Comparative Analysis of Aquatic versus Land-Based Exercise in Post-Surgical Rehabilitation of ACL Reconstruction: Functional and Biomechanical Outcomes

Paramedical Science

Introduction: The anterior cruciate ligament (ACL) of the knee is crucial for controlling the movement of the tibia relative to the femur and guiding knee extension. ACL injuries, often resulting from both contact and non-contact mechanisms, are prevalent and can significantly impair knee function. Rehabilitation post-ACL reconstruction is essential for recovery, with both land-based and aquatic exercises being common approaches. This study aims to compare the effectiveness of these two rehabilitation methods. Objectives: To determine whether aquatic exercises lead to less difficulty with activities of daily living and better outcomes in terms of joint effusion and lower-extremity function compared to land-based exercises in patients after intra-articular ACL reconstruction. Method: A randomized controlled trial was conducted with 30 subjects who underwent intra-articular ACL reconstruction. Subjects were randomly assigned to two groups (n=15 each). Group A performed aquatic exercises, while Group B performed land-based exercises. Both groups followed identical exercise programs initially, with progressive adjustments from the second week onwards. The Lysholm scale was used to measure outcomes at 2, 4, and 8 weeks postoperatively. Data analysis was performed using the unpaired t-test and ANOVA. Results: Both rehabilitation programs were found to be equally effective in improving overall knee function. However, Group A (aquatic exercises) showed significantly less joint effusion and facilitated recovery of lower-extremity function more effectively than Group B (land exercises), as indicated by higher Lysholm scores. Conclusion: The study concludes that while both aquatic and land-based exercise programs are effective for post-ACL reconstruction rehabilitation, aquatic exercises offer additional benefits in reducing joint effusion and enhancing lower-extremity functional recovery. Therefore, the alternate hypothesis (H₁) is supported, indicating a significant difference between the effects of aquatic and land-based exercises in the rehabilitation of intra-articular ACL reconstruction patients.

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