Adapted from: Melbourne ACL rehabilitation guide 2.0 (Randall Cooper and Mick Hughes).
- Pre-op Phase: Injury recovery & readiness for surgery
a. Goals: Eliminate swelling and Regain full range of motion
b. Exit criteria: 0 deg passive knee extension 125 + passive knee flexion *0-1 + Stroke test
- Recovery from surgery
a. Goals: Full knee extension, swelling down to mild, increased quadriceps motor control
b. Exit Criteria: 0 - 5 degrees Quadriceps lag test All other exit criteria as above
- Strength and neuromuscular control
a. Goals: single-leg balance, muscle strength, single-leg squat technique
b. Exit Criteria: 0 score Stroke test Single leg calf raises >85% vs. contralateral Functional alignment test: 5 x single leg squat test(= 'Good') Unipedal stance test (eyes open: 43 sec, closed: 9 sec) *Single leg bridge strength (20 reps) and endurance test (30 sec) and >85% contralateral
- Running, agility, and landing
a. Goals: Hopping performance, agility program, modified game, full strength/ balance
b. Exit Criteria: All hop tests >95% compared to contralateral side Single leg hop test Triple hop test Triple cross over hop test Side hop test Single leg squat (>22 repetitions both limbs) Cooper & Hughes Sports Vestibular Balance Test= Pass on both limbs *Star Excursion Balance Test (Gribble et al, 2012) >95% vs. contralateral side
- Return to sport
a. Exit Criteria: >95/100 Melbourne Return to Sports Score (Authors: Randall Cooper & Mick Hughes)
b. Clinical examination: Pivot-shift test, Prone hang test, Effusion, PROM flexion II.
c. Functional testing: Dynamic/vestibular balance tests as above Single leg rise test (90deg flexion) Single hop Triple hop Triple cross over hop test Side hop Ill.
d. Fatigued state (7/10 VAS scale): Single hop, Triple hop, Triple cross over, Side hop IV.
e. General fitness tests: Pass/Fall sport-specific V.
f. Questionnaires: *IKDC Subjective Knee Evaluation • ACL-RSI •Tampa Scale of Kinesiophobia.