Our research project was presented at the 17th Annual Pilates Method Alliance conference in October 2017 in a poster format

Abstract

Using Pilates Exercises after Reconstructive Knee Surgery to Restore Full ROM in the Knee Joint in Week 7 – 12 Post Op. Single Case Study.

Authors:
Joanna Telacka MS NCPT, Wojciech Telacki MS PT; Harmonious Pilates, Inc. Roslyn, New York, USA, harmoniouspilates@yahoo.com

Purpose:
The purpose of this study was to show that apparatus based Pilates exercises are an effective method of rehabilitation in restoring full ROM in the knee joint post surgery; week 7-12

Subject:
1 subject: 49 year old female. Knee reconstruction surgery due to a skiing accident– medial meniscus repaired, lateral meniscus debridement, ACL replaced with allograft customized to the subject’s particular knee anatomy. The complexity of the surgery resulted in conservative recovery protocol to ensure that the initial healing process would not be compromised. Non weight bearing during week 1-4, knee brace week 1-6, knee joint ROM restricted to 90 ° flexion week 1 – 6.

Assessment:
Knee joint ROM measured with goniometer, knee flexors, knee extensors, and plantar flexors strength measured by manual muscle test.

Materials:
Reformer, Chair, Mat, stationary bike, passive ROM, heat, ice.

Methods:
3 to 5 times per week for 6 weeks; heat 15 min, Reformer, Chair, Mat protocol: Selected intermediate level Reformer and Chair closed kinetic chain exercises as a preferred method of post surgery rehabilitation. These exercises promote sequential movement in mobilizing the ankle, knee and hip joints. Every exercise is a compound movement where more muscle groups are recruited and used per exercise than in open kinetic chain exercises that promote more shearing forces. Selected intermediate level Reformer and Mat exercises as isometric exercises are used to strengthen thigh and lower leg. Passive stretching in weeks 6 – 10, stationary bike - gradually lowering the seat to increase ROM in knee joint, low RPM, gradually increasing duration from 2 min to 10 min. Ice for 15-30 min.

Results:
Increase in passive ROM from 90° to 140 ° flexion within first 3 weeks. Week 4 and 5 ROM increased to 148°.  The strength of knee flexors, knee extensors and plantar flexors increased from 3/ 5 to 4/5.

Conclusion:
The Pilates method is an effective tool in restoring knee joint ROM. Using springs and various configurations of the football on the Reformer, as well as springs on the Chair, allows one to perform closed kinetic chain exercises with precision by flexing and extending the knee joint as much as possible, in a controlled environment. In addition, using isometric exercises within the Pilates repertoire strengthens knee flexors, extensors and plantar flexors. This improves knee joint congruity and prepares the subject for the next phase of the rehabilitation –dynamic strength training and proprioception.

Key Words:
Pilates for ACL reconstruction, Pilates and rehabilitation, Pilates and knee reconstruction, ACL replacement, closed kinetic chain exercises.

Funding:
None

Call For Research