title: Differential Effects of 2 Rehabilitation Programs Following Anterior Cruciate Ligament Reconstruction.
abstract: BACKGROUND
  The muscular function restoration related to the type of physical rehabilitation followed after anterior cruciate ligament reconstruction (ACLR) using autologous hamstring tendon graft in terms of strength and cross-sectional area (CSA) remain controversial.
  
  
  OBJECTIVE
  To analyze the CSA and force output of quadriceps and hamstring muscles in subjects following either an Objective Criteria-Based Rehabilitation (OCBR) algorithm or the usual care (UCR) for ACL rehabilitation in Spain, before and 1 year after undergoing an ACLR.
  
  
  METHODS
  Longitudinal clinical double-blinded randomized controlled trial.
  
  
  METHODS
  Sports-medicine research center.
  
  
  METHODS
  40 recreational athletes (30 male, 10 female [24 ± 6.9 y, 176.55 ± 6.6 cm, 73.58 ± 12.3 kg]).
  
  
  METHODS
  Both groups conducted differentiated rehabilitation procedures after ACLR. Those belonging to OCBR group were guided in their recovery according to the current evidence-based principles. UCR group followed the national conventional approach for ACL rehabilitation.
  
  
  METHODS
  Concentric isokinetic knee joint flexor-extension torque assessments at 180°/s and Magnetic Resonance Imaging (MRI) evaluations were performed before and 12 months after ACLR. Anatomical muscle CSA (mm2) was assessed, in Quadriceps, Biceps femoris, Semitendinous, Semimembranosus, and Gracilis muscles at 50% and 70% femur length.
  
  
  RESULTS
  Reduced muscle CSA was observed in both treatment groups for Semitendinosus and Gracilis 1 year after ACLR. At 1-year follow-up, subjects allocated to the OCBR demonstrated greater knee flexor and extensor peak torque values in their reconstructed limbs in comparison with patients treated by UCR.
  
  
  CONCLUSIONS
  Objective atrophy of Semitendinosus and Gracilis muscles related to surgical ACLR was found to persist in both rehabilitation groups. However, OCBR after ACLR lead to substantial gains on maximal knee flexor strength and ensured more symmetrical anterior-posterior laxity levels at the knee joint.
authors.forename: Igor
authors.initials: I
authors.lastname: Setuain
authors.forename: Mikel
authors.initials: M
authors.lastname: Izquierdo
authors.forename: Fernando
authors.initials: F
authors.lastname: Idoate
authors.forename: Eder
authors.initials: E
authors.lastname: Bikandi
authors.forename: Esteban M
authors.initials: EM
authors.lastname: Gorostiaga
authors.forename: Per
authors.initials: P
authors.lastname: Aagaard
authors.forename: Eduardo L
authors.initials: EL
authors.lastname: Cadore
authors.forename: Jesús
authors.initials: J
authors.lastname: Alfaro-Adrián
mesh_terms: D000293:Adolescent; D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000534:rehabilitation* / Q000601:surgery; D059549:Anterior Cruciate Ligament Reconstruction; D001265:Athletic Injuries / Q000534:rehabilitation* / Q000601:surgery; D004311:Double-Blind Method; D005260:Female; D000070633:Hamstring Muscles / Q000502:physiology; D000070632:Hamstring Tendons / Q000637:transplantation; D006801:Humans; D007719:Knee Joint; D008137:Longitudinal Studies; D008297:Male; D053580:Muscle Strength; D052097:Quadriceps Muscle / Q000502:physiology; D016059:Range of Motion, Articular; D013848:Thigh / Q000000981:diagnostic imaging; D019415:Torque; D055815:Young Adult
keywords: ACL; MRI; muscle strength; objective criteria-based rehabilitation