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Rehab Acl
Rehab Acl
Rehab Acl
ACCELERATED REHAB
From theory to intervention application
withstand tension
During the rehabilitation program, pain and
edema should dictate the speed at which the
patient may progres
KT1000 (Medmetric, San Diego) is helpful as well
SIZE:
Theo số đo chu vi
khớp gối (ngang vị
trí xương bánh chè)
Size S với số đo
chu vi khớp gối
từ 30 34 cm
Size M 34 38 cm
Size L 38 42 cm
Size XL 42 46 cm
Size XXL 46
50 cm
BRACE & WEIGHT BEARING
Before, WB was prohibited earlier Rehab
protocols
Current trend is immediate WB
90o of flexion
MOTION
Early passive and active ROM using CPM
Prevention is the key to achieve ROM: control
rehab programs
OPEN VS CLOSED KINETIC CHAINE
EXERCISES
CKC safer than OKC
CKC apply less anteriorly directed forces on the tibia, increase
biofemoral compressive force, increase cocontraction of hamstring and
quad, mimic functional activities more closely than OKC, and reduce
the incidence of patellofemoral complication
CKC exercises are defined as those in which the foot is still in contact
with a solid surface GRF is transmitted to all of the joints in lower
limbs and muscles apsnning all of the joints of lower extremities are
used
Squat/leg press
OKC: one segments of the limp is stabilized while the other moves
freely, and only musscle spanning the knee are required to perform the
excercises
Leg extension machine
for both hamstring tendon and patellar tendon grafts. Quadriceps muscle
torque was not significantly different for any group. But the early
addition of OKC exercises for patients receiving hamstring tendon
autografts resulted in significant increased laxity over time
Potential increased strain to the graft with OKC exercises in low levels of
Heel Slide
• Multipleangle isometrics
• Continue as above; advance
•Advance closed chain strengthening (include PNF
strengthening and PREstep patterns), endurance and
up/down flexibility
• LE stretching program • Advance proprioceptive
• Endurance training (e.g., training to high speed stepping
drills, unstable surface challenge
bike, pool)
drills, and balance exercises
• Proprioceptive training:
• Initiate a walk/jog program at
singleleg stance, tilt board, the end of this phase
BAPS board
• Initiate plyometric drills:
• Stabilization exercises, bounding, jumping
elastic bands, band walking • LE stretching program (IJ)
PHASE 2: 4 TO 10 WEEKS
ATTENTION
full passive ROM and normalized painfree
independent gait and lasts until the patient
begins to run
both concentric and eccentric, and isolate specific
muscles as well as combine the entire kinetic
chain
protect the healing graft by keeping exercises in
https://mikereinold.com/tag/onlinekneeseminarcom/page/4/
EXERCISES PROPRIOCEPTIVE TRAINING
• No instability • Ligament
• No swelling stability—joint
• No pain arthrometer
• Good to normal muscle • Muscle strength
strength (4/5 to 5/5 on • Functional status
MMT)
• Unrestricted ADL
function
• Possible use of
functional brace
PHASE 3 : WEEKS 11–24 (36M)
INTERVENTION
• Continue LE stretching program
• Advance PRE/initiate isokinetic training (if desired)
• Advanced closedchain exercise, plyometric drills
(bouncing, jumping rope, box jumps: double /singleleg)
• Advanced proprioceptive training
• Progressive agility drills (figure8, skillspecific
patterns)
• Simulated work or sportspecific endurance training
• Progress running program: fullspeed jogging, sprints,
running and cutting
BÀI TẬP CO BẬT PLYOMETRIC
ADVANCED BALANCE
RETURNTOACTIVITY
PHASE: ≥ 6 MONTHS
GOAL
• Increase strength
• Increase power
• Increase endurance
• Regain ability to function at highest desired level
• Transition to maintenance program
• Reduce risk of reinjury
PHASE: ≥ 6 MONTHS
RETURNTOACTIVITY
Patient presentation Examination
Blood
supply
Lack of
blood
supply
IMMOBILIZATION, PROTECTIVE BRACING,
AND WEIGHT BEARING
Maintained in full extension in the postoperative
immobilizer
Thighhigh compression stockings to control swelling may be
worn.
To protect the repaired meniscus during the first few
0
60o:4ws
90o: 4
6ws
090o
46ws
EXERCISE PRECAUTIONS AFTER
MENISCUS REPAIR*
Advanced Rehabilitation
■ Do not perform exercises that involve deep
squatting, deep lunges, twisting, or pivoting for
at least 4 to 6 months. (The greater the flexion
angle, the greater the stress on the meniscus.)
■ Do not begin jogging or running program until 5
to 6 months.
Return to Activity
■ Refrain from recreational and sports activities
that involve repetitive, high joint compressions
and shear forces.
■ Avoid prolonged squatting in full flexion.
REHAB PROGRAM