The effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction: a systematic review
Abstract Background To explore the effectiveness of preoperative rehabilitation programmes (PreHab) on postoperative physical and psychological outcomes following anterior cruciate ligament reconstruction (ACLR). Method A systematic search was conducted from inception to November 2019. Randomised co...
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12891-020-03676-6 |
| _version_ | 1818317021886021632 |
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| author | Hayley M. Carter Chris Littlewood Kate E. Webster Benjamin E. Smith |
| author_facet | Hayley M. Carter Chris Littlewood Kate E. Webster Benjamin E. Smith |
| author_sort | Hayley M. Carter |
| collection | DOAJ |
| description | Abstract Background To explore the effectiveness of preoperative rehabilitation programmes (PreHab) on postoperative physical and psychological outcomes following anterior cruciate ligament reconstruction (ACLR). Method A systematic search was conducted from inception to November 2019. Randomised controlled trials (RCTs) published in English were included. Risk of bias was assessed using Version 2 of the Cochrane risk-of-bias tool, and the Grading of Recommendations Assessment system was used to evaluate the quality of evidence. Results The search identified 739 potentially eligible studies, three met the inclusion criteria. All included RCTs scored ‘high’ risk of bias. PreHab in all three RCTs was an exercise programme, each varied in content (strength, control, balance and perturbation training), frequency (10 to 24 sessions) and length (3.1- to 6-weeks). Statistically significant differences (p < 0.05) were reported for quadriceps strength (one RCT) and single leg hop scores (two RCTs) in favour of PreHab three months after ACLR, compared to no PreHab. One RCT reported no statistically significant between-group difference for pain and function. No RCT evaluated post-operative psychological outcomes. Conclusion Very low quality evidence suggests that PreHab that includes muscular strength, balance and perturbation training offers a small benefit to quadriceps strength and single leg hop scores three months after ACLR compared with no PreHab. There is no consensus on the optimum PreHab programme content, frequency and length. Further research is needed to develop PreHab programmes that consider psychosocial factors and the measurement of relevant post-operative outcomes such as psychological readiness and return to sport. Trial registration PROSPERO trial registration number. CRD42020162754 . |
| first_indexed | 2024-12-13T09:30:42Z |
| format | Article |
| id | doaj.art-9756244b66794bb99ba4bcc292ec0c66 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-13T09:30:42Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-9756244b66794bb99ba4bcc292ec0c662022-12-21T23:52:30ZengBMCBMC Musculoskeletal Disorders1471-24742020-10-0121111310.1186/s12891-020-03676-6The effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction: a systematic reviewHayley M. Carter0Chris Littlewood1Kate E. Webster2Benjamin E. Smith3Department of Physiotherapy, London Road Community Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, London Road Community HospitalDepartment of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan UniversitySchool of Allied Health, Human Services and Sport, La Trobe UniversityDepartment of Physiotherapy, London Road Community Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, London Road Community HospitalAbstract Background To explore the effectiveness of preoperative rehabilitation programmes (PreHab) on postoperative physical and psychological outcomes following anterior cruciate ligament reconstruction (ACLR). Method A systematic search was conducted from inception to November 2019. Randomised controlled trials (RCTs) published in English were included. Risk of bias was assessed using Version 2 of the Cochrane risk-of-bias tool, and the Grading of Recommendations Assessment system was used to evaluate the quality of evidence. Results The search identified 739 potentially eligible studies, three met the inclusion criteria. All included RCTs scored ‘high’ risk of bias. PreHab in all three RCTs was an exercise programme, each varied in content (strength, control, balance and perturbation training), frequency (10 to 24 sessions) and length (3.1- to 6-weeks). Statistically significant differences (p < 0.05) were reported for quadriceps strength (one RCT) and single leg hop scores (two RCTs) in favour of PreHab three months after ACLR, compared to no PreHab. One RCT reported no statistically significant between-group difference for pain and function. No RCT evaluated post-operative psychological outcomes. Conclusion Very low quality evidence suggests that PreHab that includes muscular strength, balance and perturbation training offers a small benefit to quadriceps strength and single leg hop scores three months after ACLR compared with no PreHab. There is no consensus on the optimum PreHab programme content, frequency and length. Further research is needed to develop PreHab programmes that consider psychosocial factors and the measurement of relevant post-operative outcomes such as psychological readiness and return to sport. Trial registration PROSPERO trial registration number. CRD42020162754 .http://link.springer.com/article/10.1186/s12891-020-03676-6Anterior cruciate ligament (ACL)RehabilitationPostoperative outcomesSystematic review |
| spellingShingle | Hayley M. Carter Chris Littlewood Kate E. Webster Benjamin E. Smith The effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction: a systematic review BMC Musculoskeletal Disorders Anterior cruciate ligament (ACL) Rehabilitation Postoperative outcomes Systematic review |
| title | The effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction: a systematic review |
| title_full | The effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction: a systematic review |
| title_fullStr | The effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction: a systematic review |
| title_full_unstemmed | The effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction: a systematic review |
| title_short | The effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction: a systematic review |
| title_sort | effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament acl reconstruction a systematic review |
| topic | Anterior cruciate ligament (ACL) Rehabilitation Postoperative outcomes Systematic review |
| url | http://link.springer.com/article/10.1186/s12891-020-03676-6 |
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