Exercise-therapy and education for individuals one year after anterior cruciate ligament reconstruction: a pilot randomised controlled trial

Abstract Background Guided rehabilitation beyond 6-months is rare following anterior cruciate ligament reconstruction (ACLR), despite high prevalence of unacceptable symptoms and quality life (QoL). Our primary aim was to determine the feasibility a randomised controlled trial (RCT) evaluating physiotherapist-guided intervention for individuals 1-year post-ACLR with persistent symptoms. secondary if worthwhile treatment effect could be observed lower-limb focussed (compared trunk-focussed intervention), improvement in knee-related QoL, symptoms, function. Design Participant- assessor-blinded, pilot RCT. Methods Participant eligibility criteria: i) 12–15 months post-ACLR; ii) < 87.5/100 on Knee injury Osteoarthritis Outcome Score (KOOS) QoL subscale; either one-leg rise test 22 repetitions, single-hop 90% limb symmetry; or Anterior Pain Scale 87/100. Participants were exercise education. Both interventions involved 8 face-to-face physiotherapy sessions over 16-weeks. Feasibility assessed by rate (> 1 3 screened), recruitment 4 participants/month), retention (< 20% drop-out), attendance unsupervised adherence 80%). Between-group differences (KOOS-QoL, ACL-QoL), (KOOS-Pain, KOOS-Symptoms), function (KOOS-Sport, functional performance tests) used verify that (greater than minimal detectable change each measure) contained within 95% confidence interval. Results 47% those screened eligible, 27 participants (3 participants/month; 48% men, 34±12 years) randomised. Two did not commence treatment, two lost follow-up (16% drop-out). Physiotherapy > 80% both groups but reported low 55%). had potentially effects KOOS-QoL ACL-QoL, while greater KOOS-Sport, KOOS-Pain, performance. Conclusions A larger-scale RCT warranted. All criteria met, reasonable recommendations made achieve future trials. Strategies increase are required. The potential indicates fully-powered may detect clinically meaningful effect. Trial registration Prospectively registered ( ACTRN12616000564459 ).