A systematic review of evidence for anterior cruciate ligament rehabilitation: how much and what type?

Risberg, May Arna; Lewek, Michael D.; Snyder‐Mackler, Lynn

doi:10.1016/j.ptsp.2004.02.003

Cited by 154 publications

(172 citation statements)

References 65 publications

Supporting

Mentioning

161

Contrasting

Unclassified

Order By: Relevance

“…Previous systematic reviews on this topic have provided insight into the reported effects of NMES 3, 22 and have made suggestions for future research; however, no systematic review has compared the relative effect sizes (ESs) of between-group differences following a course of NMES for quadriceps strength, functional performance, or self-reported function. Our primary purposes were to summarize the outcomes of NMES versus control treatments by calculating the ESs and associated 95% confidence intervals (CIs) for the outcome measures of (1) Language limits were set to include only English-language articles.…”

mentioning

confidence: 99%

“…Twelve RCTs met the inclusion criteria, while 289 studies were excluded based on title, abstract, or content. There were an additional 3 RCTs identified from the cross-referencing of a previous literature review, 3,17,18,22,32 a clinical practice guideline, 1 and a Cochrane-collaboration protocol, 15 for a total of 15 RCTs. Further assessment excluded 6 of the 15 RCTs; 1 did not have true randomization 16 and 5 studies did not present group means and standard deviations.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Effects of Neuromuscular Electrical Stimulation After Anterior Cruciate Ligament Reconstruction on Quadriceps Strength, Function, and Patient-Oriented Outcomes: A Systematic Review

Kim¹,

Croy²,

Hertel³

et al. 2010

J Orthop Sports Phys Ther

142

104

View full text Add to dashboard Cite

[ literature review ] P ostoperative weakness, muscle atrophy, and impaired knee function are common following anterior cruciate ligament (ACL) reconstruction. During the first 4 weeks after surgery, significant quadriceps strength deficits, when compared to the contralateral limb, have been reported. 26,28 Although knee stability is significantly improved, long-term outcomes report knee extensor weakness ranging from 6% 12 to 18% 23 as late as 1 to 6 years following reconstruction. Ernst et al 8 further demonstrated that persistent lower extremity compensations exist following ACL reconstruction and adversely affect single-limb performance, including vertical jump takeoff and landing. Other investigators 12 found that patients following ACL reconstruction who had knee extensor strength less than 80% of the contralateral side had gait kinematics similar to patients with ACL-deficient knees. In the same study, patients with knee extensor strength greater than 90% of the contralateral limb demonstrated gait kinematics similar to healthy individuals without ACL injury.12 A clear challenge for the rehabilitation specialist treating patients who have undergone ACL reconstruction is the resolution of the quadriceps strength deficit through the safest and most expeditious means available.Neuromuscular electrical stimulation (NMES) applied to the quadriceps is used in the clinical rehabilitation of quadriceps weakness following ACL reconstruction. 18Some investigators initiate NMES on the third postoperative day 21 t MeTHodS: Searches were performed for randomized controlled trials using electronic databases from 1966 through October 2008. Methodological quality was assessed using the Physiotherapy Evidence Database Scale. Betweengroup effect sizes and 95% confidence intervals (CIs) were calculated.t reSulTS: Eight randomized controlled trials were included. The average Physiotherapy Evidence Database Scale score was 4 out of possible maximum 10. The effect sizes for quadriceps strength measures (isometric or isokinetic torque) from 7 studies ranged from -0.74 to 3.81 at approximately 6 weeks postoperatively; 6 of 11 comparisons were statistically significant, with strength benefits favoring NMES treatment. The effect sizes for functional performance measures from 1 study ranged from 0.07 to 0.64 at 6 weeks postoperatively; none of 3 comparisons were statistically significant, and the effect sizes for self-reported function measures from 1 study were 0.66 and 0.72 at 12 to 16 weeks postoperatively; both comparisons were statistically significant, with benefits favoring NMES treatment.t ConCluSion: NMES combined with exercise may be more effective in improving quadriceps strength than exercise alone, whereas its effect on functional performance and patient-oriented outcomes is inconclusive. Inconsistencies were noted in the NMES parameters and application of NMES.t leVel oF eVidenCe: Therapy, level 1a-.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

