BACKGROUND: There is no consensus regarding the optimal postoperative rehabilitation program after anterior cruciate ligament (ACL) reconstruction. PURPOSE: The purpose of this study was to examine the long-term outcome of a 6-month neuromuscular exercise (NE) training program versus a traditional strength exercise (SE) training program after ACL reconstruction. STUDY DESIGN: Randomized controlled trial; level of evidence, 1. METHODS: Seventy-four patients were randomly assigned to either a NE program or a SE program and tested preoperatively and at 6 months, 1 year, and 2 years after ACL reconstruction. Outcome measurements were as follows: Cincinnati knee score, visual analog scale for pain and global function, Short Form 36, functional knee tests, and isokinetic muscle strength tests. RESULTS: There were no significant differences between the NE and SE programs 1 and 2 years after ACL reconstruction for the primary outcome measurement (Cincinnati knee score). There were significantly improved knee function (global function) and reduced pain during activity for the NE group, compared with the SE group, and significantly improved hamstring muscle strength for the SE group, compared with the NE group, 2 years after ACL reconstruction. CONCLUSION: On the basis of these results, a postoperative program combining both NE and SE should be included after ACL reconstruction to improve knee function.

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