Effects Of Aquatic Exercise Therapy On Lower Extremity Function And Negative Emotions In Patients In The Early Post-operative Period After Anterior Cruciate Ligament Reconstruction

Objective: The efficacy of aquatic exercise therapy applied to early rehabilitation after anterior cruciate ligament reconstruction(ACLR)is unclear.The purpose of this study was to compare the effects of aquatic exercise therapy and conventional treatment on lower extremity function and negative affect in patients in the early postoperative period after ACLR.Methods: A total of 40 patients aged 18-45 years and 2-4 weeks postoperatively in the early postoperative period of ACLR were included according to the inclusion and exclusion criteria.The subjects were randomly divided into two groups,namely,the conventional treatment group(group A)and the aquatic exercise treatment group(group B),with 20 subjects in each group.group A underwent conventional rehabilitation treatment for 40 min once a day,3-5 days a week;group B underwent aquatic exercise treatment for the same total duration as the conventional treatment group,for a total of 6 weeks.Range of motion(ROM),Visual analogue scale(VAS),swelling(patellar midpoint circumference),thigh circumferential atrophy index(10cm above the patella),passive joint position sense,percentage of static healthy affected plantar force,Lysholm,self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were assessed before and after the intervention.Record the time of abduction during the intervention.Dynamic plantar pressure temporal parameters were evaluated after the intervention.The data were analyzed using SPSS26.0 software,and differences were statistically significant if p<0.05.Results: 1.Range of motion: intra-group comparison: flexion and extension ROM increased in both groups compared to pre-intervention,with statistically significant differences(p<0.01).Between-group comparison: flexion ROM as well as improvement values were significantly greater in group B than in group A after the intervention,with statistically significant differences(p<0.05).2.Visual analogue scale: intra-group comparison: compared with pre-intervention,VAS scores decreased in both groups,with statistically significant differences(p<0.01).Between-group comparison: VAS scores in group B were smaller than those in group A after the intervention,with statistically significant differences(p<0.05).3.knee swelling and thigh circumferential atrophy index: intra-group comparison:compared with the pre-intervention,the degree of swelling decreased in both groups,and thigh circumferential atrophy index decreased in group B,with statistically significant differences(p<0.05).Comparison between groups: we compared the improved values of thigh circumferential atrophy index between the two groups after the intervention,with statistically significant differences(p<0.05).4.Passive joint position perception: intra-group comparison: compared with pre-intervention,the difference in passive joint position perception of knee 60.in both groups decreased,with statistically significant differences(p<0.01).The difference in passive joint position perception was significantly smaller in group B than in group A after the intervention(p<0.01).5.Plantar pressure: intra-group comparison: compared with the pre-intervention,the difference in the percentage of plantar force on the healthy and affected side of group B decreased,with statistically significant differences(p<0.01);after the intervention,compared with the healthy side,the total duration of the whole foot support phase and total duration of the stirrup release phase on the affected side of group A decreased,and the total duration of the stirrup release phase on the affected side of group B decreased,with statistically significant differences(p<0.01).Comparison between groups: After the intervention,the symmetry indices of the whole-foot support phase and stirrup release phase in group B were smaller than those in group A,with statistically significant differences(p<0.01).6.Lysholm knee score scale: within-group comparison: compared with the pre-intervention period,Lysholm scores decreased in both groups,with statistically significant differences(p<0.01).Between-group comparison: Lysholm scores in group B were greater than those in group A after the intervention,with statistically significant differences(p<0.05).7.Rehabilitation process: Compared with group A,group B had an earlier overall deinflection time,but the difference was not statistically significant(p>0.05).8.Negative emotions: intra-group comparison: SDS scores were reduced in both groups compared to pre-intervention,with statistically significant differences(p<0.05).Between-group comparison: SAS and SDS scores were compared between the two groups before and after the intervention,and the differences were not statistically meaningful(p>0.05).Conclusions: 1.Both aquatic exercise therapy and conventional treatment were effective in improving knee ROM,pain,swelling,proprioception,and knee function in patients in the early postoperative period after ACLR.2.Aquatic exercise therapy was more effective than conventional treatment in improving knee flexion ROM,pain,the muscle atrophy,proprioception,dynamic plantar pressure temporal parameters(foot flat phace and forefoot push off phace),and knee function in patients in the early postoperative period after ACLR.3.Compared to conventional treatment,aquatic exercise therapy did not significantly reduce the time to deconditioning and improve anxiety and depression in patients in the early postoperative period after ACLR,but it had a positive effect on depression.