| Evidence-based rehabilitation following anterior cruciate ligament reconstruction. | |
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MedLine Citation:
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PMID: 20069277 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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Following a bone-patellar tendon-bone autograft (BPTB) or four-stranded semitendinosus/gracilis tendons autograft (ST/G) anterior cruciate ligament (ACL) reconstruction, the speed and safety with which an athlete returns to sports (or regains the pre-injury level of function) depends on the rehabilitation protocol. Considering the large differences in clinical and outpatient protocols, there is no consensus regarding the content of such a rehabilitation program. Therefore, we conducted a systematic review to develop an optimal evidence-based rehabilitation protocol to enable unambiguous, practical and useful treatment after ACL reconstruction. The systematic literature search identified 1,096 citations published between January 1995 and December 2006. Thirty-two soundly based rehabilitation programs, randomized clinical trials (RCT's) and reviews were included in which common physical therapy modalities (instruction, bracing, cryotherapy, joint mobility training, muscle-strength training, gait re-education, training of neuromuscular function/balance and proprioception) or rehabilitation programs were evaluated following ACL reconstruction with a BPTB or ST/G graft. Two reviews were excluded because of poor quality. Finally, the extracted data were combined with information from background literature to develop an optimal evidence-based rehabilitation protocol. The results clearly indicated that an accelerated protocol without postoperative bracing, in which reduction of pain, swelling and inflammation, regaining range of motion, strength and neuromuscular control are the most important aims, has important advantages and does not lead to stability problems. Preclinical sessions, clear starting times and control of the rehabilitation aims with objective and subjective tests facilitate an uncomplicated rehabilitation course. Consensus about this evidence-based accelerated protocol will not only enhance the speed and safety with which an athlete returns to sports, but a standardized method of outcome measurement and reporting will also increase the evidential value of future articles. |
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Authors:
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S van Grinsven; R E H van Cingel; C J M Holla; C J M van Loon |
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Publication Detail:
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Type: Journal Article Date: 2010-01-13 |
Journal Detail:
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Title: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Volume: 18 ISSN: 1433-7347 ISO Abbreviation: Knee Surg Sports Traumatol Arthrosc Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9314730 Medline TA: Knee Surg Sports Traumatol Arthrosc Country: Germany |
Other Details:
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Languages: eng Pagination: 1128-44 Citation Subset: IM |
Affiliation:
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Department of Physical Therapy, Rijnstate Hospital, Wagnerlaan 55, 6800 TA, Arnhem, The Netherlands. SvanGrinsven@Alysis.nl |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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