Journal of Novel Physiotherapies
Open Access

Abstract

There is no consensus in the literature about the effects of supervision from physiotherapists on the outcomes of rehabilitation programme following anterior cruciate ligament (ACL) reconstruction. This clinical trial was designed to compare the outcomes of the fully-supervised and the minimally-supervised rehabilitation programme following ACL reconstruction. For this purpose, a total of 48 patients who consented for this clinical trial were randomly allocated into the fully-supervised (n=24) and the minimally-supervised (n=24) conditioning programs. The patients in the fully-supervised conditioning programme received contemporary rehabilitation in the hospital where they were fully monitored by the physiotherapists during the whole session of physiotherapy. The patients in the minimally-supervised conditioning programme followed a novel approach to the rehabilitation and self-managed rehabilitation activities in the hospital without supervision from the physiotherapists. In the latter approach information about the rehabilitation activities that were to be undertaken by patients were provided to each patient in the minimally-supervised rehabilitation group at the beginning of each physiotherapy session by a physiotherapist. From an ethical prospective, the patients in the minimally-supervised rehabilitation programme were guided to the same rehabilitation programme received by the patients in the fully-supervised rehabilitation program. The number of physiotherapy sessions in the hospital is attended by the patients in the fully - supervised and the patients in the minimally-supervised rehabilitation groups were observed 14.3�±4.9 (mean�±SD) and 14.5�±4.3, respectively; p = 0.1, indicating that the patients in both the latter groups have attended similar number of physiotherapy sessions in the hospital. All the patients were assessed before surgery on 6th, 12th and 24th week post-surgery on patients reported outcome measures (PROMs) (IKDC, KOOS, K-SES, Lysholm and VAS). Findings of this trial suggested, a statistically significant group �� time interaction for subsections physical activities of the K-SES (F (3.0, 114) = 2.6, p= 0.02). No differences were observed for the remaining three subsections of the K - SES, all five subsections of the KOOS, IKDC, Lysholm and VAS, suggesting that the patients in minimally-supervised rehabilitation group can achieve the same levels of function to the patients in the fully-supervised rehabilitation groups. Based on the findings of this trial, it can be concluded that the outcomes of the rehabilitation following ACL reconstruction may not be influenced by the levels of supervision from the rehabilitation team. haider.kmu@hotmail.com

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