Time Effect Of One-time Aquatic Rehabilitation On Improving Knee Function In Patients With Anterior Cruciate Ligament Reconstruction

Objective:With the increasingly wide application of aquatic rehabilitation training in the field of musculoskeletal rehabilitation,it is worth exploring what advantages it has compared with traditional resistance training in the aspect of timeliness.This study intends to implement aquatic rehabilitation training and conventional Post-ACL reconstruction rehabilitation on ACL-reconstructed patients,comparing the differences between the time effect of them before training,immediately after training,24 hours after training and 48 hours after training.The purpose of this study is to explore the advantages of aquatic rehabilitation training on timeliness for ACL-reconstructed patients.Methods:14 adult male patients who had undergone ACL reconstruction operations 6-9 weeks ago in Peking University Third Hospital were recruited for this study.All of them were instructed to perform a 90-min aquatic rehabilitation training and a 90-min conventional Post-ACL reconstruction rehabilitation separately.The active/passive range of motion,muscle hardness and elasticity(rectus femoris,medial femoris,biceps femoris),degree of knee swelling,plantar pressure distribution in standing posture and balance performance of the subjects’ affected knees were measured before intervention,immediately after intervention,24 hours and 48 hours after intervention.The two tests were separated by more than 72 hours.Repeated measures analysis of variance was used to test the timeliness of training effects.Results:Compared with pre-training,the range of active and passive knee flexion was significantly improved immediately,24 and 48 hours after aquatic rehabilitation training(p<0.01).Although a significant improvement was also observed immediately after conventional Post-ACL reconstruction rehabilitation(p<0.01),there was a significant decrease after 24 and 48 hours compared with immediately after training(p<0.01);compared with pre-training,the range of active knee extension was significantly improved immediately,24 and 48 hours after aquatic rehabilitation training(p<0.01).However,there was no significant change immediately,24 and 48 hours after conventional Post-ACL reconstruction rehabilitation(p>0.05),and no significant difference between the groups was observed(p>0.05);compared with pretraining,a significant improvement in the range of passive knee extension appeared immediately after aquatic rehabilitation training(p<0.01)and there was no significant changes in other time phases(p>0.05).For the conventional Post-ACL reconstruction rehabilitation,there was no significant changes in all time phases and no significant difference between groups(p>0.05).Compared with immediately after aquatic rehabilitation training,the muscle hardness and elasticity of the medial femoris muscle at 48 hours after training showed a significant increase(p<0.05);compared with immediately after conventional Post-ACL reconstruction rehabilitation,the muscle hardness and elasticity of the biceps femoris muscle at 24 and 48 hours after training both significantly decreased(p<0.05).The degree of the knee joint swelling was significantly improved immediately,24 hours and 48 hours after aquatic rehabilitation training compared with pre-training;the degree of the knee joint swelling was significantly increased at 24 hours and 48 hours after conventional Post-ACL reconstruction rehabilitation compared with pre-training.Compared with pre-training,the weight-bearing degree of plantar pressure on the affected side showed significant improvements immediately,24 hours and 48 hours after training but there was no significant difference in each time phase before or after conventional Post-ACL reconstruction rehabilitation.Compared with before aquatic rehabilitation training,the time of affected side unilateral standing with eyes closed at 24 hours and 48 hours after training was significantly prolonged.However,there was no significant difference in each time phase before and after conventional Post-ACL reconstruction rehabilitation.Besides,none of the outcomes showed significant differences between groups(p>0.05).Conclusions:The effect of aquatic rehabilitation training is able to last longer than conventional Post-ACL rehabilitation for ACL reconstructed patients.Therefore,longer time intervals can be arranged when making rehabilitation training plans;although parts of ACL reconstructed patients’ knee functions can be improved by performing conventional Post-ACL rehabilitation,it might not be able to last for a long period of time.