The Muscle Strength of the Knee Joint after ACL Reconstruction Depends on the Number and Frequency of Supervised Physiotherapy Visits

Abstract

The aim of this study in anterior cruciate ligament reconstruction (ACLR) patients was to assess the effect of six months of supervised physiotherapy with a higher number of visits (SPHNV) compared to supervised physiotherapy with a lower number of visits (SPLNV) on the maximal peak torque (PT) and isometric torque (IT) of values obtained for hamstring (H) and quadriceps (Q) muscles of the knee joints under isokinetic and isometric conditions. Hypothesis: SPHNV improves IT and PT more than SPLNV. Group I had ACLR with a higher number of visits (n = 20), Group II had ACLR with a lower number of visits (n = 20), and Group III served as the control (n = 20). In Groups I and II, IT values were measured for quadriceps and hamstring muscles of the knee joints in the 13th and 24th weeks and for PT in the 18th and 24th weeks after ACLR (60 and 180 °/s). In group III, the measurements were taken once. The isometric torque and isokinetic peak torque values were measured in N*m and they were normalized to body mass as relative IT (RIT) and relative PT (RPT) were expressed in N*m/kg. Results: In both ACLR groups, the RIT and RPT values obtained from the operated knee joints significantly increased in the 24 weeks following ACLR compared to the uninvolved side. Group II had significantly lower RIT and RPT values for quadriceps and hamstring muscles of the operated limbs compared with the uninvolved limbs (p = 0.008, p = 0.001). In group I, the larger number of visits positively correlated with the higher PT for quadriceps and hamstring muscles of the operated and uninvolved knees (from r = 0.506; p = 0.023 too r = 0.566; p = 0.009), respectively. Six months of SPHNV positively correlated with and improved the IT and PT values in patients after ACLR much more significantly than six months of SPLNV.