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Keywords

Exercise, surgery, patient outcomes

Abstract

The objective of this study was to illustrate the case of an intercollegiate soccer player who sustained a grade 3 anterior cruciate ligament (ACL) injury and underwent surgical repair at 4 months. The patient engaged in her regular daily activity prior to the surgical procedure. One week prior to surgery the patient produced 140° of active knee flexion and -1° of active knee extension, and scored 69.0 on the International Knee Documentation Committee Subjective Knee Evaluation (SKE). One day post-ACL reconstruction by semitendinosus autograft, the patient’s knee range of motion (ROM) was 40° of flexion and 20° of extension and reported a score of 21.8 on the SKE. The patient began rehabilitation immediately following surgery with the goal to increase ROM of the involved limb. A Total Motion Release® (TMR ®) rehabilitation protocol was implemented for the first four weeks in lieu of a traditional ACL reconstruction rehabilitation protocol. Three sessions were completed each week over a four-week period, for a total of 12 sessions. Rehabilitation sessions consisted of 15 minutes of ice massage of the quadriceps with simultaneous quadriceps contraction/relaxation immediately followed by TMR ®. The patient ended each session with progressive exercise: 5 minutes of half rotations on the bike on day one, progressing to a 20 minute light jog on the treadmill by week four. Patient was re-assessed by the orthopedic surgeon at a one and six month post-operative follow-up appointments. Changes in flexion and extension ROM and SKE were assessed weekly prior to treatment to evaluate knee ROM. Four weeks following the TMR® protocol, knee range of motion was restored demonstrating the effectiveness of TMR®.

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