Rehabilitation practices of Turkish physiotherapists following anterior cruciate ligament reconstruction: an online survey.

Abstract

We aimed to investigate the anterior cruciate ligament reconstruction (ACL-R) rehabilitation and return-to-sport (RTS) practices of Turkish physiotherapists. An online survey with 25 questions on ACL-R rehabilitation and RTS practices was created on Google Forms and distributed to physiotherapists via social media. Two-hundred sixty-four physiotherapists' responses were analysed. About 62.3% of therapists treated patients prior to ACL-R. Open-kinetic-chain (OKC) exercises frequently started at 4-6 weeks post-operatively (34.8%). Return-to-running cleared at 3-4 months (37%) and RTS cleared at 6-9 months (40.2%) mostly. Manual muscle tests were used by 58.4% of physiotherapists to evaluate knee strength before RTS. About 46.7% of physiotherapists did not assess psychological readiness for RTS. Physiotherapists with a bachelor's degree cleared patients for RTS earlier (<9 months) than those with postgraduate degrees (p = 0.001) but used patient-reported outcome measures (PROMs) more frequently (p = 0.010). Physiotherapists with over 5 years of experience used PROMs and psychological readiness scales more frequently (p = 0.035, p = 0.001) but also cleared patients for RTS earlier (p = 0.014). This study revealed that physiotherapist rehabilitation practices after ACL-R are not fully consistent with the current best evidence. This inconsistency in rehabilitation practices may lead to suboptimal patient outcomes after ACL-R. Encouraging physiotherapists to incorporate the latest evidence into practice might lead to better rehabilitation outcomes.