Video Gallery

Video Gallery

Welcome to the AAOS Video Gallery, providing an enhanced viewing experience of AAOS video content.

Neuromuscular Training for ACL Reconstructed Knees - A Protocol Proposal

February 19, 2016

Contributors: Felipe Faria; Julio Filho Gali, MD; Phelipe Augusto Cintra Da Silva, MD

INTRODUCTION: Rehabilitation program is usually incorporated to anterior cruciate ligament reconstruction (ACLR) in order to recover joint mobility, muscular strength, proprioception, and to return to sports. However neuromuscular deficits commonly persist after surgical reconstruction and standard rehabilitation of athletes. The goal of our study was to evaluate the effect of neuromuscular training in subjects that had ACLR using the functional movement screen (FMS).

METHODS: Our training protocol consisted of 6 phases, each of 6 weeks duration. It began two months after ligament reconstruction and was based on core stability exercises and limb asymmetries and neuromuscular deficits correction. The FMS was used to compare the study and control group performance. Patients with a score of 14 or less on the FMS were considered more likely to suffer an injury than those with a higher score. The study group was compounded of 10 individuals (8 male and 2 female; mean age 37.5 years) who had completed our proposed protocol after ACLR. The control group consisted of 10 people (9 male and 1 female; mean age 32.1 years) who were allowed to return to sports activities after completing a regular ACLR rehabilitation protocol. None were professional athletes but they had a minimum of 50 hours of sports activities per year. All tests were performed by a discerning and experienced physical educator.

RESULTS: The average FMS score of the study group was 16.6 compared to the control group at 12.3. According to the FMS score, functional training for ACLR rehabilitation added a statistically significant benefit ( p < 0,0002) to diminish the risk of new injury, compared to regular ACLR rehabilitation protocol.

DISCUSSION: Different from traditional muscular strength program, functional training exercises joints and muscles on three planes of motion with focus on neuromuscular control, joint mobility and stability, alignment of the trunk and lower limb joints. However functional training can also provide muscular strength, power, and endurance. On the other hand FMS is a performance, balance, and coordination test that assesses the whole body interaction and can be used as a new objective tool to measure the safe return to sports activities after ACLR. Return to sports is allowed 10 months after surgery at minimum. The results of our study may recommend functional training as a requirement for ACLR rehabilitation programs. Randomized controlled trials may be necessary to scientifically prove the efficacy of our protocol.

Results for "Knee: Ligament"

1 of 6
1 of 6