Anterior Cruciate Ligament Rehabilitation for the 10- to 18-Year-Old Adolescent Athlete: Practice Guidelines Based on International Delphi Consensus
Background: There are 2 treatment options for adolescent athletes with anterior cruciate ligament (ACL) injuries—rehabilitation alone (nonsurgical treatment) or ACL reconstruction plus rehabilitation. However, there is no clear consensus on how to include strength and neuromuscular training during e...
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| Veröffentlicht in: | Orthopaedic journal of sports medicine 2023-07, Vol.11 (7), p.23259671231172454-23259671231172454 |
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| creator | van Melick, Nicky Dietvorst, Martijn van Oort, Maaike I.A.M. Claessens, Remco L.A. Janssen, Rob P.A. Bogie, Rob Claussen, William Greenberg, Elliot M. Grindem, Hege Kearney, Sharon van Keulen, Matthijs Lips, Martijn Macrina, Lenny McWilliam, David Moksnes, Håvard Norris, Richard Paterno, Mark V. Picot, Brice Piskulic, David Prato, Luis F. Sayer, Timothy A. Sethi, Faraz Silvers-Granelli, Holly Truong, Linda Whalan, Matthew Witvrouw, Erik |
| description | Background:
There are 2 treatment options for adolescent athletes with anterior cruciate ligament (ACL) injuries—rehabilitation alone (nonsurgical treatment) or ACL reconstruction plus rehabilitation. However, there is no clear consensus on how to include strength and neuromuscular training during each phase of rehabilitation.
Purpose:
To develop a practical consensus for adolescent ACL rehabilitation to help provide care to this age group using an international Delphi panel.
Study Design:
Consensus statement.
Methods:
A 3-round online international Delphi consensus study was conducted. A mix of open and closed literature-based statements were formulated and sent out to an international panel of 20 ACL rehabilitation experts. Statements were divided into 3 domains as follows: (1) nonsurgical rehabilitation; (2) prehabilitation; and (3) postoperative rehabilitation. Consensus was defined as 70% agreement between panel members.
Results:
Panel members agreed that rehabilitation should consist of 3 criterion-based phases, with continued injury prevention serving as a fourth phase. They also reached a consensus on rehabilitation being different for 10- to 16-year-olds compared with 17- and 18-year-olds, with a need to distinguish between prepubertal (Tanner stage 1) and mid- to postpubertal (Tanner stages 2-5) athletes. The panel members reached a consensus on the following topics: educational topics during rehabilitation; psychological interventions during rehabilitation; additional consultation of the orthopaedic surgeon; duration of postoperative rehabilitation; exercises during phase 1 of nonsurgical and postoperative rehabilitation; criteria for progression from phase 1 to phase 2; resistance training during phase 2; jumping exercises during phase 2; criteria for progression from phase 2 to phase 3; and criteria for return to sports (RTS). The most notable differences in recommendations for prepubertal compared with mid- to postpubertal athletes were described for resistance training and RTS criteria.
