Francesco clark walking papers1/27/2024 ![]() 5- 7 Disruption to the native ACL after injury, leads to mechanical instability of the knee, and can alter neuromuscular control due to disrupted mechanoreceptors within the ligament 8 and altered somatosensory input and joint proprioception. Movement dysfunction is thought to be a risk factor for both primary and secondary ACL injuries. One area which is becoming increasingly important is movement re-training or ‘functional’ training. 2, 3 To optimize patient outcomes after ACL reconstruction (ACLR) and limit long-term associated problems which can follow injury (e.g., knee osteoarthritis), 4 there is a need to optimize the rehabilitation and RTS approach. Outcomes following injuries such as anterior cruciate ligament (ACL) rupture are unsatisfactory, with lower than optimal return to sport (RTS) rates 1 and high re-injury risk. This approach supports patient autonomy, medical team communication and collaboration and can provide structure to the movement re-training process. The task-based progression was formed by combining theory, the best available evidence, and significant practice experience applied to movement re-training after ACLR. Although this task-based progression is designed for patients following a rehabilitation program after ACLR, it may have generalizability for all major lower limb injuries. Monitoring knee function and movement and neuromuscular status to safely transition between these tasks is important. This paper presents a 10 task progressions system which can form an important aspect of the movement-based re-training process, providing structure and patient autonomy. when to begin running) and how to transition between tasks. However, there is a lack of guidance on when to implement certain tasks (e.g. In its basic form, movement re-training after ACLR is about progressing a patient through gradually more demanding tasks from the point of being able to walk to being able to perform highly complex sports movements. Movement re-training is considered an important element of rehabilitation after ACLR, but there is a lack of knowledge on the ‘how’ and ‘what’ movement re-training should occur after ACLR. To do this likely involves a strong focus on optimizing rehabilitation processes and practices. There is a need to improve patient outcomes after anterior cruciate ligament reconstruction (ACLR).
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