The Effect of Aquatic Rehabilitation on Knee Function in Anterior Cruciate Ligament Reconstruction Patients.

The Impact of Aquatic Rehabilitation on Gait and Muscle Function in Patients After Anterior Cruciate Ligament Reconstruction.

The goal of this clinical trial is to compare the applicability and effectiveness of an aquatic rehabilitation training program with a conventional land-based rehabilitation program in terms of lower extremity biomechanics and knee function in Anterior Cruciate Ligament Reconstruction (ACLR) patients. The main questions it aims to answer are:

• Does aquatic rehabilitation accelerate the recovery of gait symmetry and muscle function in patients after ACLR？
• Previous studies have not uncovered the training characteristics of aquatic rehabilitation, which allow for training movements that cannot be performed on land, and it is unknown whether these different training movement characteristics are more effective for patients with ACLR.

Participants were randomly divided into an aquatic rehabilitation group (AR) and a land-based rehabilitation group (LR), and each group performed 70-90 minutes of training per session for a total of 6 sessions. This included warm-up activities, mobility training, strength training, functional exercises, and finishing activities. Each training session was conducted 1-2 days apart, 2-3 sessions per week, and the training was completed within 2-3 weeks.

The experimental procedures of this study included collecting basic information about the subjects (age, height, weight, injury history, and surgery) and assessing muscle properties, degree of knee swelling, thigh circumference, knee flexion mobility, balance ability, gait, and the IKDC2000 score. Post-intervention testing was performed with the same testing procedures as the pre-intervention testing. The IKDC score was assessed again for one year after the intervention.

The results of all outcomes measured before and after the intervention were analyzed and calculated using IBM SPSS Statistics 26.0. The data were tested for normality using the Shapiro-Wilk test. For data conforming to a normal distribution, results are expressed as mean (Mean) and standard deviation (SD). An independent-samples t-test was used to compare whether there was a statistically significant difference in baseline and post-intervention values between the two intervention groups, and a paired-samples t-test was used to test whether there was a statistically significant difference before and after the intervention within each group. For data that did not conform to a normal distribution, results are expressed as median and interquartile range (IQR). The Mann-Whitney U test was used to compare baseline and post-intervention values between the two intervention groups, and the Wilcoxon signed-rank test was used to examine whether there was a statistically significant difference before and after the intervention within each group. Statistical significance was set at P < 0.05, and P < 0.01 was considered highly significant.

Inclusion Criteria:

• Patients 4-8 weeks after unilateral ACL reconstruction surgery, or combined meniscus removal or resection, or 6-10 weeks after combined meniscus suturing after unilateral ACL reconstruction;
• No other lower extremity injury in the last 3 months, except for meniscal injury.

Exclusion Criteria:

• Contraindications related to underwater conditions such as open wounds, infectious diseases, history of neurological diseases (stroke, degenerative diseases of the central or peripheral nervous system, etc.), and being on psychotropic or anti-hypertensive drugs;
• Fear of water and inability to comply with experimental arrangements;
• History of ACL reconstruction surgery on the contralateral lower extremity and not more than half a year ago.