Clinical Outcomes and Return-to-Sports Participation of 50 Soccer Players After Anterior Cruciate Ligament Reconstruction Through a Sport-Specific Rehabilitation Protocol

Abstract

Background:Rehabilitation of soccer players after anterior cruciate ligament reconstruction is usually performed without sport-specific guidelines, and the final phases are often left to the team coaches. The possibility of changing this approach has not yet been investigated.Study Design:Case series.Hypothesis:A specific rehabilitation protocol for soccer players, with direct control of the last on-field rehabilitation phases, may lead to complete functional recovery.Methods:Fifty competitive soccer players who followed a sport-specific rehabilitation protocol for soccer were evaluated during the recovery period until their return to competition. The assessment of the functional outcomes was performed using the Knee Outcome Survey–Sports Activity Scale and isokinetic and aerobic fitness tests.Results:The average start of on-field rehabilitation was 90 ± 26 days after surgery; the average time to return to the competitions was 185 ± 52 days. The improvement in the Knee Outcome Survey–Sports Activity Scale during on-field rehabilitation was significant (P < 0.01; from 79 ± 15% to 96 ± 7%). The isokinetic and aerobic fitness tests showed a significant improvement of muscle strength (knee extensors, +55%, P < 0.01; knee flexors, +86%, P < 0.01) and aerobic threshold (+23%, P < 0.01) from the beginning to the end of on-field rehabilitation.Conclusions:Adding on-field rehabilitation to the traditional protocols after anterior cruciate ligament reconstruction may safely lead to complete functional recovery in soccer players.

Neuromuscular Training to Target Deficits Associated With Second Anterior Cruciate Ligament Injury

“…The goal of this paper was to provide evidence-based guidelines for the late-phase postoperative care of these athletes in preparation for a safe return to sports activity. Specific return-to-sport training was not the focus of this paper but may be an important component of return-to-activity preparation 27,88 and should be implemented based on the needs of each athlete and the demands of the sport, as previously published for sports like soccer, basketball, and downhill skiing. 11,72,153 To date, the effectiveness of the exercise components described has not been empirically tested on athletes following ACLR; however, recent reports indicate that the addition of on-field rehabilitation helps to address lingering deficits in the return-to-sport phase.…”

“…11,72,153 To date, the effectiveness of the exercise components described has not been empirically tested on athletes following ACLR; however, recent reports indicate that the addition of on-field rehabilitation helps to address lingering deficits in the return-to-sport phase. 11,27,72,153 Future studies should focus on randomized controlled trials of specific, targeted neuromuscular interventions.…”

Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus

“…Our evidence statement consists of three phases (see online supplementary appendix 2) with a goal-based progression: the so-called traffic-light method of progression through phases. This is relatively new in rehabilitation, but it assures a more patient-tailored rehabilitation 118 127. Patients can start with the next phase only if specific goals of the previous phase are achieved and these should be confirmed with objective tests (see online supplementary appendix 2 for criteria).…”

On-Ice Return-to-Hockey Progression After Anterior Cruciate Ligament Reconstruction

“…Return-to-sport guidelines 12 and graded exposures 3 exist following ACLR for other sports. Both sports-specific drills and strength and conditioning exercises are essential to comprehensive rehabilitation.…”