Effect of water-based walking exercise on rehabilitation of patients following ACL reconstruction: a prospective, randomised, single-blind clinical trial

The above titled Research Article was published in the latest Physiotherapy Journal and can be accessed by following this link by CSP Members when logged in. 



To compare water-based treadmill walking training with land-based treadmill walking training following anterior cruciate ligament (ACL) reconstruction.


Prospective, randomised, single-blind clinical trial.


Single-centre study.


Sixty patients undergoing rehabilitation following ACL reconstruction were assigned at random into two groups.


Patients in the water-based training group (WBG) underwent treadmill training in water, and patients in the land-based training group (LBG) underwent treadmill training on land.

Main outcome measures

Muscle strength was evaluated using the ratio of peak torque to body weight (PT/BW) before and after 3 weeks of training.


After 3 weeks of training, both groups had significantly higher PT/BW ratios, passive position sense (PAPS) and Lysholm scores compared with pre-treatment levels. In the affected leg, the PT/BW ratio for the knee extensor muscles, PAPS and Lysholm scores showed significantly greater improvement in the WBG than in the LBG. No significant differences in the PT/BW ratio, single leg balance index and stability limit index of the knee flexor muscles at different angular velocities were seen between the two groups.


The results suggest that water-based walking exercise could lead to greater improvements in extensor muscle strength, proprioception and knee performance compared with land-based training following ACL reconstruction.


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