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Using Goal-Setting to rehab ACL injury

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Brittany Coble

on 2 February 2014

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Transcript of Using Goal-Setting to rehab ACL injury

Cognitive Skill
Physical Therapy for Reconstructed ACL
Goal-Setting
Exercises Cont...
Strengthen and Increase ROM
Walking
Short-Term Goals
1-Isometric Contractions
2-Strengthen and ROM
3- Walking
4- Agility and Plyometric

Long-Term Goal- Back to playing Sport
Exercises Cont...
Shuttle Machine
The Shuttle is a useful tool for rehabilitating ACL injuries because the shuttle can be used to initiate strength, balance, proprioception, and plyometric training for limited weight bearing patients. The Shuttle can zero out the effects of gravity while the patient will lie on their back with their feet shoulder width apart and gradually flex their knee to help acheive greater ROM. Resistance can be added to help increase lower extremity strength.
Standing Squats
Mini Squats will be introduced in the 3rd week of rehabilitation. Patient will stand against a wall or door with a stability ball between them and the wall, ball placed in their lower back, heels away from the door. Patient will slide down as if they are trying to sit in a chair and go down as far as they can until it is painful and then they will stand back up.
ACL Injuries, Rehabilitation, and Prevention by 388 team
Isometric Quad Contractions
Isometric quad exercises aim to strengthen the quads by contracting the muscle, with no, or very little movement of the knee joint. They are ideal exercises for early stage rehab to prevent muscle wasting.

Start with leg straight out on table and contract quads by pressing leg into table-Hold for 5 secs. You can progress by adding a rolled towel under the leg and increase towel height to increase intensity-also work up to holding contraction for 10 sets of 10 secs.
Tens Unit- Electrical Stimulation Machine that contracts quads passively.

Single Leg Raises- Start seated on table with unaffected leg bent. Keep injured leg laying straight out on table and while keeping knee straight, lift leg a few inches off the table making sure it doesn't reach heights above the bent knee. Increase intensity by holding the straight leg off the table for longer periods of time.
Aim: to fully extend/straighten the knee. In general, flexion (ability to bend) is much easier to regain than extension.
Exercises:
1) Bike- generally used a warm-up. Patient will place feet on pedals (generally in the first few visits they can't make the pedal go around completely), but as ROM increases they are able to pedal normally. To get increased ROM have them gently pull the pedal towards them, which is putting their knee in flexion until it is too painful, then push the pedal the other way. Keep doing this while trying to get more flexion of knee.
Patient will move through these walking short term goals:

With Crutches-just trying to make it through daily tasks, then progress to walking without crutches.

Stairs- will be incorporated taking one step at a time, while progressing to one step at a time and limited rail holding.
Agility and Plyometrics
Agility exercises are designed to improve the power and strength in the muscles that move your knee after the ACL graft has healed. These exercises are also referred to as plyometrics, and they are an important part of retraining in the rehabilitation process.
At this time (3-4 months into rehab) the patient will progress from squats along the wall to squats using dyna discs- they are air filled, unstable discs that make the patient incorporate more muscles at 1 time.
The patient will also move to movements more similar to what she will experience in her sport, so we will have her quickly steping on and over the box (from side to side). Then progress to jumping on and over the box.
Long-Term Goal
http://streubelphysicaltherapy.com/clinic.php
http://www.emoryhealthcare.org/acl-program/index.html
http://www.aclsolutions.com/rehab_5.php
YouTube Videos
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