Conclusion:
Together with available evidence, this international Delphi statement provides a framework based on expert consensus and describes a practice guideline for adolescent ACL rehabilitation, which can be used in day-to-day practice. This is an important step toward reducing practice inconsistencies, improving the quality of rehabilitation after adolescent ACL injuries, and closing the evidence-practice gap while waiting for further studies to provide |
| doi_str_mv | 10.1177/23259671231172454 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10363891</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_23259671231172454</sage_id><sourcerecordid>2842455528</sourcerecordid><originalsourceid>FETCH-LOGICAL-c467t-cf6087d9d43c074c8694abf97839f6c493213d73e98b7b2d204f80cd1a64a3e33</originalsourceid><addsrcrecordid>eNp1kc9u1DAQxiMEolXpA3BBlrhwSfG_xDYXtF2gVFqpCMGBU-TYk40rb7zYDhLvwQPjdEspIHyxPf7NN-P5quopwWeECPGSMtqoVhDKypXyhj-ojpdYvQQf3jsfVacpXeOyZEMUE4-rIya4okKS4-rHasoQXYhoHWfjdAa0cVu9gymjjzDq3nmXdXZhQkOB8giI4BrlgIisv4CO9ZW3aGWDh2SWpFUePWR4hT5EbbIzgC5mZ8G7CRI61wksKlqXS9XpRld79Ab8fnRoHaYEU5rTk-rRoH2C09v9pPr87u2n9ft6c3VxuV5tasNbkWsztFgKqyxnBgtuZKu47gclJFNDa7hilDArGCjZi55aivkgsbFEt1wzYOyken3Q3c_9DuzSf9S-20e30_F7F7Tr_nyZ3Nhtw7eOYNYyqUhReHGrEMPXGVLudq7MwXs9QZhTRyUv1jQNlQV9_hd6HeYyA39DcdyQ0n6hyIEyMaQUYbjrhuBu8b37x_eS8-z-N-4yfrlcgLMDkPQWfpf9v-JPKSC1wg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2844051694</pqid></control><display><type>article</type><title>Anterior Cruciate Ligament Rehabilitation for the 10- to 18-Year-Old Adolescent Athlete: Practice Guidelines Based on International Delphi Consensus</title><source>DOAJ Directory of Open Access Journals</source><source>Sage Journals GOLD Open Access 2024</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>van Melick, Nicky ; Dietvorst, Martijn ; van Oort, Maaike I.A.M. ; Claessens, Remco L.A. ; Janssen, Rob P.A. ; Bogie, Rob ; Claussen, William ; Greenberg, Elliot M. ; Grindem, Hege ; Kearney, Sharon ; van Keulen, Matthijs ; Lips, Martijn ; Macrina, Lenny ; McWilliam, David ; Moksnes, Håvard ; Norris, Richard ; Paterno, Mark V. ; Picot, Brice ; Piskulic, David ; Prato, Luis F. ; Sayer, Timothy A. ; Sethi, Faraz ; Silvers-Granelli, Holly ; Truong, Linda ; Whalan, Matthew ; Witvrouw, Erik</creator><creatorcontrib>van Melick, Nicky ; Dietvorst, Martijn ; van Oort, Maaike I.A.M. ; Claessens, Remco L.A. ; Janssen, Rob P.A. ; Bogie, Rob ; Claussen, William ; Greenberg, Elliot M. ; Grindem, Hege ; Kearney, Sharon ; van Keulen, Matthijs ; Lips, Martijn ; Macrina, Lenny ; McWilliam, David ; Moksnes, Håvard ; Norris, Richard ; Paterno, Mark V. ; Picot, Brice ; Piskulic, David ; Prato, Luis F. ; Sayer, Timothy A. ; Sethi, Faraz ; Silvers-Granelli, Holly ; Truong, Linda ; Whalan, Matthew ; Witvrouw, Erik ; Adolescent ACL Rehabilitation Group ; the Adolescent ACL Rehabilitation Group</creatorcontrib><description>Background:
There are 2 treatment options for adolescent athletes with anterior cruciate ligament (ACL) injuries—rehabilitation alone (nonsurgical treatment) or ACL reconstruction plus rehabilitation. However, there is no clear consensus on how to include strength and neuromuscular training during each phase of rehabilitation.
Purpose:
To develop a practical consensus for adolescent ACL rehabilitation to help provide care to this age group using an international Delphi panel.
Study Design:
Consensus statement.
Methods:
A 3-round online international Delphi consensus study was conducted. A mix of open and closed literature-based statements were formulated and sent out to an international panel of 20 ACL rehabilitation experts. Statements were divided into 3 domains as follows: (1) nonsurgical rehabilitation; (2) prehabilitation; and (3) postoperative rehabilitation. Consensus was defined as 70% agreement between panel members.
