PURPOSE: Quadriceps weakness is common after anterior cruciate ligament (ACL) reconstruction, resulting in prolonged disability and increased risk for reinjury and osteoarthritis. Functional resistance training (FRT) combines resistance training with task-specific training and may prove beneficial in restoring quadriceps strength. The primary purpose of this study was to determine if a walking-specific FRT program (eg, resisted walking) improves knee strength in individuals after ACL reconstruction. METHODS: Thirty participants were randomized into one of three groups: (1) FRT with a customized knee BRACE applied to the ACL leg, (2) FRT with elastic BAND tethered to the ankle of the ACL leg, or (3) a TARGET MATCH condition where no resistance was externally applied. Participants in all groups received training while walking on a treadmill 2 to 3 times per week for 8 wk. Isometric knee extension and flexion strength were measured before the start of the intervention, after the intervention (POST), and 8 wk after intervention completion (POST-2). RESULTS: The BRACE group had greater knee extensor strength compared with the TARGET MATCH group at POST and POST-2 (p < 0.05). The BRACE group had greater knee flexor strength than the TARGET MATCH group at POST and POST-2 (p < 0.05) and the BAND group at POST (p < 0.05). CONCLUSIONS: FRT applied via a customized knee brace results in improvements in knee extensor and flexor strength after ACL reconstruction. FRT is a beneficial adjuvant to ACL rehabilitation and leads to better strength compared with standard of care.

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