Background: A 19-year-old man presented with right knee pain while bearing weight on the right leg and difficulty bending the right knee. He was diagnosed with a complete -tear of the anterior cruciate ligament. After ACL reconstruction this individual was referred to physical therapy treatment. Objective: To investigate if neuroscience pain education, and eccentric training, have any therapeutic significance in post-ACL reconstructive patients. Method: After assessment, the first day of the first week, introduced a treatment protocol consisting of basic range of motion (ROM) and isometric exercises for three sets of 10–30 sec hold. From first to fourth week eccentric exercises along with pain neuroscience education (PNE) sessions were given on alternate days, with three sessions for PNE and eccentric exercises until fourth week. Result: As shown in this study, treatment with a combination of PNE and eccentric training results in improved quadriceps muscle strength, range of motion, and overall function. Conclusion: This report suggested that PNE in conjunction with eccentric exercise has clinical merit. Clinical implication of study is examining the effectiveness of this approach should be conducted in the form of well-designed, clinical studies.
Fractures of the patella are often reported in individuals with multiple injuries. It comprises 2.8% of all fractures,[1] most of which are middle-aged and employed adult population. Various studies have revealed that all fractures have resulted from high-energy blow or trauma of direct compressive and indirect forces caused due to industrial accidents which often involve the articulating surfaces along with the soft tissue.[2] Various literature reviews have focused to manage patellar fractures with open reduction internal fixation. Most patellar fractures require Kirschner wire, and anterior tension band screws as the patella have a mechanical advantage over quadriceps muscle which increases its leverage.[3] Despite the rigid fixation, there is loss of knee range of motion and stiffness postoperatively due to the fibrosis in the healing phase. Knee stiffness involves the severe restriction of the flexion, extension and knee joint pain along with muscle atrophy.[4] Several studies have reported the problems like knee effusion, pain, and quadriceps atrophy postoperatively which should be paid attention to. Several rehabilitation guidelines are available for postoperative knee stiffness but none of the guidelines is universally accepted. No guideline discusses and concludes the specific rehabilitation technique[5] but indeed is suggestive mention of a common goal. As per the standard exercise, prescription protocol guidelines are considered for specific mode intensity, repetition, and duration of exercises followed during formulating the exercise programme.
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