I Eitzen et al. A Progressive 5-Week Exercise Therapy Program Leads to Significant Improvement in Knee Function Early After Anterior Cruciate Ligament Injury. Journal of Orthoaepedic & Sports Physical Therapy, August 6, 2010.

In a prospective cohort study without a control group, Eitzen and colleagues sought to present a five-week progressive exercise therapy program in the early stage after anterior cruciate ligament (ACL) injury. They also evaluated changes in knee function after completion of the program for patients with ACL injury in general and also when subjects were classified as potential copers or non-copers. Finally, the investigators examined potential adverse events. One hundred patients were included in a five-week progressive exercise therapy program within three months after injury. Knee function before and after completion of the program was evaluated from isokinetic quadriceps and hamstrings muscle strength tests, four single-leg hop tests, two different self-assessment questionnaires, and a global rating of knee function. A two-way mixed analysis of variance (ANOVA) was conducted to evaluate changes from pre-to posttest for the limb symmetry index (LSI) for muscle strength and single-leg hop tests, and the change in scores for the patient-reported questionnaires. In addition, absolute values and the standardized response mean (SRM) for muscle strength and single-leg hop tests were calculated at pre- and posttest for the injured and uninjured limb. Adverse events during the five-week period were recorded. The progressive 5-week exercise therapy program led to significant improvements (p<0.05) in knee function from pre- to posttest both for patients classified as potential copers and non-copers. SRM values for changes in muscle strength and single-leg hop performance from pre- to posttest for the injured limb were moderate to strong (0.49-0.84), indicating the observed improvements to be clinically relevant. Adverse events occurred in 3.9% of the patients.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that short-term progressive exercise therapy programs are well tolerated and should be incorporated in early stage ACL rehabilitation, either to improve knee function before ACL reconstruction or as a first step in further non-operative management.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE CONSUMER: There is the need to replicate this study using controls. In the meantime, it would be appropriate to use the short-term progressive exercise therapy programs in early stage ACL rehabilitation.