Results:
Panel members agreed that rehabilitation should consist of 3 criterion-based phases, with continued injury prevention serving as a fourth phase. They also reached a consensus on rehabilitation being different for 10- to 16-year-olds compared with 17- and 18-year-olds, with a need to distinguish between prepubertal (Tanner stage 1) and mid- to postpubertal (Tanner stages 2-5) athletes. The panel members reached a consensus on the following topics: educational topics during rehabilitation; psychological interventions during rehabilitation; additional consultation of the orthopaedic surgeon; duration of postoperative rehabilitation; exercises during phase 1 of nonsurgical and postoperative rehabilitation; criteria for progression from phase 1 to phase 2; resistance training during phase 2; jumping exercises during phase 2; criteria for progression from phase 2 to phase 3; and criteria for return to sports (RTS). The most notable differences in recommendations for prepubertal compared with mid- to postpubertal athletes were described for resistance training and RTS criteria.
Conclusion:
Together with available evidence, this international Delphi statement provides a framework based on expert consensus and describes a practice guideline for adolescent ACL rehabilitation, which can be used in day-to-day practice. This is an important step toward reducing practice inconsistencies, improving the quality of rehabilitation after adolescent ACL injuries, and closing the evidence-practice gap while waiting for further studies to provide clarity.</description><identifier>ISSN: 2325-9671</identifier><identifier>EISSN: 2325-9671</identifier><identifier>DOI: 10.1177/23259671231172454</identifier><identifier>PMID: 37492781</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Athletes ; Clinical practice guidelines ; Orthopedics ; Rehabilitation ; Sports injuries ; Sports medicine ; Strength training ; Teenagers</subject><ispartof>Orthopaedic journal of sports medicine, 2023-07, Vol.11 (7), p.23259671231172454-23259671231172454</ispartof><rights>The Author(s) 2023</rights><rights>The Author(s) 2023.</rights><rights>The Author(s) 2023. This work is licensed under the Creative Commons Attribution – Non-Commercial – No Derivatives License https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2023 2023 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c467t-cf6087d9d43c074c8694abf97839f6c493213d73e98b7b2d204f80cd1a64a3e33</citedby><cites>FETCH-LOGICAL-c467t-cf6087d9d43c074c8694abf97839f6c493213d73e98b7b2d204f80cd1a64a3e33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10363891/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10363891/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,21945,27830,27901,27902,44921,45309,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37492781$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Melick, Nicky</creatorcontrib><creatorcontrib>Dietvorst, Martijn</creatorcontrib><creatorcontrib>van Oort, Maaike I.A.M.</creatorcontrib><creatorcontrib>Claessens, Remco L.A.</creatorcontrib><creatorcontrib>Janssen, Rob P.A.</creatorcontrib><creatorcontrib>Bogie, Rob</creatorcontrib><creatorcontrib>Claussen, William</creatorcontrib><creatorcontrib>Greenberg, Elliot M.</creatorcontrib><creatorcontrib>Grindem, Hege</creatorcontrib><creatorcontrib>Kearney, Sharon</creatorcontrib><creatorcontrib>van Keulen, Matthijs</creatorcontrib><creatorcontrib>Lips, Martijn</creatorcontrib><creatorcontrib>Macrina, Lenny</creatorcontrib><creatorcontrib>McWilliam, David</creatorcontrib><creatorcontrib>Moksnes, Håvard</creatorcontrib><creatorcontrib>Norris, Richard</creatorcontrib><creatorcontrib>Paterno, Mark V.</creatorcontrib><creatorcontrib>Picot, Brice</creatorcontrib><creatorcontrib>Piskulic, David</creatorcontrib><creatorcontrib>Prato, Luis F.</creatorcontrib><creatorcontrib>Sayer, Timothy A.</creatorcontrib><creatorcontrib>Sethi, Faraz</creatorcontrib><creatorcontrib>Silvers-Granelli, Holly</creatorcontrib><creatorcontrib>Truong, Linda</creatorcontrib><creatorcontrib>Whalan, Matthew</creatorcontrib><creatorcontrib>Witvrouw, Erik</creatorcontrib><creatorcontrib>Adolescent ACL Rehabilitation Group</creatorcontrib><creatorcontrib>the Adolescent ACL Rehabilitation Group</creatorcontrib><title>Anterior Cruciate Ligament Rehabilitation for the 10- to 18-Year-Old Adolescent Athlete: Practice Guidelines Based on International Delphi Consensus</title><title>Orthopaedic journal of sports medicine</title><addtitle>Orthop J Sports Med</addtitle><description>Background:
There are 2 treatment options for adolescent athletes with anterior cruciate ligament (ACL) injuries—rehabilitation alone (nonsurgical treatment) or ACL reconstruction plus rehabilitation. However, there is no clear consensus on how to include strength and neuromuscular training during each phase of rehabilitation.
