Rehabilitation After Anterior Cruciate Ligament Injury: Review of Current Literature and Recommendations

Jenkins, Sarah M.; Guzman, Alvarho; Gardner, Brandon B; Bryant, Stewart A.; Sol, Shane Rayos Del; McGahan, Patrick J.; Chen, James

doi:10.1007/s12178-022-09752-9

Cited by 41 publications

(33 citation statements)

References 74 publications

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“…In this period, targeted exercises for the hamstring muscles were avoided, in order not to incur into early overloads (Jenkins et al., 2022) and respect the biological healing times of the donation site (Buckthorpe et al., 2021). Therefore, the PT decided to start the BFR protocol starting from the sixth week after surgery, as suggested by a recent study (Buckthorpe et al., 2021), with the recommendation to start targeted muscle strengthening strategies for hamstring muscles compatibly with patient's knee reported pain and function.…”

Section: Intervention and Rehabilitation Protocolmentioning

confidence: 99%

Use of blood flow restriction for increasing the strength of the ischiocrural muscles in anterior cruciate ligament rehabilitation: A case report

Ceccarelli,

Andreani,

Soave

et al. 2023

Physiotherapy Res Intl

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BackgroundThe hamstring muscles have a key function in the stability of the knee, limiting the anterior translation of the tibia. Therefore, to better perform rehabilitation after anterior cruciate ligament (ACL) surgery, it is important to develop a specific program based on hamstring strength recovery. It is possible to increase strength and muscle hypertrophy through high load exercises (HL); the recommended load is about 60%–80% of a maximum repetition (MR). Although low‐load resistance training (LL) is ineffective at reproducing these values, the use of Blood Flow Restriction (BFR) with LL exercises appears to allow athletes to increase strength and muscle hypertrophy. This could limit functional decline and mitigate muscle atrophy allowing to optimize the recovery path and load management in post‐operative patients. Recent scientific evidence, as far as the increasingly frequent use of BFR in rehabilitation and sports rehabilitation is concerned, suggests that these devices could represent one of the most significant innovations in the physiotherapy field. The aim of this study was to increase the strength of the hamstrings in the early phases of ACL rehabilitation with an LL‐BFR training protocol for speeding up the development of adequate muscle strength.Case descriptionsThe patient, a 25‐year‐old male professional footballer, suffered from ACL injury during a football match, and after three months, he underwent a reconstruction ACL surgery with medial Hamstring tendon autograft. The athlete engaged a pre‐operative program to restore a full active and passive knee range of motion and increase muscular strength. The first rehabilitation phase was supported by the adoption of BFR for hamstring strengthening, starting from the sixth week post‐surgery (T0). A complete assessment of posterior hamstring muscles was performed through a hand‐held dynamometer and load detection platforms. Three different types of exercises, focusing on the hamstring muscles, were chosen. Two further assessments were performed over time (T1 ant T2), highlighting different changes that occurred.ResultsInteresting results showed a significant increase between T0 and T1 for all the assessed outcomes; in this case an average increase in strength of 59.87% between the beginning and the end of 4 weeks rehabilitation protocol was obtained in the first interval (T0‐T1), while only 25.26% resulted in the second interval (T1‐T2). However, the collected data should be considered with caution due to some limitations: the single experience of a single patient can hardly be generalized. Moreover, the reliance on isometric measurement of maximal strength and the absence of a direct strength measurement of the hamstrings during squat remain questionable.ConclusionThe final results suggest the capacity of the LL‐BFR exercises to recreate a condition of a high intensity muscular effort with respect to load management, especially after surgery. This highlights the need to further investigate BFR adoption as it allows the patients to speed up their rehabilitation goals in developing adequate muscle strength.

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Section: Intervention and Rehabilitation Protocolmentioning

confidence: 99%

Use of blood flow restriction for increasing the strength of the ischiocrural muscles in anterior cruciate ligament rehabilitation: A case report

Ceccarelli,

Andreani,

Soave

et al. 2023

Physiotherapy Res Intl

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“…This may be related to the fact that younger athletes are more likely to attempt to return to their sport at a higher capacity than older athletes, raising the risk of injury (11). Copers endure an ACLdeficient knee better than noncopers and thus deciding whether to have surgery requires a thorough and informed discussion centered on the patient's goals and capacity to tolerate rigorous rehabilitation (45). Nonoperative treatment, which includes early counseling, bracing, and activity adjustment, is often preferred by older, less active people (45).…”

Section: Practical Applicationsmentioning

confidence: 99%

“…This may be related to the fact that younger athletes are more likely to attempt to return to their sport at a higher capacity than older athletes, raising the risk of injury (11). Copers endure an ACL-deficient knee better than noncopers and thus deciding whether to have surgery requires a thorough and informed discussion centered on the patient's goals and capacity to tolerate rigorous rehabilitation (45). Nonoperative treatment, which includes early counseling, bracing, and activity adjustment, is often preferred by older, less active people (45).…”

