This study aimed to assess the effects of a month-long preoperative rehabilitation program that incorporated intensive machine-based training, on pre- and postoperative knee extension strength and the likelihood of returning to sports activities after ACL reconstruction.
This study included nine patients (mean age 16.8 years; four males, five females; median pre-injury Tegner activity score: 9) scheduled for ACL reconstruction at our hospital who participated in a one-month structured preoperative rehabilitation program (pre-rehab group), and 10 patients (mean age 17.7 years; five males, five females; median pre-injury Tegner activity score: 9) scheduled for ACL reconstruction who did not participate in the pre-rehab program (control group). The pre-rehab program involved high-intensity machine training (leg press, leg extension; five repetitions maximum) and closed kinetic chain exercises, performed 2–3 times per week. Isokinetic knee extension strength was measured at baseline (one month before surgery), the day before surgery, and six months postoperatively. Anterior knee laxity was assessed with the KT-1000 at six months. The return to sports status was evaluated a year after surgery to determine the long-term functional outcomes of the intervention. Statistical analysis was performed using SPSS for Windows software (SPSS Inc, Chicago, IL). The level of significance was determined at P .05.
The pre-rehab group showed significant improvements in knee extension strength, reaching 158% of baseline strength on the day before surgery and 160% six months postoperatively (p 0.05). Conversely, the control group demonstrated no significant changes; strength values remained at 95% preoperatively and 105% postoperatively. No significant differences were observed in anterior knee laxity between the groups (pre-rehab group: 0.9 ± 0.8 mm; control group: 0.2 ± 0.6 mm). The return to sports rate was not statistically significant between the groups (pre-rehab group: 89%, control group: 70%), the pre-rehab group tended to have a higher rate of return to sports compared to the control group.
This study suggests that a comprehensive preoperative rehabilitation program incorporating high-intensity machine-based training significantly enhances knee extension strength in patients who have undergone ACL reconstruction. The lack of significant differences in knee laxity confirms the safety of the intervention. High-intensity machine training can improve strength without compromising joint stability and may increase the likelihood of a successful return to sports. While the outcomes are encouraging, further research involving larger cohorts will be valuable to confirm these findings and explore additional factors.
This study underscores the importance of incorporating preoperative rehabilitation, particularly high-intensity machine-based training, as part of ACL reconstruction protocols. This approach has proven to be safe and effective in strengthening the knee without compromising stability, potentially increasing the chances of a successful return to playing sports and improving patient outcomes.
Preoperative rehabilitation
Knee muscle strength
