Impact of intensive and traditional rehabilitation on quadriceps strength after anterior cruciate ligament reconstructive surgery

Abstract

After knee anterior cruciate ligament reconstructive surgery, the recovery of the former level of physical activity takes from 3 to 12 months. Such a wide range of recovery period of physical activity suggests that rehabilitation in most cases is not optimal. According to the majority of authors, after the surgery, a patient can resume intensive physical activity, when the difference in muscle strength between the operated lower extremity and another extremity is not greater than 10-15%. The aim of this study was to compare the impact of intensive and normal rehabilitations on the recovery of knee extensor muscle strength after the surgery. MATERIAL AND METHODS: A total of 40 patients were enrolled in this study. The subjects were divided into two groups. Both groups were engaged in physical activity. The mean age of patients (16 men and 4 women) in the first group at the time of surgery was 26.4+/-8.1 years, mean height - 179.8+/-8.5 cm, and mean weight - 76.0+/-14.0 kg. An intensive rehabilitation was applied for the first group of the patients studied. The second group consisted of 13 men and 7 women who were engaged in moderate physical activity. Their mean age at the time of surgery was 27.0+/-9.3 years, mean height - 173.2+/-6.2 cm, and mean weight - 71.0+/-9.0 kg. A traditional rehabilitation was applied to this group. Muscle strength was measured in the patients of both groups studied approximately 5.2 months following surgery using the Biodex isokinetic dynamometer. RESULTS: The patients undergoing an intensive rehabilitation achieved higher levels of knee extensor muscle strength than those patients undergoing a traditional rehabilitation program. Applying an aggressive rehabilitation program, knee extensor muscles recover more quickly than using a traditional rehabilitation program. The comparison of intensive and traditional rehabilitation programs applied to the operated and unoperated lower extremities has shown that the indexes of knee extensor muscle strength differed by 11.51-12.74%. Applying a traditional rehabilitation, a 23.68-49.42% difference in knee flexor muscle strength between operated and unoperated extremities was noted. CONCLUSIONS: The effect of intensive rehabilitation aimed at strength recovery of knee extensor muscles after anterior cruciate ligament reconstructive surgery is greater than after ordinary rehabilitation.