Journal Club: Refining Your ACL Rehab Approach

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Today we are back to discussing the infamous ACL. Much research and literature has been published regarding the best approach to ACL rehab. We would do well to digest all of that information to make sure we are providing the highest level of care to our patients who have had ACL reconstruction.

Today’s discussion will add to that knowledge base and help us think more clearly about what interventions may be helpful. Should we only use open chain exercises early on in the rehab process? When should we introduce closed chain exercises? Are open chain exercises more stressful to the graft? All of these are good questions and that's where this video becomes very helpful.

Tune Up Your Clinical Practice in ACL Rehabilitation & Quadriceps Strength Training

I watched this video from JOSPT several weeks ago and found it quite fascinating. Partly because the data and information was really interesting, challenging some of my preconceived notions, and partly because I still can’t believe the researchers actually found volunteers to have probes jammed inside their knees and then exercise on machines! That’s grit.

The first 20 minutes are certainly worth your time and provide so much information. But the main takeaway for me was the research discussing forces on the knee/ACL during gait. I was pretty shocked to learn that the forces on the graft are higher during walking than traditional open chain exercises. The researchers in this discussion used that information to argue that if we are comfortable having a patient walk fairly early on a surgical graft, then there really is minimal to no risk of graft damage during a bout of open chain exercises early in the rehab process. Fascinating stuff in the open vs. closed chain debate.

There are several other intriguing bits of information in this video so I would encourage you to check it out and grow your brain. I hope you use this information to continue to provide the highest quality of care to your patients for the best outcomes.

Jason

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