anterior cruciate ligament (ACL) rupture is a common injury with an incidence of 68.6 in 100,000 patients per year. Despite extensive research on ACL rupture, there are insufficient high-quality studies to determine clear treatment strategies for adults lacking the ACL. This study aims to examine the functional differences between surgical and conservative treatment based on the quality of the surgical process. Methodology In this prospective, comparative study, a total of 136 patients aged between 18 and 35 years were enrolled per inclusion and exclusion criteria. Using the lottery system, patients were dividedinto the following two groups: group A (n = 71) and group B (n = 65). Group A was treated with arthroscopic ACL reconstruction and rehabilitation, whereas group B was treated conservatively (rehabilitation). Patient data, including age, sex, body mass index, International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner Activity Level (TAL) score, and complications were recorded and compared. Results The demographic data were comparable, where males had dominancy in both groups. The mean IKDC and KOOS scores were higher in group A at all follow-ups compared to group B. The scores gradually increased at every follow-up till six months. At the final follow-up, the IKDC and KOOS scores were higher in group A than in group B, and a significant difference was observed among both groups. The TAL score also gradually increased at every follow-up till 6 months. At the final follow-up, the TAL score was higher in group A than in group B, with a significant difference between the two groups (p = 0.0032). Complications in both groups were comparable. Conclusions This study showed that both the conservatively treated group and the rebuilt group had identical outcomes, with the exception of the conservative group having greater objectively quantifiable instability. However, at the final follow-up, patients reported feeling just as satisfied with their knee without surgery, demonstrating no subjective difference in activity levels or functional outcomes. Therefore, non-athletes with an ACL-insufficient knee should still choose conservative treatment.

Application of Digital Therapy in Post-operative Rehabilitation of Knee Anterior Cruciate Ligament Reconstruction

Digital therapy is important in treating motor system disease. The outcome of digital therapy in post-operative rehabilitation of knee anterior cruciate ligament (ACL) reconstruction is assessed. 142 patients are treated with digital rehabilitation therapy after ACL reconstruction. Patients' pain score, joint motion, lower limb function score, anxiety score are statistically analyzed. Patients' satisfaction, device usage and adverse events are documented. At post-operative 1st day, 8th weeks, 12th weeks, pain score are 4, 2, 1, knee joint range of motion are 55°, 110°, 143°, lower limb function score are 18, 56, 76, anxiety score are 32.5, 26, 23.5 respectively. Patients' satisfaction are 9.4. Mean duration of device usage is (177.6±38.0) minutes per week. Rehabilitation-related and device-related adverse event does not happen. Digital therapy promotes post-operative rehabilitation after ACL reconstruction.

Kinematic Comparison Of Clinical Assessments For Anterior Cruciate Ligament Rehabilitation

Kinematic Comparison Of Clinical Assessments For Anterior Cruciate Ligament Rehabilitation

Neuromuscular Characteristics of Unilateral and Bilateral Maximal Voluntary Isometric Contractions following ACL Reconstruction.

Despite the advancement of diagnostic surgical techniques in anterior cruciate ligament (ACL) reconstruction and rehabilitation protocols following ACL injury, only half of the athletes return to sports at a competitive level. A major concern is neuromechanical dysfunction, which occurs with injuries persisting in operated and non-operated legs following ACL rehabilitation. One of the criteria for a safe return to sports participation is based on the maximal voluntary isometric contraction (MVIC) performed unilaterally and a comparison between the 'healthy knee' and the 'operated knee'. The present study aimed to investigate MVIC in athletes following ACL rehabilitation during open kinetic chain exercise performed unilaterally and bilateral exercises. Twenty subjects participated in the present investigation: 10 male athletes of regional-national level (skiers, rugby, soccer, and volleyball players) who were previously operated on one knee and received a complete rehabilitation protocol (for 6-9 months) were included in the ACL group (age: 23.4 ± 2.11 years; stature: 182.0 ± 9.9 cm; body mass: 78.6 ± 9.9 kg; body mass index: 23.7 ± 1.9 kg/m2), and 10 healthy male athletes formed the control group (CG: age: 24.0 ± 3.4 years; stature: 180.3 ± 10.7 cm; body mass: 74.9 ± 13.5 kg; body mass index: 22.8 ± 2.7 kg/m2). MVICs synchronised with electromyographic (EMG) activity (recorded on the vastus lateralis, vastus medialis, and biceps femoris muscles) were performed during unilateral and bilateral exertions. The rate of force development (RFD) and co-activation index (CI) were also calculated. The differences in the MVIC and RFD between the two legs within each group were not significant (p > 0.05). Vastus lateralis EMG activity during MVIC and biceps femoris EMG activity during RFD were significantly higher in the operated leg than those in the non-operated leg when exertion was performed bilaterally (p < 0.05). The CI was higher in the operated leg than that in the non-operated leg when exertion was performed bilaterally (p < 0.05). Vice versa, vastus medialis EMG activity during RFD was significantly higher in the right leg than that in the left leg when exertion was performed bilaterally (p < 0.05) in the CG. MVICs performed bilaterally represent a reliability modality for highlighting neuromechanical asymmetries. This bilateral exercise should be included in the criteria for a safe return to sports following ACL reconstruction.

