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Influence of Isokinetic Muscle Strength Training Combined With Early Functional Exercise on Joint Function After Knee Cruciate Ligament Reconstruction.

Lin Y, Chen T, Lin H, Lv W, Ke X, Yang X et al. · Annali italiani di chirurgia · 2026

Researchers looked back at 252 matched patients recovering from knee cruciate ligament (ACL/PCL) reconstruction, comparing those who did early functional rehab alone with those who added isokinetic strength training starting 4 weeks after surgery. The combined group scored higher on knee function questionnaires (IKDC and KOOS) at 8, 12 and 24 weeks, and by 24 weeks also had greater range of motion and stronger knee extensors and flexors.
Takeaway: Ask your rehab team about adding isokinetic strength work from about week 4 after knee ligament reconstruction, alongside standard early functional exercise.
Abstract (source)

Aim: The

Purpose: of this study was to evaluate and analyze the influence of isokinetic muscle strength training combined with early functional exercise on joint function after knee cruciate ligament reconstruction.

Methods: A total of 294 patients undergoing knee cruciate ligament reconstruction from January 2023 to June 2025 were retrospectively selected. Based on different exercise

methods, 155 patients who received early functional exercise for 24 weeks were included in a control group (CG), and the other 139 patients receiving isokinetic muscle strength training (starting from the 4th week after surgery) combined with early functional exercise were enrolled as an experimental group (EG). After propensity score matching (PSM), 252 patients were retained for analysis, including 126 cases in the EG and 126 cases in the CG. The primary clinical outcomes encompassed International Knee Documentation Committee Subjective Knee Form (IKDCSKF) and Knee Injury and Osteoarthritis Outcome Score (KOOS) before training (T0) and at 8 weeks (T1), 12 weeks (T2) and 24 weeks (T3) after surgery, and the secondary outcomes included joint range of motion (ROM) and isokinetic muscle strength test

Results: involving extensor peak torque (EPT), flexor peak torque (FPT) and hamstrings/quadriceps (H/Q).

Results Repeated measures analysis of variance (ANOVA) revealed significant group × time interaction effects for both IKDCSKF and KOOS scores (both p p p p p p p p p = 0.001). No significant difference was found in the proportion of patients with normal H/Q between the two groups (χ 2 = 0.06, p = 0.798). The β (95% CI) for EG on IKDCSKF score was 4.35 (2.82~5.87), and the β (95% CI) on KOOS score was 5.22 (3.91~6.53).

Conclusions: Isokinetic muscle strength training combined with early functional exercise was associated with greater improvement in joint function and knee flexor and extensor muscle strength in patients undergoing knee cruciate ligament reconstruction. In addition, the intervention protocol may be independently associated with the patient's joint function.

Primary studyResistance Training & Hypertrophy
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