Purpose:
To develop a practical consensus for adolescent ACL rehabilitation to help provide care to this age group using an international Delphi panel.
Study Design:
Consensus statement.
Methods:
A 3-round online international Delphi consensus study was conducted. A mix of open and closed literature-based statements were formulated and sent out to an international panel of 20 ACL rehabilitation experts. Statements were divided into 3 domains as follows: (1) nonsurgical rehabilitation; (2) prehabilitation; and (3) postoperative rehabilitation. Consensus was defined as 70% agreement between panel members.
Results:
Panel members agreed that rehabilitation should consist of 3 criterion-based phases, with continued injury prevention serving as a fourth phase. They also reached a consensus on rehabilitation being different for 10- to 16-year-olds compared with 17- and 18-year-olds, with a need to distinguish between prepubertal (Tanner stage 1) and mid- to postpubertal (Tanner stages 2-5) athletes. The panel members reached a consensus on the following topics: educational topics during rehabilitation; psychological interventions during rehabilitation; additional consultation of the orthopaedic surgeon; duration of postoperative rehabilitation; exercises during phase 1 of nonsurgical and postoperative rehabilitation; criteria for progression from phase 1 to phase 2; resistance training during phase 2; jumping exercises during phase 2; criteria for progression from phase 2 to phase 3; and criteria for return to sports (RTS). The most notable differences in recommendations for prepubertal compared with mid- to postpubertal athletes were described for resistance training and RTS criteria.
Conclusion:
Together with available evidence, this international Delphi statement provides a framework based on expert consensus and describes a practice guideline for adolescent ACL rehabilitation, which can be used in day-to-day practice. This is an important step toward reducing practice inconsistencies, improving the quality of rehabilitation after adolescent ACL injuries, and closing the evidence-practice gap while waiting for further studies to provide clarity.</description><subject>Athletes</subject><subject>Clinical practice guidelines</subject><subject>Orthopedics</subject><subject>Rehabilitation</subject><subject>Sports injuries</subject><subject>Sports medicine</subject><subject>Strength 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I.A.M.</creator><creator>Claessens, Remco L.A.</creator><creator>Janssen, Rob P.A.</creator><creator>Bogie, Rob</creator><creator>Claussen, William</creator><creator>Greenberg, Elliot M.</creator><creator>Grindem, Hege</creator><creator>Kearney, Sharon</creator><creator>van Keulen, Matthijs</creator><creator>Lips, Martijn</creator><creator>Macrina, Lenny</creator><creator>McWilliam, David</creator><creator>Moksnes, Håvard</creator><creator>Norris, Richard</creator><creator>Paterno, Mark V.</creator><creator>Picot, Brice</creator><creator>Piskulic, David</creator><creator>Prato, Luis F.</creator><creator>Sayer, Timothy A.</creator><creator>Sethi, Faraz</creator><creator>Silvers-Granelli, Holly</creator><creator>Truong, Linda</creator><creator>Whalan, Matthew</creator><creator>Witvrouw, Erik</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AFRWT</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230701</creationdate><title>Anterior Cruciate Ligament Rehabilitation for the 10- to 18-Year-Old Adolescent Athlete: Practice Guidelines Based on International Delphi Consensus</title><author>van Melick, Nicky ; Dietvorst, Martijn ; van Oort, Maaike I.A.M. ; Claessens, Remco L.A. ; Janssen, Rob P.A. ; Bogie, Rob ; Claussen, William ; Greenberg, Elliot M. ; Grindem, Hege ; Kearney, Sharon ; van Keulen, Matthijs ; Lips, Martijn ; Macrina, Lenny ; McWilliam, David ; Moksnes, Håvard ; Norris, Richard ; Paterno, Mark V. ; Picot, Brice ; Piskulic, David ; Prato, Luis F. ; Sayer, Timothy A. ; Sethi, Faraz ; Silvers-Granelli, Holly ; Truong, Linda ; Whalan, Matthew ; Witvrouw, Erik</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c467t-cf6087d9d43c074c8694abf97839f6c493213d73e98b7b2d204f80cd1a64a3e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Athletes</topic><topic>Clinical practice guidelines</topic><topic>Orthopedics</topic><topic>Rehabilitation</topic><topic>Sports injuries</topic><topic>Sports medicine</topic><topic>Strength training</topic><topic>Teenagers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Melick, Nicky</creatorcontrib><creatorcontrib>Dietvorst, Martijn</creatorcontrib><creatorcontrib>van Oort, Maaike I.A.M.</creatorcontrib><creatorcontrib>Claessens, Remco L.A.</creatorcontrib><creatorcontrib>Janssen, Rob P.A.</creatorcontrib><creatorcontrib>Bogie, Rob</creatorcontrib><creatorcontrib>Claussen, William</creatorcontrib><creatorcontrib>Greenberg, Elliot M.</creatorcontrib><creatorcontrib>Grindem, Hege</creatorcontrib><creatorcontrib>Kearney, Sharon</creatorcontrib><creatorcontrib>van Keulen, Matthijs</creatorcontrib><creatorcontrib>Lips, Martijn</creatorcontrib><creatorcontrib>Macrina, Lenny</creatorcontrib><creatorcontrib>McWilliam, David</creatorcontrib><creatorcontrib>Moksnes, Håvard</creatorcontrib><creatorcontrib>Norris, Richard</creatorcontrib><creatorcontrib>Paterno, Mark V.</creatorcontrib><creatorcontrib>Picot, Brice</creatorcontrib><creatorcontrib>Piskulic, David</creatorcontrib><creatorcontrib>Prato, Luis F.</creatorcontrib><creatorcontrib>Sayer, Timothy A.</creatorcontrib><creatorcontrib>Sethi, Faraz</creatorcontrib><creatorcontrib>Silvers-Granelli, Holly</creatorcontrib><creatorcontrib>Truong, Linda</creatorcontrib><creatorcontrib>Whalan, Matthew</creatorcontrib><creatorcontrib>Witvrouw, Erik</creatorcontrib><creatorcontrib>Adolescent ACL Rehabilitation Group</creatorcontrib><creatorcontrib>the Adolescent ACL Rehabilitation Group</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Orthopaedic journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Melick, Nicky</au><au>Dietvorst, Martijn</au><au>van Oort, Maaike I.A.M.</au><au>Claessens, Remco L.A.</au><au>Janssen, Rob P.A.</au><au>Bogie, Rob</au><au>Claussen, William</au><au>Greenberg, Elliot M.</au><au>Grindem, Hege</au><au>Kearney, Sharon</au><au>van Keulen, Matthijs</au><au>Lips, Martijn</au><au>Macrina, Lenny</au><au>McWilliam, David</au><au>Moksnes, Håvard</au><au>Norris, Richard</au><au>Paterno, Mark V.</au><au>Picot, Brice</au><au>Piskulic, David</au><au>Prato, Luis F.</au><au>Sayer, Timothy A.</au><au>Sethi, Faraz</au><au>Silvers-Granelli, Holly</au><au>Truong, Linda</au><au>Whalan, Matthew</au><au>Witvrouw, Erik</au><aucorp>Adolescent ACL Rehabilitation Group</aucorp><aucorp>the Adolescent ACL Rehabilitation Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anterior Cruciate Ligament Rehabilitation for the 10- to 18-Year-Old Adolescent Athlete: Practice Guidelines Based on International Delphi Consensus</atitle><jtitle>Orthopaedic journal of sports medicine</jtitle><addtitle>Orthop J Sports Med</addtitle><date>2023-07-01</date><risdate>2023</risdate><volume>11</volume><issue>7</issue><spage>23259671231172454</spage><epage>23259671231172454</epage><pages>23259671231172454-23259671231172454</pages><issn>2325-9671</issn><eissn>2325-9671</eissn><abstract>Background:
There are 2 treatment options for adolescent athletes with anterior cruciate ligament (ACL) injuries—rehabilitation alone (nonsurgical treatment) or ACL reconstruction plus rehabilitation. However, there is no clear consensus on how to include strength and neuromuscular training during each phase of rehabilitation.