The Effects of Exercise with Blood Flow Restriction (BFR) in the Post Operative Rehabilitation of Anterior Cruciate Ligament (ACL) Reconstruction Patients: A Case Series

The Effects of Exercise with Blood Flow Restriction (BFR) in the Post Operative Rehabilitation of Anterior Cruciate Ligament (ACL) Reconstruction Patients: A Case Series

Anterior Cruciate Ligament Rehabilitation for the 10- to 18-Year-Old Adolescent Athlete: Practice Guidelines Based on International Delphi Consensus.

There are 2 treatment options for adolescent athletes with anterior cruciate ligament (ACL) injuries-rehabilitation alone (nonsurgical treatment) or ACL reconstruction plus rehabilitation. However, there is no clear consensus on how to include strength and neuromuscular training during each phase of rehabilitation. To develop a practical consensus for adolescent ACL rehabilitation to help provide care to this age group using an international Delphi panel. Consensus statement. A 3-round online international Delphi consensus study was conducted. A mix of open and closed literature-based statements were formulated and sent out to an international panel of 20 ACL rehabilitation experts. Statements were divided into 3 domains as follows: (1) nonsurgical rehabilitation; (2) prehabilitation; and (3) postoperative rehabilitation. Consensus was defined as 70% agreement between panel members. Panel members agreed that rehabilitation should consist of 3 criterion-based phases, with continued injury prevention serving as a fourth phase. They also reached a consensus on rehabilitation being different for 10- to 16-year-olds compared with 17- and 18-year-olds, with a need to distinguish between prepubertal (Tanner stage 1) and mid- to postpubertal (Tanner stages 2-5) athletes. The panel members reached a consensus on the following topics: educational topics during rehabilitation; psychological interventions during rehabilitation; additional consultation of the orthopaedic surgeon; duration of postoperative rehabilitation; exercises during phase 1 of nonsurgical and postoperative rehabilitation; criteria for progression from phase 1 to phase 2; resistance training during phase 2; jumping exercises during phase 2; criteria for progression from phase 2 to phase 3; and criteria for return to sports (RTS). The most notable differences in recommendations for prepubertal compared with mid- to postpubertal athletes were described for resistance training and RTS criteria. Together with available evidence, this international Delphi statement provides a framework based on expert consensus and describes a practice guideline for adolescent ACL rehabilitation, which can be used in day-to-day practice. This is an important step toward reducing practice inconsistencies, improving the quality of rehabilitation after adolescent ACL injuries, and closing the evidence-practice gap while waiting for further studies to provide clarity.

Content validity, interpretability, and internal consistency of the "Quality First" assessment to evaluate movement quality in hop tests following ACL rehabilitation. A cross-sectional study.

Current approaches fail to adequately identify sport readiness after anterior cruciate ligament (ACL) rehabilitation. Altered landing biomechanics after ACL reconstruction are associated with increased risk of a noncontact ACL reinjury. There is a lack of objective factors to screen for deficient movement patterns. Therefore, the aim of this study was to investigate content validity, interpretability, and internal consistency for the newly developed "Quality First" assessment to evaluate movement quality during hop tests in patients after ACL rehabilitation. Participants in this cross-sectional study were recruited in collaboration with the Altius Swiss Sportmed Center in Rheinfelden, Switzerland. After a successful ACL reconstruction, the movement quality of 50 hop test batteries was evaluated between 6 and 24 months postoperatively with the "Quality First" assessment. Content validity was assessed from the perspective of professionals. To check the interpretability, classical test theory was employed. Cronbach's α was calculated to evaluate internal consistency. Content validity resulted in the inclusion of three different hop tests (single-leg hop for distance, vertical hop, and side hop). The "Quality First" assessment is enabled to evaluate movement quality in the sagittal, vertical, and the transversal plane. After the exclusion process, the "Quality First" assessment was free from floor and ceiling effects and obtained a sufficient Cronbach's α. The final version consists of 15 items, rated on a 4-point scale. By means of further validations, the "Quality First" assessment could offer a possibility to evaluate movement quality after ACL rehabilitation during hop tests.

