Aquatic Versus Land-based Exercises as Early Functional Rehabilitation for Elite Athletes with Acute Lower Extremity Ligament Injury: A Pilot Study
Received 18 November 2009; accepted 5 March 2010. published online 05 July 2010.
Objective
To compare outcomes between aquatic and land-based exercises during early-phase recovery from acute lower extremity ligament injuries in elite athletes.
Design
A single-blinded, covariate adaptive randomized, controlled study.
Setting
National training center for elite athletes.
Participants
Twenty-two athletes with isolated grade I or II ligament injury in ankles or knees were randomized into either an aquatic or land-based exercise group.
Interventions
Early functional rehabilitation program (ranging, strengthening, proprioceptive training, and functional exercises) was performed in both groups. All exercises were identical except for the training environment.
Main Outcome Measurements
Data were collected at baseline and at 2 and 4 weeks using a visual analog scale (VAS) for pain; static stability (overall stability index [OSI] level 5 and 3); dynamic stability (TCT), and percentage single-limb support time (%SLST).
Results
Both groups showed decreases in VAS, OSI 5 and 3, and TCT, with a concomitant increase in %SLST at 2 and 4 weeks (P < .05). No significant differences were detected between the 2 groups in any of the outcome measures. However, the line graphs for VAS, OSI 3, TCT, and %SLST in the aquatic exercise group were steeper than those in the land-based exercise group indicating significant group by time interactions (P < .05). These data indicate that the aquatic exercise group improved more rapidly than the land-based exercise group.
Conclusions
For elite athletes with acute ligament sprains in the lower limb, aquatic exercises may provide advantages over standard land-based therapy for rapid return to athletic activities. Consequently, aquatic exercise could be recommended for the initial phase of a rehabilitation program.
aDepartment of Sports Medicine and Science, National Training Center of Korea Olympic Committee, Seoul, Korea⁎
bDepartment of Sports Medicine and Science, National Training Center of Korea Olympic Committee, Seoul, Korea†
cDepartment of Sports Medicine and Science, National Training Center of Korea Olympic Committee, Seoul, Korea‡
dDepartment of Physical Medicine and Rehabilitation, Kyunghee University Medical Center, Seoul, Korea¶
eRehabilitation Program, Department of Neurology, Wake Forest University Baptist Medical Center, Winston-Salem, NC∥
Address correspondence to: E.K.
Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org
ABSTRACT