title: Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus.
abstract: OBJECTIVE
  The Royal Dutch Society for Physical Therapy (KNGF) instructed a multidisciplinary group of Dutch anterior cruciate ligament (ACL) experts to develop an evidence statement for rehabilitation after ACL reconstruction.
  
  
  METHODS
  Clinical practice guideline underpinned by systematic review and expert consensus.
  
  
  METHODS
  A multidisciplinary working group and steering group systematically reviewed the literature and wrote the guideline. MEDLINE and the Cochrane Library were searched for meta-analyses, systematic reviews, randomised controlled trials and prospective cohort studies published between January 1990 and June 2015.
  
  
  METHODS
  Included literature must have addressed 1 of 9 predetermined clinical topics: (1) preoperative predictors for postoperative outcome, (2) effectiveness of physical therapy, (3) open and closed kinetic chain quadriceps exercises, (4) strength and neuromuscular training, (5) electrostimulation and electromyographic feedback, (6) cryotherapy, (7) measurements of functional performance, (8) return to play and (9) risk for reinjury.
  
  
  CONCLUSIONS
  Ninety studies were included as the basis for the evidence statement. Rehabilitation after ACL injury should include a prehabilitation phase and 3 criterion-based postoperative phases: (1) impairment-based, (2) sport-specific training and (3) return to play. A battery of strength and hop tests, quality of movement and psychological tests should be used to guide progression from one rehabilitation stage to the next. Postoperative rehabilitation should continue for 9-12 months. To assess readiness to return to play and the risk for reinjury, a test battery, including strength tests, hop tests and measurement of movement quality, should be used.
authors.affiliation: Funqtio, Steyl, The Netherlands.|Radboud University Medical Center, Research Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands.
authors.forename: Nicky
authors.initials: N
authors.lastname: van Melick
authors.affiliation: Sport Medisch Centrum Papendal, Arnhem, The Netherlands.|Research Group Musculoskeletal Rehabilitation, HAN University of Applied Sciences, Nijmegen, The Netherlands.
authors.forename: Robert E H
authors.initials: RE
authors.lastname: van Cingel
authors.affiliation: B&sis, Eindhoven, The Netherlands.
authors.forename: Frans
authors.initials: F
authors.lastname: Brooijmans
authors.affiliation: Neeter Fysiotherapie, Amsterdam, The Netherlands.
authors.forename: Camille
authors.initials: C
authors.lastname: Neeter
authors.affiliation: Kliniek ViaSana, Mill, The Netherlands.
authors.forename: Tony
authors.initials: T
authors.lastname: van Tienen
authors.affiliation: FysioGym Topsport, Enschede, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: Hullegie
authors.affiliation: Funqtio, Steyl, The Netherlands.
authors.forename: Maria W G
authors.initials: MW
authors.lastname: Nijhuis-van der Sanden
mesh_terms: D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries / Q000534:rehabilitation*; D059549:Anterior Cruciate Ligament Reconstruction / Q000534:rehabilitation*; D032921:Consensus; D019317:Evidence-Based Medicine; D005081:Exercise Therapy; D006801:Humans; D026741:Physical Therapy Modalities; D011182:Postoperative Care; D017410:Practice Guidelines as Topic; D020127:Recovery of Function; D000068958:Return to Sport
keywords: Anterior cruciate ligament; Rehabilitation