Accelerated hydrotherapy and land-based rehabilitation in soccer players after anterior cruciate ligament reconstruction: a series of three single subject case studies

Abstract

Objective. To investigate the effectiveness of accelerated rehabilitation and accelerated hydrotherapy after anterior cruciate ligament (ACL) reconstruction in male athletes participating in soccer. Design. A non-concurrent single subject, multiple baseline design (ABA design) was conducted over 10 weeks. A series of three N=1 studies was conducted to assess the effect of an accelerated hydrotherapy programme on pain, function, and range of motion. Setting. The study was conducted at a private physiotherapy practice in Port Elizabeth, South Africa. Interventions. The land rehabilitation programme was a homebased programme supervised every week by the physiotherapist. The accelerated hydrotherapy consisted of a 6-week programme, and participants attended two treatment sessions of accelerated hydrotherapy per week each of 30 minutes\' duration. Main outcome measures. The knee injury and osteoarthritis outcome scale (KOOS) as a subjective measure of pain, function and quality of life; the goniometer to measure active knee ROM and the 6-minute walking test (6MWT) as an objective measure of function. Results. All three patients demonstrated good improvement during the treatment phase for the KOOS scale and progressed well in terms of their walking ability during the study. Significant improvement was gained during the baseline phase for all three participants with high initial levels of knee flexion while active knee extension improved gradually in all three participants. Conclusion. The study findings indicate that an accelerated landbased and hydrotherapy programme may be useful in improving patient outcomes and that there are no risks for harm. Clinical relevance. The study findings indicate that accelerated hydrotherapy may be a useful and safe adjunct to an accelerated land-based programme after ACL reconstruction

South African Journal of Sports Medicine Vol. 20 (4) 2008: pp. 109-114