Functional proprioceptive stimulation promotes early rehabilitation following ACL reconstruction: a randomized...

Early-phase rehabilitation following anterior cruciate ligament reconstruction (ACLR) should prioritize the recovery of knee joint mobility while considering sensorimotor alterations that may occur after injury and surgery. Continuous passive motion (CPM) and functional proprioceptive stimulation (FPS) may support joint mobility recovery, but their combined effects during early rehabilitation after ACLR have not yet been investigated. This preliminary randomized controlled trial evaluated the effects of combining FPS with CPM compared with CPM alone during the first two weeks of rehabilitation following ACLR.

Twenty-four participants undergoing ACLR were randomly allocated to either a CPM + FPS group or a CPM group. Participants completed a standardized physiotherapy program consisting of 10 sessions over 2 weeks. Depending on group allocation, participants received CPM alone or CPM combined with synchronized FPS during the first 30 min of each session. Active range of motion (AROM), passive range of motion (PROM), active and passive knee extension deficit, pain intensity, and daily analgesic use were assessed throughout the intervention. Repeated continuous outcomes were analyzed using linear mixed-effects models including participant random intercepts, while analgesic use was analyzed as a repeated binary outcome using a binomial mixed-effects model.

A significant group × time interaction was observed for AROM (p = 0.001), with greater improvement in the CPM + FPS group than in the CPM group (+48.6° vs. +31.4°, p = 0.036). Although the CPM + FPS group demonstrated a larger post-intervention PROM gain than the CPM group (+43.5° vs. +31.1°), this was not significant (p = 0.083). Pain intensity (p < 0.001) and analgesic medication (p < 0.05) decreased over the 2-week period without significant between-group difference.

Within a 2-week postoperative standardized early rehabilitation program following ACLR, the addition of FPS to CPM was associated with greater improvement in AROM. Although PROM also tended to improve to a greater extent in the CPM + FPS group, the evidence supporting this finding was less robust. No significant between-group difference was observed for pain intensity. These preliminary findings support the potential value of FPS as a pragmatic adjunct to CPM for early mobility recovery.Clinical Trial Registration: [ClinicalTrials.gov], identifier NCT07553013.