Policlinico Città di Udine, Viale Venezia 410, 33100, Udine, Italy.
Sports Medicine and Science (LIROMS), Luxembourg Institute of Research in Orthopedics, Luxembourg, Luxembourg.
Knee Surg Sports Traumatol Arthrosc. 2020 Nov;28(11):3647-3654. doi: 10.1007/s00167-020-05960-3. Epub 2020 Apr 2.
The aim of this study was to report current rehabilitation recommendations after ACL reconstruction in ESSKA community, with a particular focus on the specific criteria utilized to guide activity progression METHODS: A web-based survey was developed to investigate preferences between time-based and functional ACL reconstruction rehabilitation progression milestones of ESSKA community.
Eight hundred and twenty completed questionnaires were received. Responders were from 86 different countries worldwide, 63% of them from European countries. Functional criteria were considered more appropriate to decide if a patient can start specific activities/exercises by 67% of the responders. Good core and lower extremity neuromuscular control were the most often used functional criteria for decision-making regarding readiness for sport-specific rehabilitation (66%), sport-specific drills without (65%) and with contact (66%). Strength assessed with an isokinetic dynamometer was considered by about half of the responders a determinant to initiate sport-specific drills without (51%-isokinetic strength, LSI > 80%) and with contact (58%-isokinetic strength, LSI > 85-90%). To determine readiness for sport-specific drills, hop tests were used by 40% of respondents for drills without contact and 48% of respondents for drills with contact.
The results of this survey involving mainly orthopaedic surgeons indicate that functional measures are considered more appropriate than milestones based on time from surgery to guide progression through the postoperative rehabilitation process after ACLR. The main clinical relevance of this study is that updated information on collective agreement could be useful for clinicians and physiotherapists to delineate their postoperative treatments after ACLR. These results should be interpreted with caution, as this sample represents only a small portion of ESSKA community involved in knee surgery and treating patients following ACLR.
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本研究旨在报告 ESSKA 社区中 ACL 重建后的当前康复建议，特别关注用于指导活动进展的具体标准。
开发了一个基于网络的调查，以研究 ESSKA 社区中基于时间和功能的 ACL 重建康复进展里程碑之间的偏好。
共收到 820 份完成的问卷。应答者来自全球 86 个不同的国家，其中 63%来自欧洲国家。67%的应答者认为功能标准更适合决定患者是否可以开始进行特定的活动/锻炼。良好的核心和下肢神经肌肉控制是决定是否准备好进行特定运动康复（66%）、特定运动训练（65%）和接触（66%）的最常用功能标准。约一半的应答者认为使用等速测力计评估的力量是开始无接触（51%-等速力量，LSI＞80%）和有接触（58%-等速力量，LSI＞85-90%）特定运动训练的决定因素。为了确定是否准备好进行特定运动训练，40%的应答者使用跳跃测试进行无接触训练，48%的应答者进行接触训练。
这项主要涉及骨科医生的调查结果表明，功能测量比基于手术后时间的里程碑更适合指导 ACLR 后术后康复过程中的进展。本研究的主要临床意义是，有关集体协议的最新信息可能对临床医生和物理治疗师有用，以划定他们在 ACLR 后的术后治疗。这些结果应谨慎解释，因为该样本仅代表参与膝关节手术和治疗 ACLR 后患者的 ESSKA 社区的一小部分。
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