Current preoperative physiotherapy management strategies for patients awaiting Anterior Cruciate Ligament Reconstruction (ACLR): A worldwide survey of physiotherapy practice

Carter, Hayley; Webster, Kate E.; Smith, Brenda

doi:10.1016/j.knee.2020.12.018

Cited by 14 publications

(12 citation statements)

References 29 publications

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“…A survey by Carter, Webster, and Smith (Carter et al, 2021) among 122 physiotherapists worldwide established that 84% of the respondents reported many ACLR patients who were waiting for ACLR did not receive prehabilitation. However, this study did not report the reasons on why preoperative physiotherapy was omitted.…”

Section: Discussionmentioning

confidence: 99%

“…A systematic review found little variation in the content of prehabilitation and in general, the protocol consist of exercises including muscle control and co-contraction of the knee muscle specifically the quadriceps and hamstring (Giesche et al, 2020). Previous studies recommended that prehabilitation protocols should consist of strengthening and stretching exercises of the lower limb (4 to 6 weeks with 2 to 4 times per week) with considerations to include advanced neuromuscular (perturbation, balance, stability, proprioceptive exercises) and plyometric exercises (Carter et al, 2021;Wilk & Arrigo, 2016). As recent literature highlights that there is no specific evidencebased guidelines for strength and neuromuscular training in the early stage after ACL injury (Giesche et al, 2020), further research exploration in this area is recommended.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, it is predicted that with progressive structured prehabilitation, it will provide a better functional outcome following surgery and increase the chance of early and safe return to sports activity at pre-injury level. While the effects of prehabilitation prior to ACLR surgery seem beneficial in improving the ACLR recovery rate, more research are also required here to identify the correct exercises dosage (duration, intensity, frequency) and optimal exercise protocol (Carter et al, 2021;Ebrahimi Atri & Taghizadeh, 2021;von Essen et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

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Pattern of Anterior Cruciate Ligament Reconstruction (ACLR) among Athletes in Malaysia between 2015 and 2020

Zainudin

Ibrahim

Nadzalan

et al. 2022

Teor. metod. fiz. vihov.

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Background. Individual involvement in sports activity is rising and thus increases the risk of knee injury. Anterior Cruciate Ligament (ACL) rupture is the most common knee injury requiring ACL reconstruction (ACLR). However, limited evidence is available to date on ACLR characteristics in Malaysia for comparison with Western countries. This study aims to describe the epidemiological characteristic of ACLR surgery and the trend of pre-operative physiotherapy (pre-habilitation). Materials and methods. ACLR cases recorded in a tertiary hospital database between January 2015 and December 2020 were extracted and reviewed. This retrospective study was approved by the hospital’s Research Ethics Committee (UKMPPI/111/8/JEP-2020-500). All ACLR cases involving sports injuries were included with the exclusion of non-sports related injuries. Yearly ACLR cases were retrieved using an Injury Information form containing variables namely age, gender, type of ACL tear, accompanying meniscus injury, duration from injury to surgery and pre-habilitation details. Descriptive statistics were used to summarize the sample data. Results. A total of 131 ACLR cases were reported between 2015 and2020 (Male, n =122; Female, n = 25). The number of ACLR cases fluctuated during the observed years, with a maximum of 30 cases reported in a year and 98% of the cases were represented by the youth age group (15 – 47 years old). The average age at time of surgery was 27.1 (± 7.79). On an average, 80% of athletes stated no history of previous knee injury. The most common type of ACL injury was a complete tear (88%), followed by partial tear (9%), and re-rupture (3%). A meniscus injury was noted in 61% of cases. The time from injury to surgery was 15 weeks. The study found low percentage of the ACLR patients who received pre-habilitation prior to surgery (<20%). Conclusions. ACLR cases are showing a fluctuating trend every year. Despite the majority of the ACL cases being a complete tear, the participants waited more than four months to undergo ACLR, with only a quarter of them had pre-habilitation prior to surgery. The reasons for these situations require investigation. Future research inclusive of a larger database is also desirable to develop a better insight into ACL injury pattern.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pattern of Anterior Cruciate Ligament Reconstruction (ACLR) among Athletes in Malaysia between 2015 and 2020

Zainudin

Ibrahim

Nadzalan

et al. 2022

Teor. metod. fiz. vihov.