Effects of Neuromuscular Electrical Stimulation After Anterior Cruciate Ligament Reconstruction on Quadriceps Strength, Function, and Patient-Oriented Outcomes: A Systematic Review

Kim¹,

Croy²,

Hertel³

et al. 2010

J Orthop Sports Phys Ther

142

104

View full text Add to dashboard Cite

show abstract

“…9 Neuromuscular exercise programs have been found to be beneficial in patients with knee injury and knee OA, 11,42 and have previously also been reported to be effective in middleaged patients after meniscectomy. 21,45 Hence, exercises aimed at improving both quadriceps muscle strength and neuromuscular performance should be included in rehabilitation programs for patients with knee degeneration.…”

Section: T T Discussionmentioning

confidence: 99%

A 12-Week Exercise Therapy Program in Middle-Aged Patients With Degenerative Meniscus Tears: A Case Series With 1-Year Follow-up

Stensrud¹,

Roos²,

Risberg³

2012

J Orthop Sports Phys Ther

View full text Add to dashboard Cite

“…101 A Cochrane review of exercise therapy after isolated ACL injuries and 2 systematic reviews of ACL rehabilitation identified only 8 studies that evaluated different aspects of nonoperative management. 24,89 None of the 8 studies included rehabilitation of skeletally immature individuals, and no RCTs of different rehabilitation programs for skeletally immature patients with ACL injuries have been published to our knowledge.…”

Section: Physeal Sparing Reconstructionmentioning

confidence: 99%

“…The neuromuscular rehabilitation component is based on the principles described in several studies on ACL injury prevention in adolescent athletes 46,86,97 and in adults with ACL injuries. 89,105 All children are given a functional, custom-fit knee brace that they are instructed to use when they are participating in pivoting sports and physical education classes in school. The children's activity levels, episodes of giving way, compliance with the use of the brace, and knee function are monitored monthly via a structured web-based questionnaire.…”

Section: Proposed Treatment Algorithmmentioning

confidence: 99%

Management of Anterior Cruciate Ligament Injuries in Skeletally Immature Individuals

Moksnes

Engebretsen²,

Risberg³

2012

Journal of Orthopaedic & Sports Physical Therapy

View full text Add to dashboard Cite

Synopsis Anterior cruciate ligament (ACL) injuries in skeletally immature individuals remain a challenge for the child, the parents, orthopaedic surgeons, and physical therapists. The main challenges are the potential risk of recurrent instability, secondary injuries following nonoperative treatment, and the risks involved with surgical treatment due to the vulnerability of the epiphyseal growth plates. We first present the physiological background for considerations that must be made when advising on treatment alternatives for skeletally immature individuals after ACL injury. The implications of continuous musculoskeletal development for treatment decisions are emphasized. No randomized controlled trials have been performed to investigate outcomes of different treatment algorithms. There is no consensus in the literature on clinical treatment decision criteria for whether a skeletally immature child should undergo transphyseal ACL reconstruction, physeal sparing ACL reconstruction, or nonoperative treatment. Additionally, well-described rehabilitation programs designed for either nonoperative treatment or postoperative rehabilitation have not been published. Based on the currently available evidence, we propose a treatment algorithm for the management of ACL injuries in skeletally immature individuals. Finally, we suggest directions for future prospective studies, which should include development of valid and reliable outcome measures and specific rehabilitation programs. J Orthop Sports Phys Ther 2012;42(3):172-183, Epub 4 September 2011. doi:10.2519/jospt.2012.3608

show abstract

A systematic review of evidence for anterior cruciate ligament rehabilitation: how much and what type?

Cited by 154 publications

References 65 publications

Effects of Neuromuscular Electrical Stimulation After Anterior Cruciate Ligament Reconstruction on Quadriceps Strength, Function, and Patient-Oriented Outcomes: A Systematic Review

Effects of Neuromuscular Electrical Stimulation After Anterior Cruciate Ligament Reconstruction on Quadriceps Strength, Function, and Patient-Oriented Outcomes: A Systematic Review

A 12-Week Exercise Therapy Program in Middle-Aged Patients With Degenerative Meniscus Tears: A Case Series With 1-Year Follow-up

Management of Anterior Cruciate Ligament Injuries in Skeletally Immature Individuals

Contact Info

Product

Resources

About