Quality and Variability of Online Available Physical Therapy Protocols From Academic Orthopaedic Surgery Programs for Anterior Cruciate Ligament Reconstruction

2016 ◽  
Vol 32 (8) ◽  
pp. 1612-1621 ◽  
Author(s):  
Eric C. Makhni ◽  
Erica K. Crump ◽  
Michael E. Steinhaus ◽  
Nikhil N. Verma ◽  
Christopher S. Ahmad ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Physical Therapy ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Orthopaedic Surgery ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

scholarly journals Temporal Utilization of Physical Therapy Visits After Anterior Cruciate Ligament Reconstruction

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098229
Author(s):  
Patrick J. Burroughs ◽  
Joseph B. Kahan ◽  
Harold G. Moore ◽  
Jonathan N. Grauer ◽  
Elizabeth C. Gardner
Keyword(s):  
Anterior Cruciate Ligament ◽  
Physical Therapy ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Postoperative Period ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Study Cohort ◽  
Cruciate Ligament Reconstruction ◽  
The Mean ◽  
Anterior Cruciate

Background: Physical therapy (PT) rehabilitation is critical to successful outcomes after anterior cruciate ligament reconstruction (ACLR). Later-stage rehabilitation, including sport-specific exercises, is increasingly recognized for restoring high-level knee function. However, supervised PT visits have historically been concentrated during the early stages of recovery after ACLR. Purpose/Hypothesis: To assess the number and temporal utilization of PT visits after ACLR in a national cohort. We hypothesized that PT visits would be concentrated early in the postoperative period. Study Design: Descriptive epidemiological study. Methods: The Humana PearlDiver database was searched to identify patients who underwent ACLR between 2007 and 2017. Patients with additional structures treated were excluded. The mean ± SD, median and interquartile range (IQR), and range of number of PT visits for each patient were determined for the 52 weeks after ACLR. PT visits over time were also assessed in relation to patient age and sex. Results: In total, 11,518 patients who underwent ACLR met the inclusion criteria; the mean age was 32.62 ± 13.70 years, and 42.7% were female patients. Of this study cohort, 10,381 (90.4%) had documented PT postoperatively; the range of PT visits was 0 to 121. On average, patients had 16.90 ± 10.60 PT visits (median [IQR], 16 [9-22]) after ACLR. Patients completed a mean of 52% of their PT visits in the first 6 weeks, 75% in the first 10 weeks, and 90% in the first 16 weeks after surgery. Patients aged 10 to 19 years had the highest number of PT visits (mean ± SD, 19.67 ± 12.09; median [IQR], 18 [12-25]), significantly greater than other age groups ( P < .001). Conclusion: PT after ACLR is concentrated in the early postoperative period. Physicians, therapists, and patients may consider adjusting the limited access to PT to optimize patient recovery. Clinical Relevance: As supervised PT visits may be limited, the appropriate temporal utilization of supervised PT visits must be maximized. Strategies to ensure sessions for later neuromuscular and activity-specific rehabilitation are needed.

Comparison of Home versus Physical Therapy-Supervised Rehabilitation Programs after Anterior Cruciate Ligament Reconstruction

2005 ◽  
Vol 33 (9) ◽  
pp. 1288-1297 ◽  
Author(s):  
John A. Grant ◽  
Nicholas G. H. Mohtadi ◽  
Murray E. Maitland ◽  
Ronald F. Zernicke
Keyword(s):  
Anterior Cruciate Ligament ◽  
Physical Therapy ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Range Of Motion ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Rehabilitation Program ◽  
Cruciate Ligament Reconstruction ◽  
Home Based ◽  
Anterior Cruciate

Background Because of health care funding and policy changes, there is a need to examine the effects of an evolution toward patient-directed (ie, home-based) rehabilitation programs on clinical outcomes of patients undergoing anterior cruciate ligament reconstruction. Hypothesis There will be no difference in the effectiveness of a home-based rehabilitation program and a standard physical therapy-supervised rehabilitation program in patients 3 months after nonacute anterior cruciate ligament reconstruction with bone-patellar tendon-bone grafts. Study Design Randomized controlled clinical trial; Level of evidence, 1. Methods There were 145 patients (16-59 years) who attended a presurgery education class. Home-based patients attended 4 physical therapy sessions, and physical therapy-supervised patients attended 17 physical therapy sessions over the first 12 weeks after surgery. All patients followed the same standardized rehabilitation program. Study outcome measures included active-assisted knee flexion and passive knee extension range of motion, knee range of motion during walking, KT computerized arthrometer results, and isokinetic quadriceps and hamstrings strength. Patient outcomes were dichotomized as either clinically acceptable or unacceptable. Rehabilitation programs were compared by the proportion of acceptable patients in each group. Results The home-based group had a significantly higher percentage of patients with acceptable flexion and extension range of motion compared to the standard physical therapy group (flexion, 67% vs 47%; extension, 97% vs 83%). There were no significant differences between the groups in range of motion during walking, ligament laxity, and strength. Conclusion A structured, minimally supervised rehabilitation program was more effective in achieving acceptable knee range of motion in the first 3 months after anterior cruciate ligament reconstruction than a standard physical therapy-based program. Clinical Relevance Recreational athletes undergoing nonacute anterior cruciate ligament reconstruction can successfully reach acceptable rehabilitation goals in the first 3 months after surgery with a limited number of purposeful physical therapy education sessions, allowing recreational athletes more flexibility when integrating the necessary postoperative rehabilitation into their daily activities.

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