Single Session Interventions
Author Intervention Gait Metric Notable Outcomes
Blackburn
et al.
2021[@524013]
Participants randomized to local muscle vibration (LMV) at the quadriceps vs whole body vibration (WBV) assessed pre-post 3D motion capture and kinetics to assess peak vertical ground reaction forces (vGRF) and its loading rate, peak internal knee extension and abduction moments (KEM), and peak knee flexion and varus angles. WBV acutely increased peak KEM and LMV decreased loading rates compared to controls.
Hu et al.
2016[@524014]
Participants completed regular walking and robotic assisted therapy for a single session of 20 minutes. Outcomes assessed pre-post. 10 min walk test and timed-up-and-go test. Surface Electromyography (sEMG) of the vastus medialis (VM) during the gait cycle. Times for both the 10MWT and TUG test decreased significantly. VM sEMG activity increased. A follow-up study confirmed these findings to be persistent at one-month post-intervention
Hunt et al. 2010[@524015] Participants experienced anterior tibiofemoral glides performed for 10 minutes. Outcomes assessed pre, post, and 10 minutes following the intervention. 3D motion capture gait analysis via Eagle Cameras, Motional Analysis Corp). Maximum knee extension increased acutely during stance phase of gait acutely but did not last at follow up. No other gait metric showed a significant difference post intervention.
Interventions of Less Than or Equal to 12 Weeks
Luc-Harkey
et al.
2018[@524016]
Participants completed 4 separate walking trials while receiving real-time biofeedback of vertical ground reaction force (vGRF) projected on a screen at a self-selected walking speed for 20 minutes. Outcomes assessed during the session. 3D motion capture gait analysis and force plate metrics during gait cycle. Peak vGRF of the ACLR limb increased significantly during high loading and decreased during low loading compared to control indicating a cueing an increase in vGRF may be beneficial for increasing knee extension moment, and knee excursion in ACLR patients.
Capin, et al. 2019[@524017] Participants randomized into a 10-session strength, agility, plyometric, and secondary prevention (SAPP) training or SAPP training plus perturbation training. Outcomes assessed pre-post-1yr 2yr follow up. Limb symmetry during walking via 3D motion capture, force plates, and EMG. Neither SAPP nor SAPP + PERT training improved walking mechanics in women at up to 2 years post-op.
Capin et al.
2018[@524018]
Participants randomized to a 10-session strength, agility, plyometric, and secondary prevention (SAPP) training or a SAPP training plus perturbation training. Outcomes assessed pre-post-1yr 2yr follow up. Limb symmetry during walking via 3D motion capture, force plates, and EMG. Neither SAPP nor SAPP + PERT training improved walking mechanics in men at up to 2 years post ACLR.
Coury et al. 2006[@524019] Participants performed 3 sets of 10 maximal eccentric quadricep contractions twice a week for 12 weeks. Outcomes assessed pre-post. Goniometry to assess knee flexion/extension range of motion (ROM) and valgus/varus positioning during gait. Knee extension and flexion ROM increased significantly during gait at 9 months post ACLR.
Capin et al. 2017[@524020] Participants randomized to a 10 session strength, agility, plyometric, and secondary prevention (SAPP) training or SAPP training plus perturbation training. Outcomes assessed pre-post-1yr 2yr follow up. Limb symmetry during walking using 3D motion capture, force plates, and EMG. Neither SAPP nor SAPP + Perturbation training improved interlimb symmetries in men at up to 2 years post ACLR.
Decker et al. 2004[@524021] Participants (avg. 28 yrs. old) randomized to a 6-week walking vs walking with a prescribed stride frequency (PSF) protocol. Outcomes assessed pre-post 3D motion capture and force plates to quantity hip position and knee position at heel strike, knee midstance range of motion and kinetic measures of hip extensor impulse and knee extensor impulse Gait retraining with FHDO showed improvements in lower-extremity positions, hip and knee extensor angular impulse, and work parameters at both 6- and 12-weeks post ACLR. PSF showed no statistical improvements.
Moran et al. 2019[@524022] Participants (avg. 21 yrs. old) randomized into a neuromuscular electrical stimulation functional electrical stimulation during gait for 10 minutes 3 times per week for 4 weeks. Comfortable gait speed and single leg stance symmetry. No gait metrics improved significantly.
Luo et al.
2016[@524023]
Participants randomized into partial weightbearing treadmill training (PWBTT) or PWBTT plus traditional physical therapy (TPT). Outcomes assessed at 12 and 24 weeks after surgery. 10-meter walk time 10-meter walk time increased significantly in the PWTT + TPT, compared to TPT only.
Hartigan et al. 2009[@524024] Participants randomized into strength or perturbation training + for 10 sessions prior to ACLR outcomes assessed pre intervention and 6 months post-surgery Lower Extremity Kinematics via 3D motion analysis system Individuals who performed perturbations + strengthening were more symmetrical than those who did strengthening only 6 months post ACLR.
Eastlack et al. 2005[@524025] Participants walked using lower body positive pressure once weekly for 6 weeks after surgery. Outcomes assessed after walking intervention. EMG of the biceps femoris and vastus medialis oblique.
Ground reaction forces and knee angles during gait.
Magnitude of EMG activity was maintained at all experienced lower body pressure ranges.
Pain was significantly reduced, knee range of motion was larger under body weight support conditions at weeks 3 and 4 but by weeks 5 and 6 all conditions were similar
Interventions of Greater Than 12 Weeks
Li et al.
2019[@524026]
Participants were randomized to typical care or typical care + adjunct core stabilization and strengthening (1 hour per day for 6 months) program to established but unidentified ACL Rehabilitation protocol. Outcomes assessed pre-post. 3D motion analysis and force plates to assess cadence, stride length, stride width, and gait speed, knee range of motion, and peak reaction forces. Cadence, stride length, gait speed, and knee range of motion increased over the course of the intervention. Joint peak reaction forces increased at the ankle, knee, and hip at 6 months post ACLR.