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

Abstract Objectives To compare water-based treadmill walking training with land-based treadmill walking training following anterior cruciate ligament (ACL) reconstruction. Design Prospective, randomised, single-blind clinical trial. Setting Single-centre study. Participants Sixty patients undergoing rehabilitation following ACL reconstruction were assigned at random into two groups. Interventions 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. Results 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. Conclusion 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. Clinical Trial Registration number ChiCTR1900025930.