PT - JOURNAL ARTICLE AU - van Melick, Nicky AU - van Cingel, Robert E H AU - Brooijmans, Frans AU - Neeter, Camille AU - van Tienen, Tony AU - Hullegie, Wim AU - Nijhuis-van der Sanden, Maria W G TI - Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus AID - 10.1136/bjsports-2015-095898 DP - 2016 Dec 01 TA - British Journal of Sports Medicine PG - 1506--1515 VI - 50 IP - 24 4099 - http://bjsm.bmj.com/content/50/24/1506.short 4100 - http://bjsm.bmj.com/content/50/24/1506.full SO - Br J Sports Med2016 Dec 01; 50 AB - Aim The Royal Dutch Society for Physical Therapy (KNGF) instructed a multidisciplinary group of Dutch anterior cruciate ligament (ACL) experts to develop an evidence statement for rehabilitation after ACL reconstruction.Design Clinical practice guideline underpinned by systematic review and expert consensus.Data sources A multidisciplinary working group and steering group systematically reviewed the literature and wrote the guideline. MEDLINE and the Cochrane Library were searched for meta-analyses, systematic reviews, randomised controlled trials and prospective cohort studies published between January 1990 and June 2015.Eligibility criteria for selecting studies Included literature must have addressed 1 of 9 predetermined clinical topics: (1) preoperative predictors for postoperative outcome, (2) effectiveness of physical therapy, (3) open and closed kinetic chain quadriceps exercises, (4) strength and neuromuscular training, (5) electrostimulation and electromyographic feedback, (6) cryotherapy, (7) measurements of functional performance, (8) return to play and (9) risk for reinjury.Summary Ninety studies were included as the basis for the evidence statement. Rehabilitation after ACL injury should include a prehabilitation phase and 3 criterion-based postoperative phases: (1) impairment-based, (2) sport-specific training and (3) return to play. A battery of strength and hop tests, quality of movement and psychological tests should be used to guide progression from one rehabilitation stage to the next. Postoperative rehabilitation should continue for 9–12 months. To assess readiness to return to play and the risk for reinjury, a test battery, including strength tests, hop tests and measurement of movement quality, should be used.