2023 ISAKOS Biennial Congress ePoster
Supervised Rehabilitation Can Lead to Better Functional Outcome Than Home-Based Rehabilitation Up To 1 Year After ACL Reconstruction
Ki-Mo Jang, MD, PhD, Prof., Seoul KOREA, REPUBLIC OF
Jin Hyuck Lee, PT, PhD, Seongbuk-Gu/ Seoul, KOREA KOREA, REPUBLIC OF
Jun-Gu Park, MD, Seoul KOREA, REPUBLIC OF
Seo-Jun Lee, MD, Seoul KOREA, REPUBLIC OF
Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, KOREA, REPUBLIC OF
FDA Status Not Applicable
Summary
Supervised rehabilitation may offer additional benefits in improving muscle strength, neuromuscular control, and patient-reported knee function compared with home-based rehabilitation up to 1 year after ACLR.
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Abstract
Background
Previous studies reported no significant difference between supervised and home-based rehabilitation after anterior cruciate ligament reconstruction (ACLR). However, the function of the non-operative knee, hamstring strength at deep flexion, and neuromuscular control have been overlooked. This prospective observational study was performed to investigate the functional outcomes after ACLR in operative and non-operative knees between supervised and home-based rehabilitations.
Materials And Methods
After operations, instructional videos demonstrating the rehabilitation process and exercises were provided for the home-based rehabilitation group. The supervised rehabilitation group visited our sports medicine center and physical therapists followed up all patients during the entire duration of the study. Isokinetic muscle strength and neuromuscular control (acceleration time (AT) and overall stability index (OSI)) of both operative and non-operative knees, as well as patient-reported knee function (Lysholm score), were assessed and compared between the two groups 6 months and 1 year postoperatively.
Results
The supervised rehabilitation group showed higher hamstring (H) and quadriceps (Q) muscle strength in non-operative knees at 6 months (H, p = 0.033; Q, p = 0.045) and higher H strength in operative and non-operative knees at 1 year (operative knees, p = 0.035; non-operative knees, p = 0.01) than the home-based rehabilitation group. At 6 months and 1 year, OSIs in operative and non-operative knees were significantly better in the supervised rehabilitation group than in the home-based rehabilitation group (operative knees, p < 0.001, p < 0.001; non-operative knees, p < 0.001, p < 0.001, at 6 months and 1 year, respectively). At 1 year, the supervised rehabilitation group also demonstrated faster AT of the hamstrings (operative knees, p = 0.016; non-operative knees, p = 0.036). Althogh Lysholm scores gradually improved in both groups over 1 year, the supervised rehabilitation group showed higher scores at 1 year (87.3 ± 5.8 vs. 75.6 ± 15.1, p = 0.016).
Conclusions
Our study demonstrated that supervised rehabilitation may offer additional benefits in improving muscle strength, neuromuscular control, and patient-reported knee function compared with home-based rehabilitation up to 1 year after ACLR.