Effects on Lower Extremity Neuromuscular Control Exercises on Knee Proprioception, Muscle Strength, and Functional Level in Patients with ACL Reconstruction

Table 1

Neuromuscular control exercises program.

1^st–3^rd days	Mobilization: tolerated weight-bearing mobilization with crutches
	Exercises:
	Quadriceps isometric setting with towel under the heel, straight leg raising (SLR) with full knee extension (with weights at ankle), raising the leg above the ground 40–50 cm in 10 seconds, holding for 10 seconds, and slowly lowering in 40 seconds
	Restriction: avoid active terminal knee extension (30° to full extension)
3^rd days-3^rd week	Range of motion: 0 to 90° flexion
	Mobilization: tolerated weight-bearing mobilization w/wo crutches
	Exercises:
	Quadriceps isometric setting with towel under the heel, SLR with full knee extension (with weights at ankle), raising the leg above the ground 40–50 cm in 10 seconds, holding for 10 seconds, and slowly lowering in 40 seconds, and heel slides (at 0–90° flexion)
	Restriction: avoid active terminal knee extension (30° to full extension)
3^rd–6^th week	Range of motion: 0 to 120° flexion
	Mobilization: tolerated to full weight-bearing mobilization with knee brace
	Exercises:
	Single leg stance, balance reach leg and balance reach arm exercises, lunges (all directions), step-up (all directions) on other side of the patients, and bilateral squat
	Restriction: avoid active terminal knee extension (30° to full extension)
6^th–12^th week	Exercises:
	Single leg stance, balance reach leg and balance reach arm exercises, lunges (all directions), step-up (all directions), step-down (all directions), one-legged squat, box heel touches (all directions), and single leg pelvic bridge on operated side of the patients, and ball exercises during athletic position
12^th–24^th week	Exercises:
	Single leg straight leg dead lift, sumo squat, and weights added to all exercises
	Special stair exercises: (stair should be 18 cm in height and 30 cm in depth)
	Explanation:
	Stair exercise (1): stand behind a stair. While one foot on the ground, put the other foot on the stair and flex the knee about 45° flexion. Raise the body to full knee extension at one leg in 60 seconds and slowly lowering the body to 45° knee flexion in 60 seconds. During the exercises, the patient should control his/her lower leg to keep straight (keep away from varus/valgus)
	Stair exercise (2): stand on a stair. Lower the body at one leg in 60 seconds and slowly turn and raise the body in 60 seconds During the exercises, the patient should control his/her lower leg to keep straight (keep away from varus/valgus)
To 9th month	(3) running program (started at the 13^th week)
	(4) jumping (multidirectional) (started at the 18^th week)
	(5) plyometrics and agility exercises (started at the 20^th to 24^th week)
	Restriction: return to sports is not allowed before 9 months after surgery