Evidence for the effects of prehabilitation before ACL-reconstruction on return to sport-related and self-reported knee function: a systematic review

  • Study design: Systematic review. Background and objectives: Preoperative neuromuscular function is predictive for knee function and return to sports (RTS) after reconstruction of the anterior cruciate ligament (ACL). The aim of this review was to examine the potential benefits of prehabilitation on pre-/postoperative objective, self-reported and RTS-specific outcomes. Methods: A systematic search was conducted within three databases. From the 1.071 studies screened, two randomized control trials (RCTs), two control trials (CTs) and two cohort studies (CS) met the inclusion criteria. Methodological quality rating adopted the PEDro- (RCT, CT) or Newcastle-Ottawa-Scale (CS). Results and conclusions: Methodological quality of the included studies was moderate (PEDro score: 6.5 ± 1.7; range 4 to 9). Two studies reported higher increases of the maximal quadriceps torque from baseline to pre-reconstruction: one study in the limb symmetry index (LSI), and one in both legs of the prehabilitation group compared to the controls. At 12-weeks post-reconstruction, one study (from two) indicated that the prehabilitation group had a lesser post-operative decline in the single-leg-hop for distance LSI (clinically meaningful). Similar findings were found in terms of quadriceps strength LSI (one study). At both pre-reconstruction (three studies) and two-year post-surgery (two studies), the prehabilitation groups reached significantly higher self-reported knee function (clinically meaningful) than the controls. RTS tended to be faster (one study). At two years post-surgery, RTS rates (one study) were higher in the prehabilitation groups. The results provide evidence for the relevance of prehabilitation prior to ACL-reconstruction to improve neuromuscular and self-reported knee function as well as RTS. More high quality confirmatory RCTs are warranted.

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Author:Florian GiescheORCiD, Daniel NiedererORCiDGND, Winfried BanzerGND, Lutz VogtGND
Parent Title (English):PLoS ONE
Place of publication:San Francisco, California, US
Document Type:Article
Date of Publication (online):2020/10/28
Date of first Publication:2020/10/28
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2021/11/03
Tag:Anterior cruciate ligament reconstruction; Body limbs; Cohort studies; Knees; Medical risk factors; Sports and exercise medicine; Strength training; Torque
Issue:10, art. e0240192
Page Number:21
First Page:1
Last Page:21
Institutes:Psychologie und Sportwissenschaften / Sportwissenschaften
Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0