Purpose:
To develop a practical consensus for adolescent ACL rehabilitation to help provide care to this age group using an international Delphi panel.
Study Design:
Consensus statement.
Methods:
A 3-round online international Delphi consensus study was conducted. A mix of open and closed literature-based statements were formulated and sent out to an international panel of 20 ACL rehabilitation experts. Statements were divided into 3 domains as follows: (1) nonsurgical rehabilitation; (2) prehabilitation; and (3) postoperative rehabilitation. Consensus was defined as 70% agreement between panel members.
Results:
Panel members agreed that rehabilitation should consist of 3 criterion-based phases, with continued injury prevention serving as a fourth phase. They also reached a consensus on rehabilitation being different for 10- to 16-year-olds compared with 17- and 18-year-olds, with a need to distinguish between prepubertal (Tanner stage 1) and mid- to postpubertal (Tanner stages 2-5) athletes. The panel members reached a consensus on the following topics: educational topics during rehabilitation; psychological interventions during rehabilitation; additional consultation of the orthopaedic surgeon; duration of postoperative rehabilitation; exercises during phase 1 of nonsurgical and postoperative rehabilitation; criteria for progression from phase 1 to phase 2; resistance training during phase 2; jumping exercises during phase 2; criteria for progression from phase 2 to phase 3; and criteria for return to sports (RTS). The most notable differences in recommendations for prepubertal compared with mid- to postpubertal athletes were described for resistance training and RTS criteria.
Conclusion:
Together with available evidence, this international Delphi statement provides a framework based on expert consensus and describes a practice guideline for adolescent ACL rehabilitation, which can be used in day-to-day practice. This is an important step toward reducing practice inconsistencies, improving the quality of rehabilitation after adolescent ACL injuries, and closing the evidence-practice gap while waiting for further studies to provide clarity.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>37492781</pmid><doi>10.1177/23259671231172454</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2325-9671 |
| ispartof | Orthopaedic journal of sports medicine, 2023-07, Vol.11 (7), p.23259671231172454-23259671231172454 |
| issn | 2325-9671 2325-9671 |
| language | eng |
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| source | DOAJ Directory of Open Access Journals; Sage Journals GOLD Open Access 2024; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Athletes Clinical practice guidelines Orthopedics Rehabilitation Sports injuries Sports medicine Strength training Teenagers |
| title | Anterior Cruciate Ligament Rehabilitation for the 10- to 18-Year-Old Adolescent Athlete: Practice Guidelines Based on International Delphi Consensus |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-06T16%3A57%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Anterior%20Cruciate%20Ligament%20Rehabilitation%20for%20the%2010-%20to%2018-Year-Old%20Adolescent%20Athlete:%20Practice%20Guidelines%20Based%20on%20International%20Delphi%20Consensus&rft.jtitle=Orthopaedic%20journal%20of%20sports%20medicine&rft.au=van%20Melick,%20Nicky&rft.aucorp=Adolescent%20ACL%20Rehabilitation%20Group&rft.date=2023-07-01&rft.volume=11&rft.issue=7&rft.spage=23259671231172454&rft.epage=23259671231172454&rft.pages=23259671231172454-23259671231172454&rft.issn=2325-9671&rft.eissn=2325-9671&rft_id=info:doi/10.1177/23259671231172454&rft_dat=%3Cproquest_pubme%3E2842455528%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2844051694&rft_id=info:pmid/37492781&rft_sage_id=10.1177_23259671231172454&rfr_iscdi=true |