Two studies (one strong quality, one weak quality)(7, 8) examined the effectiveness of prehabilitation exercise interventions consisting of strength, balance and proprioception training, in patients on wait lists for anterior cruciate ligament surgery. Both interventions took place over six weeks (7, 8). In the first (strong quality) (7), participants in the intervention group completed 2 supervised gym sessions and 2 supervised home based sessions per week and were compared to a usual care control group. In the second, (weak quality) (8), intervention participants completed home-based physiotherapy for at least 30/min per day. They were compared to a control group of patients not receiving physiotherapy.
Function:
Inconsistent (two studies; one strong quality(7), one weak quality(8), inconsistent effects across studies).
Strength:
Might be effective (one strong quality study; showing significant effect for intervention compared to control) (7).
Increase in Muscle Size:
Might be effective (one strong quality study; showing significant effect for intervention compared to control) (7).
Increase in Muscle-Building Proteins:
Might be effective (one strong quality study; showing significant effect for intervention compared to control) (7).
Knee Joint Stability:
Inconsistent (one strong quality study; inconsistent effects within study when measured in multiple ways) (7).
Balance:
Evidence is inconsistent (one strong quality study; inconsistent effects within study when measured in multiple ways) (7).
Delay or Cancellation of Surgery:
Evidence is lacking (one strong quality study; after the intervention, two subjects in the exercise intervention group elected not to have surgery; all subjects in the control group underwent surgery) (7).
Adverse Events:
Evidence is lacking (one strong quality study; after the intervention, no exercise intervention participants reported major adverse events. One patient experienced a single episode of knee ‘pivoting out’ while dancing vigorously) (7).