Section: Practical Applicationsmentioning

confidence: 99%

Return to Sport After an Anterior Cruciate Ligament Tear: Bridging the Gap Between Research and Practice

Arias

Monaco

Schöenfeld

2023

Strength &Amp; Conditioning Journal

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An anterior cruciate ligament (ACL) tear is one of the most frequent injuries experienced by athletes of all levels. Because so many variables are at play, there is a great deal of controversy about how and why this occurs. In addition, there are various suggested appropriate steps to take to return to sport in the fastest and safest possible way. However, a major issue in injury recovery and return to sport practices is the lack of a gold-standard method or a consistent course of action that an athlete should undertake after suffering an ACL injury. Therefore, the purpose of this paper is to review the literature to determine evidence-based methods for return to sport after ACL reconstruction and provide practical recommendations to guide the process.

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“…Согласно определению Всемирной организации здравоохранения, качество жизни является личным восприятием своего собственного жизненного плана в контексте систем культуры и ценностей, в которых человек живет в соответствии со своими целями, ожиданиями, стандартами и интересами [7]. Концепция КЖ динамично развивается, расширяются сферы ее применения в различных областях медицины и здравоохранения 1 [8][9][10][11][12], для всесторонней оценки эффективности проводимого лечения и реабилитации [13][14][15].…”

Section: Introductionunclassified

Efficacy of Physical Rehabilitation after Anterior Cruciate Ligament Reconstruction: Non-Randomized Trial

Radysh

Круглова

Boyarintsev

et al. 2023

Kuban. nauсh. med. vestnik

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Background. Anterior cruciate ligament rupture is the most common knee joint injury, especially in young people with a healthy and active lifestyle. The concept of quality of life has been dynamically developing. The scope of its application is expanding in various fields of medicine to provide a comprehensive assessment of treatment and rehabilitation efficacy.Objective — to assess the feasibility of complex individual physical rehabilitation of patients after early and delayed arthroscopic reconstruction of the anterior cruciate ligament (ACL).Methods. Open simple non-randomized trial enrolled 834 patients with the anterior cruciate ligament rupture of the knee joint. In the first group (431 patients), ACL plastic surgery was performed in the early stages — between weeks 2 and 6. In the second group (403 patients), ACL reconstruction was performed in the later stages — from week 7 to 1 year, inclusive. Each group was divided into two subgroups — the main one, in which restorative treatment and comprehensive individual rehabilitation were carried out, and the control group, with rehabilitation treatment in accordance with the standards of postoperative treatment. The study was conducted in Traumatology, Orthopedics and Medical Rehabilitation Unit of Clinical Hospital No. 1. Patients were included in the trial from 2016 to 2021. The follow-up period for each patient was one year. Statistical data processing was performed by means of Statistica 12.0 (StatSoft, Inc., USA). Independent samples were compared using non-parametric criteria: Mann — Whitney U-test and Wilcoxon T-test.Results. No statistical differences were found in the distribution according to gender, age and body mass index. A comparative analysis of scale medians of Medical Outcomes Study 36Item Short-Form Health Survey (MOSSF-36), conducted in patients before surgery, revealed no statistically significant differences ( p>0.05) between the main and control subgroups in both groups. Analyzing medians before ACL reconstruction showed a significant decrease in comparison with population studies ( p < 0.0001, Mann — Whitney U-test). The analysis of physical and mental component summaries via MOSSF-36 revealed statistically significant differences in the effectiveness of treatment of patients in 1 year after ACL plastic surgery and complex individual rehabilitation. Thus, in the main subgroups, the values of treatment efficacy medians were significantly higher than in the control ones, regardless of the timing of ACL plastic surgery ( p < 0.001, Mann — Whitney U-test). The results testify to higher median efficacy values in patients of the main subgroup of group 1 than in other subgroups ( p < 0.001, Mann — Whitney U-test). The study of correlative relationships demonstrated a stronger relationship between the medians of physical and mental component summaries in the main subgroup of the first group (correlation coefficient = 0.76), if compared to the main subgroup of the second group (coefficient = 0.67).Conclusion. The study testified to the treatment efficacy proved using the scales of physical and mental component summaries. They demonstrated more significant treatment efficacy one year after arthroscopic ACL reconstruction and individual rehabilitation in the main subgroup of group 1 than in the other subgroups.

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Rehabilitation After Anterior Cruciate Ligament Injury: Review of Current Literature and Recommendations

Cited by 41 publications

References 74 publications

Use of blood flow restriction for increasing the strength of the ischiocrural muscles in anterior cruciate ligament rehabilitation: A case report

Use of blood flow restriction for increasing the strength of the ischiocrural muscles in anterior cruciate ligament rehabilitation: A case report

Return to Sport After an Anterior Cruciate Ligament Tear: Bridging the Gap Between Research and Practice

Efficacy of Physical Rehabilitation after Anterior Cruciate Ligament Reconstruction: Non-Randomized Trial

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