Design and implementation of a neuromuscular training program following anterior cruciate ligament reconstruction

Neuromuscular training programs are increasingly integrated into clinical p ractice for lower extremity rehabilitation. A few rehabilitation programs h ave been evaluated for patients with anterior cruciate ligament (ACL) defic iency and for injury prevention, but there is limited scientific evidence o f the effect of neuromuscular training following ACL reconstruction. Theref ore, a neuromuscular training program was developed for patients after ACL reconstruction. The objective of the neuromuscular training was to improve the ability to generate a fast and optimal muscle firing pattern, to increa se dynamic joint stability, and to relearn movement patterns and skills nec essary during activities of daily living and sports activities. The main ar eas considered when designing the postoperative rehabilitation program afte r ACL reconstruction were: ACL graft healing and ACL strain values during e xercises, proprioception and neuromuscular control, and clinical studies on the effect of neuromuscular training programs. The rehabilitation program consists of balance exercises, dynamic joint stability exercises, jump trai ning/plyometric exercises, agility drills, and sport-specific exercise. The patients exercise 3 times a week for 6 months. The scientific and clinical evidence for the rehabilitation program are described and the main exercis es in the program are outlined.