Date of Award

5-1-2022

Degree Type

DPT Project

Degree Name

Doctor of Physical Therapy (DPT)

Advisor

Rhonda Manning

Abstract

STUDY DESIGN: Systematic review.

BACKGROUND: Anterior cruciate ligament (ACL) injury is a common orthopedic condition with an estimated rate of 20,000 to 600,000 injuries in the US per year, with higher incidences in athletic and female populations. The rate of re-injury following surgical ACL repair (ACLR)ranges between 13.8-33.3%. Current clinical practice guidelines for ACLR rehabilitation cite inconclusive evidence for definitive outcome measures that accurately determine successful return to sport (RTS). There is a need to establish more effective avenues of rehabilitation interventions to decrease the rate of reinjury, particularly in female athletes. Recent evidence suggests interventions utilizing external biofeedback apparatuses (EBA) in conjunction with neuromuscular rehabilitation decrease the risk of second ACL injury (sACL) after ACLR.

OBJECTIVE: The objective of this systematic review was to investigate the effects of neuromuscular interventions using external biofeedback on the rate and risk of re-injury following ACLR rehabilitation.

METHODS: Five online databases were searched from September 2020 through September2021. Key terms included ‘ACL rehabilitation,’ ‘female,’ ‘balance,’ ‘proprioception,’ ‘neuromuscular’ ‘reinjury,’ ’rerupture,’ ‘secondary injury.’ This method returned 251 articles and 7 articles were included in this systematic review.

RESULTS: The average PEDRO score of the articles included here is 4.8/10, ranging from1/10 to 8/10. The articles demonstrated a heterogeneity in the study designs and types of EBA implemented. The conglomerate results suggest there is weak evidence neuromuscular rehabilitation with EBA can reduce the risk of sACL.

CONCLUSIONS: The use of perturbation as a source of biofeedback to augment neuromuscular reeducation may reduce the rate of reinjury following ACLR. The results of this study must be interpreted with caution due to the low quantity and quality of evidence on this subject.

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