Exercise for treating isolated anterior cruciate ligament injuries in adults 

Hdl Handle:
http://hdl.handle.net/10149/58199
Title:
Exercise for treating isolated anterior cruciate ligament injuries in adults 
Authors:
Trees, A. H. (Amanda); Howe, T. E. (Tracey); Dixon, J. (John); White, L. C. (Lisa)
Affiliation:
University of Teesside. Centre for Rehabilitation Sciences; Glasgow Caledonian University. HealthQWest; South Tees NHS Trust. Physiotherapy.
Citation:
Trees, A. H. et al. (2005) 'Exercise for treating isolated anterior cruciate ligament injuries in adults', Cochrane Database of Systematic Reviews, 4, pp.1-41.
Publisher:
Wiley-Blackwell
Journal:
Cochrane Database of Systematic Reviews
Issue Date:
Oct-2005
URI:
http://hdl.handle.net/10149/58199
DOI:
10.1002/14651858.CD005316.pub2
Abstract:
Background: The anterior cruciate ligament (ACL) is the most frequently injured ligament of the knee. Injury causes pain, effusion and inflammation leading to the inability to fully activate the thigh muscles. Regaining muscular control is essential if the individual wishes to return to pre-injury level of function and patients will invariably be referred for rehabilitation. Objectives: To present the best evidence for effectiveness of exercise used in the rehabilitation of isolated ACL injuries in adults, on return to work and pre-injury levels of activity. Search strategy: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (Feb 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 1, 2005), MEDLINE (1996 to March 2005), EMBASE (1980 to March 2005), other databases and reference lists of articles. Selection criteria: Randomised controlled trials and quasi-randomised trials testing exercise programmes designed to rehabilitate adults with isolated ACL injuries. Trials where participants were randomised to receive any combination of the following: no care, usual care, a single-exercise intervention, and multiple-exercise interventions, were included. The primary outcome measures of interest were returning to work and return to pre-injury level of activity post treatment, at six months and one year. Data collection and analysis: Two authors independently assessed trial quality and extracted data. Study authors were contacted for additional information. Adverse effects information was collected from the trials. Main results: Nine trials involving 391 participants were included. Only two trials, involving 76 participants, reported conservative rehabilitation and seven trials, involving 315 participants, evaluated rehabilitation following ACL reconstruction. Methodological quality scores varied considerably across the trials, with the nature of participant and assessor blinding poorly reported. Trial comparisons fell into six categories. Pooling of data was rarely possible due to lack of appropriate data as well as the wide variety in outcome measures and time points reported. Insufficient evidence was found to support the efficacy of one exercise intervention over another. Authors' conclusions: This review has demonstrated an absence of evidence to support one form of exercise intervention against another and the use of supplementary exercises in the management of isolated ACL injuries. Further research in the form of large scale well designed randomised controlled trials with suitable outcome measures and surveillance periods, using standardised reporting should be considered.
Type:
Article
Keywords:
anterior cruciate ligament; injuries; adults; treating; ACL; intervention; rehabilitation
ISSN:
1464-780X
Rights:
In return for the grant of the licence, the author(s) shall have the following rights: The right to post the review as an electronic copy on the author's own website and/or the author's institution's website, using the PDF version of the review available in the Cochrane Database of Systematic Reviews. [Advice from CEO of The Cochrane Collaboration]
Citation Count:
1 [Scopus, 11/01/2010]

Full metadata record

DC FieldValue Language
dc.contributor.authorTrees, A. H. (Amanda)-
dc.contributor.authorHowe, T. E. (Tracey)-
dc.contributor.authorDixon, J. (John)-
dc.contributor.authorWhite, L. C. (Lisa)-
dc.date.accessioned2009-04-01T10:45:45Z-
dc.date.available2009-04-01T10:45:45Z-
dc.date.issued2005-10-
dc.identifier.citationCochrane Database of Systematic Reviews; 4: 1-41-
dc.identifier.issn1464-780X-
dc.identifier.doi10.1002/14651858.CD005316.pub2-
dc.identifier.urihttp://hdl.handle.net/10149/58199-
dc.description.abstractBackground: The anterior cruciate ligament (ACL) is the most frequently injured ligament of the knee. Injury causes pain, effusion and inflammation leading to the inability to fully activate the thigh muscles. Regaining muscular control is essential if the individual wishes to return to pre-injury level of function and patients will invariably be referred for rehabilitation. Objectives: To present the best evidence for effectiveness of exercise used in the rehabilitation of isolated ACL injuries in adults, on return to work and pre-injury levels of activity. Search strategy: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (Feb 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 1, 2005), MEDLINE (1996 to March 2005), EMBASE (1980 to March 2005), other databases and reference lists of articles. Selection criteria: Randomised controlled trials and quasi-randomised trials testing exercise programmes designed to rehabilitate adults with isolated ACL injuries. Trials where participants were randomised to receive any combination of the following: no care, usual care, a single-exercise intervention, and multiple-exercise interventions, were included. The primary outcome measures of interest were returning to work and return to pre-injury level of activity post treatment, at six months and one year. Data collection and analysis: Two authors independently assessed trial quality and extracted data. Study authors were contacted for additional information. Adverse effects information was collected from the trials. Main results: Nine trials involving 391 participants were included. Only two trials, involving 76 participants, reported conservative rehabilitation and seven trials, involving 315 participants, evaluated rehabilitation following ACL reconstruction. Methodological quality scores varied considerably across the trials, with the nature of participant and assessor blinding poorly reported. Trial comparisons fell into six categories. Pooling of data was rarely possible due to lack of appropriate data as well as the wide variety in outcome measures and time points reported. Insufficient evidence was found to support the efficacy of one exercise intervention over another. Authors' conclusions: This review has demonstrated an absence of evidence to support one form of exercise intervention against another and the use of supplementary exercises in the management of isolated ACL injuries. Further research in the form of large scale well designed randomised controlled trials with suitable outcome measures and surveillance periods, using standardised reporting should be considered.-
dc.publisherWiley-Blackwell-
dc.rightsIn return for the grant of the licence, the author(s) shall have the following rights: The right to post the review as an electronic copy on the author's own website and/or the author's institution's website, using the PDF version of the review available in the Cochrane Database of Systematic Reviews. [Advice from CEO of The Cochrane Collaboration]-
dc.subjectanterior cruciate ligament-
dc.subjectinjuries-
dc.subjectadults-
dc.subjecttreating-
dc.subjectACL-
dc.subjectintervention-
dc.subjectrehabilitation-
dc.titleExercise for treating isolated anterior cruciate ligament injuries in adults -
dc.typeArticle-
dc.contributor.departmentUniversity of Teesside. Centre for Rehabilitation Sciences; Glasgow Caledonian University. HealthQWest; South Tees NHS Trust. Physiotherapy.-
dc.identifier.journalCochrane Database of Systematic Reviews-
ref.assessmentRAE 2008-
ref.citationcount1 [Scopus, 11/01/2010]-
or.citation.harvardTrees, A. H. et al. (2005) 'Exercise for treating isolated anterior cruciate ligament injuries in adults', Cochrane Database of Systematic Reviews, 4, pp.1-41.-
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