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Table 2 ACL post-operative rehabilitation program based on hamstring tendon autograft (Wilk, et al. 2003; Majima et al. 2002).

From: Effect of cross exercise on quadriceps acceleration reaction time and subjective scores (Lysholm questionnaire) following anterior cruciate ligament reconstruction

Post operative phase

Rehabilitation regimen

Phase 1. Duration 2–4 weeks

Immediate straight leg raising.

Early range of motion exercise with an emphasis on gaining full knee extension (0°).

Weight bearing full as tolerated.

First week 70° of flexion.

Static squat (90° flexion)

Phase 2. Duration 2–3 months

Endurance training (biking).

Progressive resistance training (leg press, calf press, step up).

Dynamic squat (0°–110°).

Balance exercises.

Eccentric muscle contractions.

Progressive resistance exercise full range of motion, hop on one leg without pain.

Isokinetic exercise and assessment.

Phase 3. Duration 3–6 months

Continued progressive resistance and endurance training.

Jogging/running, swimming.

Eccentric training (active lengthening force production- such as jumping exercises).

Strengthening and functional exercise training to prepare the individual for full return activity.

Criteria for returning to full activity: 80% strength and 85% functional ability, proprioception > 90%, extension/flexion strength difference > 70% compared to the non-surgical lower extremity ysholm knee score > 90

Functional brace

6 weeks