Impact Of Russian Current Combined With Close And Open Kinetic Chain Strengthening Exercises On ACL Revision Reconstruction Using Allograft - A Case Report

Abstract

Introduction: Primary anterior cruciate ligament (ACL) restoration has been found to be a successful intervention with majority of patients experiencing functional recovery and good to exceptional clinical results in post-operative evaluations. Appropriate physiotherapy management is pivotal in the post-reconstruction phase to lower the risk of problems such as edema, pain, decreased joint range of motion, muscular weakness, muscle girth, poor balance and impaired functional activity.

Method: A 23-year-old recreational football player with post-surgical case of recurrent left ACL reconstruction came to sports physiotherapy department for rehabilitation. The recurrence was managed by arthroscopic ACL revision reconstructive surgery using tibialis posterior allograft. In this case study, we evaluated the patient’s pain, range of motion, strength of the muscles and muscles girth. In adherence to ACL rehabilitation protocol, we used Russian current combined with various closed and open kinetic chain exercises for improving range, thigh and leg muscles girth and also for improving the strength of thigh muscles. We also provided MFR to the lower limb muscles every alternate day, with patellar mobilization to increase range of motion along with strengthening of hamstring, quadriceps and calf. After that we used vigorous lower limb and core strengthening program with balance and proprioception training along with agility and plyometric training.

Result: We compared the pain, range of motion, strength and muscles girth before and after rehab and found a significant improvement after 6 months.

Conclusion: Application of Russian current was effective for pain reduction and helped in strengthening of the muscles up-to four weeks. We initially used closed kinetic chain strengthening exercises for first two weeks followed by open kinetic chain strengthening exercises, in further progression vigorous strengthening and endurance training of lower limb and core muscles, balance and proprioception, agility and plyometrics training provided a patient very good recovery and improvement in overall functional capacity of the patient after 6 months of rehabilitation.