Authors (including presenting author) :
Chan H, Wong CK, Pang PY, Chang HC
Affiliation :
Physiotherapy department , MacLehose Medical Rehabilitation Centre
Introduction :
Patient often reported difficulties in return to sports (RTS) after knee anterior cruciate ligament reconstruction surgery (ACLR). Common reasons include inadequate muscle strength and lack of confidence in transiting to on-field sports from gym training.
Studies suggested that training in group environment provides additional psychological benefit of peer support. Specific training on tasks that simulate sports within allowance of existing rehabilitation protocol may also provide psychological encouragement for future RTS. The programme aims at facilitating RTS by boosting physical competence and confidence through integration of sport-simulating tasks into rehabilitation within existing protocol in an interactive exercise class.
Objectives :
1. To enhance functional performance and muscle strength in late rehabilitation phase.
2. To improve confidence in RTS by introduction of sport-simulating tasks under physiotherapists’ supervision within existing protocol.
3. To shift RTS rehabilitation from physiotherapy department to interactive group exercise in the basketball court.
Methodology :
Program design:
-A 12-wk class training from November 2019 to February 2020
-Patients with six months post-ACLR were recruited
-One hour of sport-simulating group exercise in the basketball court + one hour of gym equipment training in physiotherapy department
-Two sessions held per week
Program content:
1. Intensive strengthening exercises for Hamstring and Quadriceps
2. Progressive single leg hopping and jumping, plyometric exercises and advanced agility drills
3. Sport-simulating training and drills within existing protocol for common sports (football, basketball etc.)
4. Neuromuscular control and prevention of re-injury
5. Core stability strengthening and cardiopulmonary training
Result & Outcome :
The program was temporary suspended from Q1 2020 due to COVID and restarted in Q4 2022.
At 6 weeks and 12 weeks: 9 participants completed the program
Outcome including:
1. Isokinetic muscle testing
Quadriceps strength improvement:
At 6 wks: 12.44%; 12 weeks 17.56%
Hamstring strength improvement:
At 6 wks: 16.22%; 12 weeks 17.83%
2. Confidence in RTS
ACL Return to sports after injury questionnaire: Statistically significant improvement with a mean improvement 16.1 out of 100 (p=0.006*, SD 13.12)
3. Patient satisfaction questionnaire
100% agreed that:
-RTS exercise class could physically and psychologically prepare them to RTS
-Training in class environment was more motivating and has better training effect
-Sports-simulating tasks supervised by physiotherapists was specific and could improve confidence in RTS.
- Were satisfied and would recommend RTS class
