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Rehabilitation after anterior cruciate ligament and meniscal injuries: a best-evidence synthesis of systematic reviews for the OPTIKNEE consensus

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  • معلومة اضافية
    • بيانات النشر:
      BMJ PUBLISHING GROUP
    • الموضوع:
      2022
    • Collection:
      The University of Melbourne: Digital Repository
    • نبذة مختصرة :
      OBJECTIVE: Synthesise evidence for effectiveness of rehabilitation interventions following ACL and/or meniscal tear on symptomatic, functional, clinical, psychosocial, quality of life and reinjury outcomes. DESIGN: Overview of systematic reviews with Grading of Recommendations Assessment, Development and Evaluation certainty of evidence. DATA SOURCES: MEDLINE, EMBASE, CINAHL, SPORTDiscus and Cochrane Library. ELIGIBILITY CRITERIA: Systematic reviews of randomised controlled trials investigating rehabilitation interventions following ACL and/or meniscal tears in young adults. RESULTS: We included 22 systematic reviews (142 trials of mostly men) evaluating ACL-injured individuals and none evaluating isolated meniscal injuries. We synthesised data from 16 reviews evaluating 12 different interventions. Moderate-certainty evidence was observed for: (1) neuromuscular electrical stimulation to improve quadriceps strength; (2) open versus closed kinetic chain exercises to be similarly effective for quadriceps strength and self-reported function; (3) structured home-based versus structured in-person rehabilitation to be similarly effective for quadriceps and hamstring strength and self-reported function; and (4) postoperative knee bracing being ineffective for physical function and laxity. There was low-certainty evidence that: (1) preoperative exercise therapy improves self-reported and physical function postoperatively; (2) cryotherapy reduces pain and analgesic use; (3) psychological interventions improve anxiety/fear; and (4) whole body vibration improves quadriceps strength. There was very low-certainty evidence that: (1) protein-based supplements improve quadriceps size; (2) blood flow restriction training improves quadriceps size; (3) neuromuscular control exercises improve quadriceps and hamstring strength and self-reported function; and (4) continuous passive motion has no effect on range of motion. CONCLUSION: The general level of evidence for rehabilitation after ACL or meniscal tear was low. ...
    • ISSN:
      0306-3674
    • Relation:
      http://hdl.handle.net/11343/334621
    • الدخول الالكتروني :
      http://hdl.handle.net/11343/334621
    • Rights:
      https://creativecommons.org/licenses/by-nc/4.0 ; CC BY-NC
    • الرقم المعرف:
      edsbas.2C4217CD