Sports Medicine Research: In the Lab & In the Field: Maybe It’s Time to Shake Up Your ACL Rehab Protocol (Sports Med Res)
Wednesday, August 9, 2017

Maybe It’s Time to Shake Up Your ACL Rehab Protocol

Efficacy of whole-body vibration board training on strength in athletes after anterior cruciate ligament reconstruction: A randomized controlled study.

Cosimo C, Bertuletti S, and Romiti D. Clin J Sports Med. 2017. [Epub Ahead of Print].

Take Home Message: After an anterior cruciate ligament (ACL) reconstruction, whole-body vibration coupled with a rehabilitation protocol increases knee extensor and flexor strength.

An ACL injury requires intensive rehabilitation. However, best rehabilitation practices are still debated. Recently, whole-body vibration (WBV) has shown some promise with increasing neuromuscular efficiency but it has not been investigated as part of an ACL rehabilitation protocol. Therefore, Cosimo and colleagues completed a randomized controlled trial to assess the efficacy of WBV after an ACL reconstruction among 38 female volleyball and basketball players (20 to 30 years old, active in sport for at least 6 years, only 1 ACL reconstruction treated arthroscopically). The authors excluded people if they had a concomitant ligament or meniscal injury, or had a previous injury or surgery to either limb. All participants were initially treated with the same 13-week rehabilitation protocol. At the beginning of week 13, participants were randomly allocated to a WBV (2.5 mm of amplitude and 26 Hz of frequency) or control group. All participants completed the same protocol; however, participants in the control group performed exercises with the WBV platform off (thus no vibration). Treatment sessions then continued in this manner for 8 weeks. The authors evaluated the participants using a Biodex isokinetic knee flexion and extension strength test at the time of randomization (13 weeks post-surgery) and after 8 weeks of treatment. On average, participants treated with WBV had greater strength gains than those in the control group.

The results of this study are important because they suggest that WBV is a viable treatment option for patients following ACL reconstruction. For clinicians that have access to a WBV training system, an ACL rehabilitation protocol with WBV may be beneficial. For clinicians who lack access to WBV training systems they may want to seek out more information before deciding to implement this treatment or consider if there are other rehab techniques that may be implemented. It will be interesting to see if WBV influences other factors such as time to return to play or risk of re-injury. In the meantime, WBV may be a nice complement to a traditional ACL rehabilitation program for those with these systems. For everyone else, it remains unclear if this study should convince you to buy a WBV system but it highlights another benefit of these systems.

Questions for Discussion: Have you used WBV as a modality? If so, when have you found this modality to be especially effective?

Written by: Kyle Harris
Reviewed by: Jeffrey Driban

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