Napoletan (1994) The effect of underwater treadmill exercise in rehabilitation of Surgical Anterior Cruciate Ligament Repair

ABSTRACT
To test the effect of underwater treadmill exercise in the post-surgical rehabilitation of anterior cruciate ligament (ACL)  reconstruction,jfili6i’gsubject were divided into two therapy groups and matched for age, gender, height, and weight. Four males and four females (age range 22 to 31 years) comprised each group. All had been arthroscopically diagnosed with complete rupture of the’ACL, and had undergone primary reconstruction. Both groups adhered to the same physical therapy protocol, and were attended by. the same staff; the critical difference was the cardiovascular conditioning equipment prescribed. The standard therapy group exercised on stationary cycles (PinonTM and Schwinn Airdynem) during ea’ch- of the six weekly. therapy sessions. As so on as wound healing permitted (.1 0, to 14 ..-gays’.’.post-surgery), the experimental (water) group began using the AquaCiserT” Underwater- treadmill-.’.=.’in—.tliree of the “six weekly sessions; they cycled on the remaining days. At four and eight weeks post – surgery both groups were tested for range of motion; calf and thigh (quad) girth; quad strength and endurance; gastrocnemius endurance; and balance. Between-group analyses were performed on mean raw measures; four and eight week measurements were also compared. These four to eight week differences were analysed in paired t-tests between groups. Analyses performed on individual measurements demonstrated no significant differences between groups. However, analysis of the difference between the four and eight..-,;.week measures indicated significant differences in the following areas: Flexion within the water group increased by a mean of 14.6° (where p , .05); surgical calf girth increased by a mean of .4 in., and the quad firth of both surgical and nonsugical legs increased by a mean of .3 in. and .4 in., respectively. The standard group showed significant increase only inflexion (mean increase of 92°). A-between group analysis of four to eight week changes indicated that nonsurgical quad girth increased significantly more in the water group-I (#15531 increase of .4 in.). Results suggest that underwater treadmill exercise ‘is a beneficial additive therapy in ACL reconstruction rehabilitation; it may even be more effective than stationary cycling in the prevention of atrophy.

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