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FRAMEWORK FOR OPTIMIZING ACL REHABILITATION UTILIZING A GLOBAL SYSTEMS APPROACH.

Steven L Dischiavi, Alexis A Wright1, Eric J Hegedus1

  • 1Department of Physical Therapy, High Point University, One University Parkway, High Point, NC, USA, 27268.

International Journal of Sports Physical Therapy
|June 23, 2020
PubMed
Summary
This summary is machine-generated.

High re-injury rates after anterior cruciate ligament (ACL) reconstruction persist. This commentary proposes a global, hip-focused framework to enhance knee rehabilitation, improving motor control for complex movements like running and jumping.

Keywords:
ACLdynamic knee valguship exercisemovement systemproximal rehabilitation

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Rehabilitation Science

Background:

  • Anterior cruciate ligament (ACL) tears are common, with high re-injury rates (25-33%) post-reconstruction.
  • Current hip strengthening protocols in knee rehabilitation may not adequately improve motor control for dynamic activities.
  • Existing 'regional' or 'proximal' rehabilitation approaches are considered too simplistic.

Purpose of the Study:

  • To provide clinicians with a framework for optimizing knee rehabilitation.
  • To introduce a more global, hip-focused approach to enhance motor control and functional recovery.
  • To adapt rehabilitation to better match sport-specific demands on the knee.

Main Methods:

  • This clinical commentary proposes a theoretical framework for rehabilitation.
  • The approach emphasizes a global, hip-focused strategy.
  • It suggests modifying exercise complexity and loading variables (speed, direction, flight).

Main Results:

  • The proposed framework aims to improve motor control during complex, dynamic movements.
  • It facilitates replication of sport-specific knee loading demands.
  • This approach offers a more comprehensive alternative to basic rehabilitation.

Conclusions:

  • A global, hip-focused rehabilitation framework can optimize knee recovery after ACL reconstruction.
  • Adapting exercise complexity and loading variables is crucial for improving motor control.
  • This approach addresses limitations of current reductionist rehabilitation philosophies.