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Kotsifaki 2023
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Kotsifaki R, Korakakis V, King E, Barbosa O, Maree D, Pantouveris M, Bjerregaard A, Luomajoki J, Wilhelmsen J, Whiteley R. Aspetar clinical practice guideline on rehabilitation after anterior cruciate ligament reconstruction. Br J Sports Med. 2023 May;57(9):500-514.
Design: Consensus Statement/Clinical Practice Guideline Methods: A Guideline Development Group systematically searched and reviewed evidence using randomised clinical trials and systematic reviews to evaluate the effectiveness of rehabilitation interventions and guide clinicians and patients on the content of the optimal rehabilitation protocol after ACLR. Results: • Exercise interventions should be considered the mainstay of ACLR rehabilitation. However, little evidence on the dose-response relationship between volume/intensity of exercise and outcomes. • Physical therapy modalities are helpful in the early phase of rehabilitation when pain, swelling and ROM limitations are present, allowing earlier pain- free commencement of exercise rehabilitation. • Cryotherapy therapy is recommended, with cold+compression being more effective than cold only. • NMES is recommended to optimize muscle activation and minimize muscle atrophy, with NMES integrated with functional exercises providing optimal strength gains. • While there is a very low level of certainty for most components of rehabilitation, most of the recommendations provided in this guideline were agreed to by expert clinicians.
Key message: According to Aspetar guidelines, cold + compression therapy and NMES are recommended in the early postop rehab protocol.
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