Physiotherapy Management in Postoperative Anterior Cruciate Ligament

Stabilization of the tibia when moving forward and rotational movements of the knee joint will be assisted by one of the ligaments in the knee joint, namely the Anterior Cruciate Ligament (ACL). This study aims to present physiotherapy management strategies to help reduce pain, prevent stiffness, increase muscle strength, decrease muscle spasms, increase the joint scope of motion, and overcome edema. The method used in this study is a case report. Primary data are obtained through auto anamnesis and physical examination. Holistic diagnosis assessment is carried out quantitatively from the study's beginning, process, and end. The result is that a 33-year-old male patient with a postoperative diagnosis of ACL underwent surgery on November 14, 2022, and has done therapy 7 times; the patient has experienced significant changes. It can be concluded that postoperative ACL rehabilitation can reduce edema and pain, increase muscle strength, and increase ROM. Finding interventions that can be applied to learning and modification of interventions is also recommended to assist in post-ACL reconstruction recovery to return to daily activities. The diagnosis and treatment of physiotherapy in patients are by the latest theories and research. In the evaluation, clinical improvement of patients and increased knowledge were obtained

Periodization in Anterior Cruciate Ligament Rehabilitation: New Framework Versus Old Model? A Clinical Commentary.

The physiological and psychological changes after anterior cruciate ligament reconstruction (ACLR) do not always allow a return to sport in the best condition and at the same level as before. Moreover, the number of significant re-injuries, especially in young athletes should be considered and physical therapists must develop rehabilitation strategies and increasingly specific and ecological test batteries to optimize safe return to play. The return to sport and return to play of athletes after ACLR must progress through the recovery of strength, neuromotor control, and include cardiovascular training while considering different psychological aspects. Because motor control seems to be the key to a safe return to sport, it should be associated with the progressive development of strength, and cognitive abilities should also be considered throughout rehabilitation. Periodization, the planned manipulation of training variables (load, sets, and repetitions) to maximize training adaptations while minimizing fatigue and injury, is relevant to the optimization of muscle strengthening, athletic qualities, and neurocognitive qualities of athletes during rehabilitation after ACLR. Periodized programming utilizes the principle of overload, whereby the neuromuscular system is required to adapt to unaccustomed loads. While progressive loading is a well-established and widely used concept for strengthening, the variance of volume and intensity makes periodization effective for improving athletic skills and attributes, such as muscular strength, endurance, and power, when compared with non-periodized training. The purpose of this clinical commentary is to broadly apply concepts of periodization to rehabilitation after ACLR.

Functional Outcomes of Motor Learning Interventions in Anterior Cruciate Ligament Injuries

Anterior cruciate ligament injury is one of the pathologies that affect the daily and professional life of the majority of athletes. When the treatment options are examined, there are two options surgical treatment and conservative treatment. Rehabilitation is essential in both cases, with or without surgery. Especially for returning to sports, long-term rehabilitation after surgery has become essential. While many different exercise methods have been tried in the prevention of anterior cruciate ligament injury and rehabilitation after reconstructive surgery, many have focused on strength training. The abnormal movement pattern that occurs with the somatosensory loss seen after anterior cruciate ligament injury results in a functional loss in the injured extremity and the contralateral extremity in the long term. Considering the incidence of injury, studies to establish the normal movement pattern and restore motor control are very important. For this reason, motor learning-based interventions that support neuroplasticity are of great interest today. This review aims to examine the functional results of current motor learning-based interventions in anterior cruciate ligament rehabilitation in line with the literature.

A prospective study of joint position sense after anterior cruciate ligament injury, reconstruction with a bone-patella tendon-bone graft, and rehabilitation

BackgroundDisruption of the anterior cruciate ligament (ACL) is associated with significant biomechanical and neuromuscular changes including deficits in joint proprioception. While previous studies have assessed joint position sense (JPS) in ACL deficient knees, methods have varied and few have done so with prospective study designs. The specific aim of this investigation was to determine the effect(s) of ACL reconstruction and recovery time may have on JPS. MethodsIn this prospective study, we assess the effects of ACL reconstruction and rehabilitation on joint position sense in a temporal study. Twelve patients with unilateral ACL injuries were assessed pre-operatively and at 2, 4, 8 months post-op. JPS measurements were performed, while the subject was standing, with passive-active (P-A) and active-active (A-A) tests. Comparisons between the injured/reconstructed and contralateral, uninjured knee were evaluated in terms of real and absolute mean errors. ResultsThere were no statistically significant differences between the injured/reconstructed and contralateral/normal side with P-A or A-A testing at 2, 4, or 8 months. ConclusionWe conclude that there is no difference in joint position sense between the injured and contralateral leg after ACL disruption and reconstruction beginning as early as 2 months post-op. This study provides further evidence that knee proprioception is not altered by ACL injury and reconstruction. Level of evidence: II.