View full text Add to dashboard Cite

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“…Previous surveys of musculoskeletal practice evaluation reported sample size of 100 participants to be adequate in answering research questions pertaining to current practice. Neither of these studies provided power calculations (Bateman et al., 2019; Bury & Littlewood, 2018; Carter et al., 2021; Smith et al., 2017). This was therefore the target sample size.…”

Section: Methodsmentioning

confidence: 99%

Surgeon and physiotherapist approaches to operative or non‐operative management of people with recurrent patellar dislocation: A case‐based UK survey

Irving

Smith

Mandalia

et al. 2022

Musculoskeletal Care

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Background Physiotherapists are often key decision‐makers on when to refer patients with recurrent patellar dislocation for surgical opinion. Limited guidance exists to aid this decision. Differences in orthopaedic surgeons' and physiotherapists' views on which patients and when to refer people for surgical consideration or non‐operative care may affect outcome. This study aimed to explore orthopaedic surgeons and physiotherapists decision‐making surrounding treatment opinions for patients with recurrent patellar dislocation. Methods An online survey performed. UK registered and practicing orthopaedic surgeons and physiotherapists were invited to participate. The survey utilised two vignettes and a series of related questions to ascertain respondents' views on decision‐making to surgical referral for people with recurrent patellar dislocation. Data were analysed using descriptive statistics and inferential statistical tests to explore factors related to responses. Results Eighty four respondent surveys were analysed (38 surgeons, 46 physiotherapists). Overall, there was a low level of agreement amongst respondents for the management of the vignettes (k = 0.215, p = < 0.0005). Some disparity existed between the professions on the definition of recurrent patellar dislocations and the clinical features which may require an early surgical assessment. Physiotherapists were three times more likely to delay a surgical opinion for the vignettes presented in this study than the surgeons. Conclusion This is the first study to investigate orthopaedic surgeons' and physiotherapists' views on decision‐making around surgical or non‐operative management for recurrent patellar dislocations. High‐quality research is required to underpin explicit guidance on decision‐making regarding management of recurrent patellar dislocation.

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“…[21] It is therefore of no surprise that clinical practice varies. [49] Typically, prehabilitation research to date has concentrated on physical aspects alone, which is likely to provide limited bene t [21] given the variety of preoperative variables identi ed. We suggest the consideration of a multi-disciplinary approach to prehabilitation to address physical and psychosocial factors, while also considering demographic/clinical factors.…”

Section: Clinical and Research Implicationsmentioning

confidence: 99%

Preoperative predictors for return to physical activity following anterior cruciate ligament reconstruction (ACLR): a systematic review

Carter

Lewis

Smith

2022

Preprint

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Background Rates of return to physical activity after anterior cruciate ligament reconstruction surgery are sub-optimal. Optimising presurgical treatment may improve return rates. The purpose of this systematic review was to identify modifiable preoperative predictors for return to physical activity after anterior cruciate ligament reconstruction. methods Six electronic databases ( CINAHL, AMED, MEDLINE, SPORTDiscus and PsycINFO via EBSCOhost and Web of Science) were searched from inception to 31 December 2021. The population of focus was adults aged 18–65 who had undergone primary anterior cruciate ligament reconstruction. Studies needed to identify at least one potential modifiable preoperative predictor variable and the relationship between the predictor(s) and return to physical activity. All time-points of assessment and study designs were included. Data extraction was completed by one reviewer and verified by a second reviewer. Two reviewers completed the risk of bias assessment using the Quality in Prognostic Studies tool and Grading of Recommendations Assessment, Development and Evaluation system. Results The search identified 345 studies, eight met the inclusion criteria. Five studies scored 'high’, and three studies scored ‘moderate’ risk-of-bias. All preoperative predictors were of very low-quality evidence. Five different outcome measures were used to assess return to physical activity including Tegner, Marx, Physical Activity Scale, return to play at the elite level and return to preinjury level (undefined). This was measured between 1 and 10 years post-surgery. Nine preoperative physical, six psychosocial and five demographic/clinical factors were assessed and five factors were found to be predictive. These included anterior knee laxity, quadriceps strength, psychological profile, patient estimated ability to return and graft type (patella tendon). Conclusion Very low-quality evidence supports preoperative physical, psychosocial and demographic/clinical factors to be predictive of return to physical activity between one- and ten-years after anterior cruciate ligament surgery. Trial registration This study was prospectively registered in PROSPERO: CRD 42020222567.

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Current preoperative physiotherapy management strategies for patients awaiting Anterior Cruciate Ligament Reconstruction (ACLR): A worldwide survey of physiotherapy practice

Cited by 14 publications

References 29 publications

Pattern of Anterior Cruciate Ligament Reconstruction (ACLR) among Athletes in Malaysia between 2015 and 2020

Pattern of Anterior Cruciate Ligament Reconstruction (ACLR) among Athletes in Malaysia between 2015 and 2020

Surgeon and physiotherapist approaches to operative or non‐operative management of people with recurrent patellar dislocation: A case‐based UK survey

Preoperative predictors for return to physical activity following anterior cruciate ligament reconstruction (ACLR): a systematic review

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