Here is an exercise progression with a patient rehabbing from an anterior cruciate ligament (ACL) tear. At the time of this video, he was eight weeks out from re-tearing his left ACL. He was functioning at a very high level because his left leg strength and dynamic knee stability showed no significant deficits.
The progression involves wearing strobe eyewear while maintaining a single-leg stance while passing and catching a ball. The physical therapist is providing external perturbations to the unstable platform. The platform is already moving forward and back, side to side, and up and down. He has no significant quadriceps weakness and has progressed from basic to intermediate exercises. Performing perturbation training occurs in later rehab stages to enhance neuromuscular training for improving dynamic knee stability.
Hartigan et al. (2009) stated that the goal of perturbation training with individuals who have torn their ACL was to break up generalized muscle stiffness for the leg when standing while receiving perturbations to improve dynamic joint stability by training the sensorimotor system to enhance proprioception.
Hartigan, E., Axe, M. J., & Snyder-Mackler, L. (2009). Perturbation training prior to ACL reconstruction improves gait asymmetries in non-copers. Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 27(6), 724–729. [ Ссылка ]
It is noticeably more difficult for him to maintain balance because of the disruption in vision and proprioception. This exercise progression with the strobe eyewear helps to improve dynamic joint stability by training the sensorimotor system to enhance proprioception.
Most of the research and clinical commentary with strobe eyewear for knee rehabilitation has been with ACL patients. The research has been investigating neuroplasticity for visual-motor training.
The clinical reasoning is
❌ Disrupted afferent input
❌ Altered proprioception
❌ Altered efferent output
❌ Change in postural control
❌ Change in movement control
The change in movement control relies on visual feedback to maintain neuromuscular control. Treatment with strobe eyewear is utilized for visual-motor training with criterion-based exercise progressions.
As always — train both legs!
Effective and efficient rehab is criterion-based, not time-based.
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Evolve Physical Therapy
20510 SW Roy Rogers Rd. Suite 120
Sherwood, OR. 97140
P: (971) 213-3335 F: (971) 213-3389
Evolve Physical Therapy
18215 NW West Union Rd, Suite B
Portland, OR 97229
P: (971) 979-0797 F: (971) 979-0997
info@ptevolve.com
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Always consult your physician before beginning any exercise program. STOP exercising if you experience any symptoms of weakness, unsteadiness, light-headedness/dizziness, chest pain or pressure, nausea, or shortness of breath.
Performing these exercises should not cause pain. If you experience pain while exercising, decrease the speed of your movement. If the pain persists - STOP. Mild soreness after exercising may be experienced after beginning a new exercise.
