COMPARISON OF THE EFFECTS OF EXERCISE IN WATER AND ON LAND ON THE REHABILITATION OF PATIENTS WITH INTRAARTICULAR ANTERIOR CRUCIATE LIGAMENTRECONSTRUCTIONS

Background and Purpose. Exercises in water have been shown to be effec tive for improving strength and passive range of motion (PROM). Tradit ional rehabilitation following intra-articular anterior cruciate ligam ent (ACL) reconstruction has taken place on land. This study was desig ned to compare the effects of exercises in water on strength and girth of the thigh musculature, knee PROM, joint laxity, effusion, and func tional outcome with the effects of similar exercises on land in subjec ts following intra-articular reconstruction of the ACL. Subjects. Twen ty subjects were randomly assigned to either a group that exercised on land or a group that exercised in water. Methods. Thigh girth, joint effusion, and knee PROM measurements were recorded at 2-week intervals for the first 8 weeks post-operatively. Isokinetic and isometric peak torque measurements for the thigh musculature, knee joint laxity asse ssments, and Lysholm scores were obtained at the end of 8 weeks. Resul ts. Higher outcome scores were recorded in the water group than in the land group, as measured by Lysholm scales. No differences were noted between groups for knee PROM, thigh girth, or quadriceps femoris muscl e performance. In the water group, less joint effusion was noted after the 8 weeks. In the land group, greater peak torque for isokinetic kn ee flexion was recorded. Conclusion and Discussion. Although exercise in water may not be as effective as exercise on land for regaining max imum muscle performance, rehabilitation in water may minimize the amou nt of joint effusion and lead to greater self-reports of functional im provement in subjects with intra-articular ACL reconstructions. [Tovin BJ, Wolf SL, Greenfield BH, et al. Comparison of the effects of exerc ise in water and on land on the rehabilitation of patients with intra- articular anterior cruciate ligament reconstructions. Phys Ther. 1994; 74:710-719.]