Neuromuscular Training on Lower Extremity in Post-operative Anterior Cruciate Ligament Reconstruction
Condition: Anterior Cruciate Ligament Injuries
MeSH terms: Anterior Cruciate Ligament Injuries
Study type: Interventional

Summary: 
      The objective of the study was to determine the effectiveness of neuromuscular physical
      Therapy as compared to strength training after ACL reconstruction in terms of pain, function,
      quality of life, strength and power of participants after ACL reconstruction.

      It was a Randomized clinical trial conducted Kanaan Physiotherapy & Spine Clinic, Lahore.
      Seventy-six patients were selected by purposive sampling technique and equally divided into
      one of two treatment groups either neuromuscular training or strength training with use of
      sealed envelope randomization. The study was completed in 6 months. Patients were assessed
      using the Cincinnati Knee Score for function, Numeric Pain Rating Scale (NPRS) for pain,
      SF-36 for quality of life, and Hop test (single leg, Triple, crossover and 6-meter hop) for
      power and strength.Patients received the treatment 3 times per week for six consecutive
      weeks.
    

Detailed description: 
      The knee joint problems and injuries has been rising as a result of more number of patients
      getting injuries in various daily livings e.g traffic and industrial accidents Ligamentous
      injuries are one of the commonest injuries of knee among which occurrence of Anterior
      cruciate ligament(ACL) injuries are of considerable importance The ACL is actually made up of
      many bundles of connective tissue and it has course from femur to tibia as shown in picture.
      The ACL is main ligament which prevents tibia to go outwards and excessive loads. When knee
      is in straight position ACL has 32mm length and 7-12mm width.ACL has 2 parts anteromedial
      bundle and posterolateral bundle. During flex position AMB goes into lengthened position and
      PLB goes into shorten position. It is made up of collagen fibres and its framework has
      proteins, glycoproteins, elastic systems, and glycoseminoglycans. Because of its elastic
      property it undergoes into many stresses. And it has nerve supply of tibial nerve and it has
      arterial supply of middle genicular artery. The Occurrence of ACL injures mostly reported
      among paediatric and adolescent population as compared to adult population. This factor which
      raises the contribution of adults to participate in sports are younger age high performance
      training, awareness of injury and use of better modalities. Short term complications of ACL
      that include loss of function, pain and reconstructive surgery period of about 24 to 36 weeks
      required for return to function. Reconstructive surgeries include autogenous or allogeneic
      graft reconstruction Many studies showed that after reconstructive surgery patients return to
      sports. Most (82%) patients are able to return to sport activity according to a meta-analysis
      results; however preinjury levels of performance are attained in only 43-65.7% of cases.
      Long-term complication of ACL injuries that significantly include osteoarthritis that develop
      later in life. One of the studies show that 50% of diagnosed patients of meniscus or ACL tear
      might develop osteoarthritis (OA) in the affected knee in about 10-20 years after surgery and
      the prevalence and severity of OA has not been shown to reduce by reconstructive surgery.
      Newer surgical approaches and techniques seems to reduce risk of developing osteoarthritis
      later in life but still questionable.
    

Intervention name(s): Neuromuscular Training; Strength Training
Intervention type(s): Other; Other
Intervention description(s): Muscular and neural training by complex exercises; Strength Training
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Anterior cruciate ligament, Neuromuscular training,Strength