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Isokinetic knee strength and proprioception before and after anterior cruciate ligament reconstruction: a comparison between home-based and supervised rehabilitation
Lim J-M, Cho J-J, Kim T-Y, Yoon B-C
Journal of Back and Musculoskeletal Rehabilitation 2019;32(3):421-429
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Rehabilitation after anterior cruciate ligament (ACL) reconstruction focuses on restoring knee deficiencies and function. However, the extent of the clinician's direct supervision that is required to recover knee function is unknown. OBJECTIVE: To investigate differences in isokinetic knee strength improvement, endurance, and proprioception between home-based (HBR) and supervised rehabilitation (SR). METHODS: Thirty participants were randomly allocated to each group after reconstruction. Isokinetic knee strength and proprioception were measured using the Biodex multi-joint and stability systems, respectively, before and after intervention. RESULTS: The SR group showed a significant improvement from baseline, but not the HBR group (SR group from 1.94 +/- 1.44 to 1.02 +/- 0.92, p < 0.05; HBR group from 1.69 +/- 0.88 to 1.61 +/- 0.90, p > 0.05). There was a significant effect of exercise type on proprioception scores after controlling for pretest values (p < 0.05). No significant difference in isokinetic knee strength was observed between the groups. CONCLUSIONS: HBR recovered knee strength as effectively as the SR, but SR was more effective than HBR for the recovery of proprioception and functional knee movement. This result indicates that guidance from health professionals play an important role in enhancing proprioception for patients following ACL reconstruction.

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