A Systematic Review of ACL Reconstruction Rehabilitation
| Autor: | Haitham Sulaiman A Habtar, Hani Mousa Alkhalaf, Khalid A. Alahmari, Mohammad Abdul Majeed Abdul Ahad, Abrar Abdulrahman M Alarabi, Mohammed Thamer Shaker Alghalibi, Obada Bashir Awad, Sami Amer M Alqarni, Abdullghany Mohammed Dowaikh, Faris Ali Alnemer, Mohammad Abdullah M Alshahrani, Fawaz Nawaf Alshaalan, Sami Aoudah Tami Alahmari, Salem Baty D Alshahrani, Mohammed Ali S Almousa, Saeed Mubarak Saeed Alshahrani |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
030222 orthopedics
medicine.medical_specialty Rehabilitation business.industry Standard treatment medicine.medical_treatment MEDLINE 030229 sport sciences Continuous passive motion Cruciate ligament 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Systematic review medicine.anatomical_structure Inclusion and exclusion criteria Clinical endpoint medicine business |
| Zdroj: | The Egyptian Journal of Hospital Medicine. 68:853-864 |
| ISSN: | 2090-7125 1687-2002 |
| DOI: | 10.12816/0038184 |
| Popis: | Background: Anterior Cruciate Ligament (ACL) reconstruction is a well-known surgical knee procedure performed by orthopaedic surgeons. There is a general consensus for the effectiveness of a postoperative ACL reconstruction rehabilitation program, however there is little consensus regarding the optimal components of a program Objective of the Study: to assess the merits and demerits of current ACL reconstruction rehabilitation programs and interventions based on the evidence supported by previously conducted systematic reviews. Methods: a Systematic search in the scientific database (Medline, Scopus, EMBASE , and Google Scholer) between 1970 and 2017 was conducted for all relevant Systematic reviews discussing the primary endpoint ( ACL reconstruction rehabilitation ) studies were analyzed and included based on the preset inclusion and exclusion criteria. Study screening and quality was assessed against PRISMA guidelines and a best evidence synthesis was performed. Results: the search results yielded five studies which evaluated eight rehabilitation components (bracing, Continuous passive motion (CPM), neuromuscular electrical stimulation (NMES), open kinetic chain (OKC) versus closed kinetic chain (CKC) exercise, progressive eccentric exercise, home versus supervised rehabilitation, accelerated rehabilitation and water based rehabilitation). A strong evidence suggested no added benefit of short term bracing (0-6 weeks post-surgery) compared to standard treatment. Whilst a moderate evidence reinforced no added advantage of continuous passive motion to standard treatment for boosting motion range. Furthermore, a moderate evidence of equal effectiveness of closed versus open kinetic chain exercise and home versus clinic based rehabilitation, on a range of short term outcomes. There was inconsistent or limited evidence for some interventions including: the use of NMES and exercise, accelerated and non-accelerated rehabilitation, early and delayed rehabilitation, and eccentric resistance programs after ACL reconstruction. Conclusion: short term post-operative bracing and continuous passive motion (CPM) introduce no benefit over standard treatment and thus not recommended. A moderate evidence suggested equal efficiency for 1) CKC and OKC are equally effective for knee laxity, pain and function, at least in the short term (6-14 weeks) after ACL reconstruction and 2) home based and clinic based rehabilitation. Nevertheless, the degree of physiotherapy input remains unclear. |
| Databáze: | OpenAIRE |
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