Acl protocol3/15/2024 ▪ Home therapeutic exercise program: Individualized ▪ Retrograde incline treadmill ambulation ▪ Aquaciser (gait training) if incision benign ▪ Proprioception training: prop board/balance system/contralateral Theraband exercises ▪ Brace changed to MD preference (OTS brace, patella sleeve, etc.) ▪ Progressive weight bearing/WBAT (patella tendon) with crutches brace opened 0° → 50°, if good quadriceps control (good quad set/ability to SLR without lag or pain) ▪ Avoid pain with therapeutic exercise and functional activities ▪ Avoid descending stairs reciprocally until adequate quadriceps control and lower extremity alignment ▪ Ascend 8″ stairs with good control without pain ▪ Demonstrate ability to unilateral (involved extremity) weight bear without pain ▪ Emphasize patient compliance to home therapeutic exercise program and weight bearing precautions/progression ▪ Home therapeutic exercise program: evaluation based ▪ Upper extremity cardiovascular exercises as tolerated ▪ Proprioception board/balance system (bilateral weight bearing) ▪ Active flexion/active-assisted extension 90° → 0° exercise ▪ PWB → WBAT (patella tendon) with brace locked at 0° with crutches ▪ Quadriceps re-education (quad sets with EMS or EMG) ▪ Avoid ambulation without brace locked at 0° ▪ Independence in home therapeutic exercise program
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