ACL REHABILITATION

RECENT ADVANCES
TOWARDS FUNCTIONAL
APPROACH
DR.KANNABIRAN,M.P.T,PhD.
DR.KANNABIRAN,M.P.T,PhD.
Senior consultant manipulative sports physiotherapist ,coimbatore
Professor in physiotherapy,RVS college of physiotherapy
WHAT PHYSICAL THERAPY AFTER
ACL RECONSTRUCTION
AGE
TYPE OF INJURY
RECONSTRUCTION- GRAFT,SURGEONS
PROFILE,TYPE OF FIXATION
PRE OP STATUS
SCOPE FOR SUPERVISED PT
RECENT BIOMECHANICAL UPDATE
FUNCTIONAL APPROACH
 EXISTING
What's new?
Home Versus
Supervised Therapy
Home Exercise Versus
Weight Machines
Aquatic Therapy
Open Versus Closed
Chain Exercise
Progression Based on
Objective Criteria
 GENERAL IMPRESSION REGARDING
EXISTING ACLR PROTOCOLS

Based on Ignored 6 months

Muscle Proximal Too early to
Strength Muscle control return to sports
 BIOMECHANICAL UPDATE
HIP & KNEE STRATEGIES

KNEE STRATEGY HIP STRATEGY

KNEE EXTENSOR MOVEMENT KNEE EXTENSOR MOVEMENT

QUADRICEPS ACTIVATION QUADRICEPS ACTIVATION

HIP EXTENSOR MOVEMENT HIP EXTENSOR MOVEMENT

HIP ENERGY ABSORPTION HIP ENERGY ABSORPTION

KNEE STRATEGY
HIP STARTEGY
IMPAIRED GLUTEUS MAXIMUS
MUSCLE PERFORMANCE
Sagittal Plane Frontal/Transverse Plane
 THOUGHT PROCESS

NEED FOR CHANGE DUE TO INCREASING

RESPONSIBILITY
A FUNCTIONAL APPROACH
IN KNEE REHABILITATION
 Functional approach
A functional approach in rehabilitation is the key
concept underpinning the management.
Functional movement is defined here as the
unique movement repertoire of an individual.
Functional rehabilitation is defined here as the
process of helping a person to recover their
movement capacity by using their own
movement repertoire(whenever possible).
 DEVELOPING A FUNCTIONAL
PROGRAM

1. The focus on functional

movement .that ought to
2. The principle of participate in this
skill/ability level particular movement
& accompany the
rehabilitation
stabilization of the
3. The code for motor body.
adaptation
MOTOR COMPLEXITY MODEL FOR
FUNCTIONAL PROGRAM
 DEVELOPING A FUNCTIONAL
PROGRAM
ADAPTIVE CODE & PHYSICAL
STIMULATION FOR PROPRIOCEPTION

Simplified complexity in tensional fields.

Shaded circles represent tension created by
muscle groups
 MERGE ADAPTIVE CODE
REHABILITATION SIMILARITY
SPHERES
AMAZING CLINICAL SHORTCUT
CHALLENGING
ENVIRONMENT
When cognitive becomes autonomous
FUNCTIONAL APPROACH COMPOSITE ABILITIES
FUNCTIONAL APPROACH REHABILITATION
(RE
(REABILITATION)
ABILITATION)
FUNCTIONAL APPROACH RE-
RE-ABILITATION
 FUNCTIONAL APPROACH
ADVANCED COMPOSITE WORKOUTS
 BALANCE/
POSTURAL STABILITY CHALLENGE.
 BALANCE/POSTURAL
STABILITY CHALLENGE.
 TAKE HOME

Rehabilitation with current concept

Enhance hip strategy
Functional Re-Abilitation motor complexity
Differentiate demand & risk in rehab.
Think movement not muscles
Team work
DEPENDS ON HOW WE SEE THINGS
INVESTIGATE THE BIG TALK !