A Randomised Controlled Trial of Proprioceptive and Balance Training after Surgical Reconstruction of the Anterior Cruciate Ligament

Abstract

A randomised controlled trial (29 participants) was used to compare a 6-week proprioceptive and balance exercise program with a 6-week strengthening program in the early phases of rehabilitation after anterior cruciate ligament (ACL) reconstruction. Measurements of functional activity were taken by a blinded assessor before the intervention and at the end of the 6 weeks. Results demonstrated that there were no significant differences between groups on hop testing at 6 weeks. For several items in the Cincinnati knee rating system and the patient specific functional scale however, the strengthening group improved more than the proprioceptive and balance group (p < .05). The hypothesis that proprioceptive and balance training would improve functional activity more than strengthening exercises was not supported. There was either no difference between the two forms of exercise or strength training may be more beneficial than proprioceptive and balance training in the early phase of rehabilitation after ACL reconstructive surgery.

Rehabilitation After Anterior Cruciate Ligament Reconstruction

“…Cooper et al compared six weeks of strength training with proprioceptive and balance training in twenty-nine randomized patients 26 . Patients were evaluated on the basis of the Cincinnati knee score, patient-specific functional scale, knee motion, and hop test after completion of the six weeks of treatment.…”

Ön Çapraz Bağ Tamir Operasyonu Sonrası Gülhane Ön Çapraz Bağ Rehabilitasyon Protokolü

“…The Gulhane ACL Rehabilitation Protocol is a more comprehensive neuromuscular training model than that reported by Risberg et al, Cooper et al, Fitzgerald, Ihara, Beard, and Lui-Ambrosso et al (4,7,13,(16)(17)(18)(19). Optimal healing of the ACL is dependent on rehabilitation.…”

“…Despite some limitations in these studies, they all showed significantly improved knee function with the use of rehabilitation programs that included neuromuscular exercises, as compared to only strength training exercises in patients with ACL deficiencies. Only a very limited number of controlled trials on the effects of neuromuscular training after ACL reconstruction have been reported (16,17). None of these studies provide baseline data (pre-operative data) and all have major limitations.…”

“…The strength-training group, however, had less swelling and improved walking and squatting, as compared to the neuromuscular training group. Cooper et al (17) concluded that there appeared to be no benefit from neuromuscular training in the early post ACL reconstruction period. Similarly, Risberg reported no differences between the two rehabilitation groups 3 months post-surgery, but that a prolonged rehabilitation program (up to 6 months) seemed to result in some benefit for the neuromuscular training group (7).…”

Perceiving movement patterns: Implications for skill evaluation, correction and development. [Percepción de los patrones de movimiento: Implicaciones para la evaluación, corrección y el desarrollo de habilidades].

“…Proprioceptive acuity is defined by Muaidi, Nicholson and Refshauge (2008, p.371) as "the ability to sense joint positions, movement and force of muscle contraction and to discriminate movements of limb segments individually and relative to each other". The bulk of the research on proprioceptive acuity has examined differences in proprioceptive acuity after injury or surgery (Cooper, Taylor, & Feller, 2005;Fischer-Rasmussen & Jensen, 2000) or during rehabilitation (Cooper et al, 2005). One approach that has been widely used in a clinical setting to establish perceivable difference is the "just noticeable difference" (JND) method.…”