Table 1 Rehabilitation protocol
Category | Description | Expected achievements |
|---|---|---|
Range of motion | • Prone knee flexion AROM | • AROM of 100 |
• Heel props for extension PROM | • Less than 1cm effusion after exercises | |
• Stationary bicycle/rowing machine for ROM stimulus and endurance | • Able to attain full extension | |
• Hamstring, quadriceps & gastrocnemius /soleus stretching | ||
• Total end range time (TERT) of 30 minutes a day until ROM guideline attained (Aim 100°) | ||
Strengthening | • Isometric quads | • Able to achieve voluntary quadriceps control, demonstrated by SLR without lag |
• Straight leg raise (if not able) | • Able to perform semi squat equal weight bearing between limbs | |
• Partial squats to 90° | ||
• Supine sub-maximal leg press or equivalent (emphasis on pain free motion and neuromuscular control vs. pure strengthening) | ||
• Front and lateral step ups progressing from 10cm | ||
• Resistive exercises against Theraband 90°-30° in sitting – progress to 90°-0° | ||
Proprioception | • Balance exercises in single leg stance | • Able to perform sit-to-stand unsupported |
• Sit to stand | • Able to perform single leg stance activities | |
• Balance ball | ||
• BalanceMaster / low wobbleboard if BalanceMaster not available | ||
• Perturbation from soft unstable surface | ||
Balance/Gait | • Braiding – alternate front and back crossover steps whilst moving laterally – progress by increasing speed | • Able to complete multiple changes of direction walking without support |
• Tandem Walk forward and backwards | ||
• Walk multiple change in direction on command | ||
• Shuttle walking to increase stamina |