THE EFFECT OF FUNCTIONAL MOVEMENT TRAINING AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION - A RANDOMIZED CONTROLLED TRIAL

Review written by Dr Travis Pollen info

BACKGROUND & OBJECTIVE

Many patients fail to return to pre-injury activity levels following anterior cruciate ligament (ACL) reconstruction. Even among those who do return to high-level activity, their risk of a subsequent ACL tear is elevated beyond pre-injury rates. This may be explained in part by insufficient rehabilitation. One intervention that has gained popularity is the Functional Movement Screen (FMS). The FMS is a series of seven field-expedient tests designed to grade movement quality. Rehabilitation interventions based on the FMS address movement patterns patients are unable to perform. The purpose of this study was to compare knee function following a routine rehabilitation program vs a combined routine and FMS-based rehabilitation program.

METHODS

A total of 38 high school and university-aged ACL reconstruction patients (10 females, 28 males) participated in a single-blind randomized controlled trial that lasted 6 months. Upon enrollment participants were randomized into two equally-sized groups. One group received 6 months of routine post-operative rehabilitation (including modality treatments, passive range of motion, and strengthening). The other group received routine rehabilitation for 3 months followed by 3 months of combined routine and FMS-based rehabilitation (combination group). The FMS component of the intervention was individualized based on movement patterns participants were unable to perform. Treatment sessions were all one hour in length and twice weekly.

The outcome measures of interest were the FMS composite score (max score = 21), Lysholm Knee Score (LKS, max score = 100), and International Knee Documentation Committee 2000 Score (IKDC, max score = 100). The LKS is a subjective measure of knee function. The IKDC is combination of subjective and objective measures of knee function. All outcome measures were assessed at 3 and 6 months post-op.

RESULTS

Prior to the divergence in treatments at 3 months post-op, the two groups did not differ on the FMS or IKDC but did differ on the LKS. From 3 to 6 months, both groups improved on all three outcome measures.

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