The Efficacy of Aquatic Exercise in Rehabilitation Post-Intra-Articular ACL Reconstruction: A Randomized Controlled Trial

Abstract

Effective rehabilitation following intra-articular anterior cruciate ligament (ACL) reconstruction is critical for restoring knee function and enabling a return to daily activities. Aquatic exercise has been proposed as a beneficial intervention due to its low-impact nature, which may enhance muscle strength and joint mobility. This study aimed to evaluate the efficacy of aquatic exercise compared to traditional land-based physical therapy in the rehabilitation of patients post-ACL reconstruction. The primary objectives were to assess improvements in knee function, pain levels, and muscle strength, while secondary objectives included evaluating range of motion (ROM) and patient satisfaction. A randomized controlled trial was conducted with 30 patients post-ACL reconstruction, randomly assigned to either an aquatic exercise group or a traditional land-based therapy group. Both groups underwent therapy sessions five times per week for 12 weeks. The aquatic exercise regimen included resistance and aerobic exercises in a heated pool. Outcomes were measured using the Lysholm Knee Scoring Scale, Visual Analogue Scale (VAS) for pain, isokinetic muscle strength testing, ROM measurements, and patient satisfaction surveys. Both groups showed significant improvements in knee function, pain reduction, and muscle strength after 12 weeks and at a 24-week follow-up. However, the aquatic exercise group demonstrated significantly greater improvement in knee function (mean difference of 12.4 points, 95% CI 9.1 to 15.7) and pain reduction (mean difference of 2.3 points on the VAS, 95% CI 1.7 to 2.9). They also had superior gains in muscle strength and ROM. Patient satisfaction was higher in the aquatic group, with reports of greater comfort and enjoyment. In conclusion, aquatic exercise is more effective than traditional land-based therapy for post-ACL reconstruction rehabilitation, leading to better outcomes in knee function, pain relief, muscle strength, and patient satisfaction. These findings support incorporating aquatic exercise into rehabilitation protocols for ACL reconstruction patients.