Table 2: Characteristics of particular stages of postoperative procedure carried out in the ACLR groups.

Postoperative physiotherapy stagesCharacteristics of particular stages

Stage I
From the 1st to the 5th week
Main goals: reducing pain and effusion, knee ROM, and gait restoration
Ice packs replaced after couple days with local cryotherapy; continuous passive motion (CPM) knee exercises, mobilization of the patellofemoral joint and soft tissue techniques, electrostimulation of vastus medialis, and magnetic field were applied. Consecutively, closed kinetic chain (CKC) proprioceptive exercises, isometric tensioning of the knee extensors and flexors muscles, followed by isometric exercises with manually dosed resistance. The exercises of muscle groups distant to the affected area, including the uninvolved lower extremity, the upper extremities, and the trunk.

Stage II
From the 6th to the 12th week
Main goals: improving gait pattern, proprioceptive stimulation
Mobilization of the patellofemoral joint, electrostimulation of vastus medialis, CKC proprioceptive exercises, isometric exercises with manually dosed resistance of the knee flexors and extensors muscles; the exercises of the uninvolved lower extremity, the upper extremities, and the trunk were continued. Treadmill walking; cycloergometer; proprioception exercises progressed to being performed on a soft surface; step-up exercises, two-legged and consecutively one-legged partial squats on a collapsible surface, and concentric and eccentric exercises for the ischiotibial muscles were added.

Stage III
From the 13th to the 20th week
Main goals: reducing strength asymmetries, teaching proper landing technique, and running for general endurance training
Isometric exercises with partial resistance from the extensor muscles of the involved knee; low intensity plyometric exercises and landing technique reeducation; functional training with movement pattern corrections; complex core exercises were added. In the end of the stage, strength training under isokinetic conditions and treadmill running for general conditioning were introduced. The training was stopped when the patient experienced subjective or objective symptoms of fatigue or pain.

Stage IV
From the 21st week until 6–8 months
Main goals: practicing complex movement patterns, strength, power, and specific endurance training
Concentric-eccentric lower limb exercises. Discipline-specific exercises without contact, unilateral plyometrics practice, agility drills, and complex neuromuscular training were added. Specific endurance exercises were introduced. The training was stopped when the patient experienced subjective or objective symptoms of fatigue or pain.