201012 New publi

Local vibration training improves the recovery of quadriceps strength in early rehabilitation after anterior cruciate ligament reconstruction: a feasibility randomized controlled trial

Authors: Claire Coulondre, Robin Souron, Alexandre Rambaud, Etienne Dalmais, Loïc Espeit, Thomas Neri, Alban Pinaroli, Gilles Estour, Guillaume Y Millet, Thomas Rupp, Léonard Feasson, Pascal Edouard, Thomas Lapole.

Published: 12 October 2020 - Ann Phys Rehabil Med.

ABSTRACT

Background: After anterior cruciate ligament reconstruction (ACLR), quadriceps strength must be maximized as early as possible.

Objectives: We tested whether local vibration training (LVT) during the early post-ACLR period (i.e., ∼10 weeks) could improve strength recovery.

Methods: This was a multicentric, open, parallel-group, randomized controlled trial. Thirty individuals attending ACLR were randomized by use of a dedicated Web application to 2 groups: vibration (standardized rehabilitation plus LVT, n=16) or control (standardized rehabilitation alone, n=14). Experimenters, physiotherapists and participants were not blinded. Both groups received 24 sessions of standardized rehabilitation over ∼10 weeks. In addition, the vibration group received 1 hr of vibration applied to the relaxed quadriceps of the injured leg at the end of each rehabilitation session. The primary outcome - maximal isometric strength of both injured and non-injured legs (i.e., allowing for limb asymmetry measurement) - was evaluated before ACLR (PRE) and after the 10-week rehabilitation (POST).

Results: Seven participants were lost to follow-up, so data for 23 participants were used in the complete-case analysis. For the injured leg, the mean (SD) decrease in maximal strength from PRE to POST was significantly lower for the vibration than control group (n=11, -16% [10] vs n=12, -30% [11]; p=0.0045, Cohen's d effect size = 1.33). Mean PRE-POST change in limb symmetry was lower for the vibration than control group (-19% [11] vs -29% [13]) but not significantly (p=0.051, Cohen's d effect size = 0.85).

Conclusion: LVT improved strength recovery after ACLR. This feasibility study suggests that LVT applied to relaxed muscles is a promising modality of vibration therapy that could be implemented early in ACLR.

Keywords: anterior cruciate ligament reconstruction; local vibration; rehabilitation; strength.

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