Evidence in Practice: Physical Therapy Intervention Following ACL Repair: A Review of Best Practice
Erica Pruett, SPT; Courtney Schulze, SPT; Jeremy Petrich, SPT; Ty Balty, SPT
Faculty Mentor: Mohamed Kohia, PT, Ph.D., MS
Erica Pruett, SPT; Courtney Schulze, SPT; Jeremy Petrich, SPT; Ty Balty, SPT
Faculty Mentor: Mohamed Kohia, PT, Ph.D., MS
Institution(s): Rockhurst University Department of Physical Therapy, Kansas City, MO
Purpose/Hypothesis: The purpose of this review is to critically analyze literature pertaining to current physical therapy management of patients following ACL injury, and to provide a summary of best practice to help guide physical therapists when treating this patient population.
Subjects: Research articles that discussed physical therapy treatment following an ACL tear, in anticipation of surgical repair, following surgical repair, or taking a conservative approach were reviewed.
Methods/ Materials: A thorough analysis of twenty-five articles was performed using Megans and Harris’ scientific rigor criteria and Sackett’s Level of Evidence for each article. Several literature databases were used, including PubMed, CINAHL, the Rockhurst Library, and Google Scholar. Included articles were written in English, full text, peer reviewed, based upon human or animal rehabilitation following ACL repair, and no more than 11 years old. All of the articles were located using online databases. Some keywords and phrases utilized in the search were: Physical Therapy Treatment, ACL, Reconstruction, Rehabilitation, and Therapeutic Exercise. The recommendations found in each article were then categorized based on Grade A, B, or C.
Results: A total of 25 articles were selected and reviewed. Fourteen articles were categorized as Level I, 7 as Level II, 1 as Level III, and 3 as Level V. The 14 articles classified as Level I provided Grade A clinical recommendations. The 7 classified as Level II provided Grade B. Wheras the 4 articles classified as Level III and V provided Grade C recommendations. Only 2 of the 25 studies evaluated fully met all 6 criterion of scientific rigor, while 5 of the studies only lacked one of the criteria. Based on this review the most effective physical therapy treatment following surgical ACL repair included open kinetic chain exercise, electrotherapy, kinesiotape, whole-body vibration, and trigger point dry needling (TPDN) within 6 months following surgery.
Conclusions: Analysis of multiple research articles has confirmed that physical therapy treatment following ACL repair has been shown to benefit patients by improving outcomes. However, no single treatment option was identified as “best practice” following surgical ACL repair.
Funding Source: No additional sources of funding
Purpose/Hypothesis: The purpose of this review is to critically analyze literature pertaining to current physical therapy management of patients following ACL injury, and to provide a summary of best practice to help guide physical therapists when treating this patient population.
Subjects: Research articles that discussed physical therapy treatment following an ACL tear, in anticipation of surgical repair, following surgical repair, or taking a conservative approach were reviewed.
Methods/ Materials: A thorough analysis of twenty-five articles was performed using Megans and Harris’ scientific rigor criteria and Sackett’s Level of Evidence for each article. Several literature databases were used, including PubMed, CINAHL, the Rockhurst Library, and Google Scholar. Included articles were written in English, full text, peer reviewed, based upon human or animal rehabilitation following ACL repair, and no more than 11 years old. All of the articles were located using online databases. Some keywords and phrases utilized in the search were: Physical Therapy Treatment, ACL, Reconstruction, Rehabilitation, and Therapeutic Exercise. The recommendations found in each article were then categorized based on Grade A, B, or C.
Results: A total of 25 articles were selected and reviewed. Fourteen articles were categorized as Level I, 7 as Level II, 1 as Level III, and 3 as Level V. The 14 articles classified as Level I provided Grade A clinical recommendations. The 7 classified as Level II provided Grade B. Wheras the 4 articles classified as Level III and V provided Grade C recommendations. Only 2 of the 25 studies evaluated fully met all 6 criterion of scientific rigor, while 5 of the studies only lacked one of the criteria. Based on this review the most effective physical therapy treatment following surgical ACL repair included open kinetic chain exercise, electrotherapy, kinesiotape, whole-body vibration, and trigger point dry needling (TPDN) within 6 months following surgery.
Conclusions: Analysis of multiple research articles has confirmed that physical therapy treatment following ACL repair has been shown to benefit patients by improving outcomes. However, no single treatment option was identified as “best practice” following surgical ACL repair.
Funding Source: No additional sources of funding