Two- to 4-Year Follow-up to a Comparison of Home Versus Physical Therapy-Supervised Rehabilitation Programs After Anterior Cruciate Ligament Reconstruction
Bibliographic record
Abstract
BACKGROUND: There have been no long-term follow-up studies comparing a predominantly home-based rehabilitation program with a standard physical therapy program after anterior cruciate ligament (ACL) reconstruction. Demonstrating the long-term success of such a cost-effective program would be beneficial to guide future rehabilitation practice. PURPOSE: To determine whether there were any differences in long-term outcome between recreational athletes who performed a physical therapy-supervised rehabilitation program and those who performed a primarily home-based rehabilitation program in the first 3 months after ACL reconstruction. STUDY DESIGN: Randomized clinical trial; Level of evidence, 1. METHODS: Patients were randomized before ACL reconstruction surgery to either the physical therapy-supervised (17 physical therapy sessions) or home-based (4 physical therapy sessions) program. Eighty-eight of the original 129 patients returned 2 to 4 years after surgery to assess their long-term clinical outcomes. Primary outcome was the ACL quality of life questionnaire (ACL QOL). Secondary outcomes were bilateral difference in knee extension and flexion range of motion, sagittal plane knee laxity, relative quadriceps and hamstring strength, and objective International Knee Documentation Committee score. Unpaired t tests and a chi-square test were used for the comparisons. RESULTS: The home-based group had a significantly higher mean ACL QOL score (80.0 +/- 16.2) than the physical therapy-supervised group (69.9 +/- 22.0) a mean of 38 months after surgery (P = .02, 95% confidence interval [CI]: 1.7, 18.4). The mean change in ACL QOL score from before surgery to follow-up was not significantly different between the groups (physical therapy = 40.0, home = 45.8, P = .26, 95% CI: -15.8, 4.4). There were no significant differences in the secondary outcome measures. CONCLUSION: This long-term study upholds the short-term findings of the original randomized clinical trial by demonstrating that patients who participate in a predominantly home-based rehabilitation program in the first 3 months after ACL reconstruction have similar 2- to 4-year outcomes compared with those patients who participate in a more clinically supervised program.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".