Table 2. Range of Motion (ROM) and Strength Criteria for Progression Through Phases in Previous Rehabilitation Protocols Published in the Literaturea.
| Study/Goals | Acute Phase | Subacute/Regenerating Phase | Functional Phase |
|---|---|---|---|
| Clanton (65) | |||
| ROM | Normal gait | Pain free full AROM | Pain free for sports movements |
| STR | Generic recommendations | ||
| Heiderscheit (13) | |||
| ROM | Normal walking stride without pain | Full ROM without pain | |
| STR | Pain free ISOM sub-maximal (50% - 70%) prone knee flexion (67) MST | Full strength (5/5) pain free prone knee flexion (90°) MST | Full strength pain free MST prone knee flexion (90° - 15°). ISOK: Less than 5% bilateral deficit in the ratio ECC-H (30°/s): CONC-Q (240°/s). Bilateral symmetry in CONC knee flexion PT angle at 60°/s |
| Mendiguchia (12) | |||
| ROM | AKE test < 10% asymetry and < 20 MTT > 5 and symmetry below horizontal | ||
| STR | Prone knee flexed 15° < 10% asymmetry ISOM strength (DYN) | ISOK: PT angle < 28 during knee flexion 60°/s, asym. < 8 Hip extension strength, ISK hip extension 60°/s < 10 asym. | |
| Schmitt (46) | |||
| ROM | Normal walking pain free | Full ROM pain free | |
| STR | Pain free submaximal ISOM contraction (50% - 75%) during prone knee flexion (90°) MST | Strength (5/5) pain free, prone knee flexion (67) MST Asymetry < 20% compared against uninjured limb Pain free max ECC in a non-lengthened state | Full strength without pain in lengthened position. Bilateral symmetry in knee flexion PT angle |
| Askling (47) | |||
| ROM | Progression in load/speed/excursion based on the avoidance of the pain criterion | ||
| STR | Progression in load/speed/excursion based on the avoidance of the pain criterion | ||
| Silder (14) | |||
| ROM | Normal walk, same stride length and stance time on injured and non injured limbs (visually assessed) | Jog FW and BW (same stride length and stance time) on injured/non injured limbs (visually assessed) | |
| STR | A pain-free ISOM contraction at 90° of knee flexion with a MST judged to be at least 4/5 | Full strength (5/5 MST) prone at 90° of knee flexion (tibia in neutral/internally and externally rotated) | Full strength (5/5 MST) in various knee positions prone, hip 0° of flexion and knee flexed at 90° and 15°; (tibia in neutral/internally and externally rotated) |
a Abbreviations: AROM, active range of motion; ECC, eccentric; DYN, dynamometer; ISOM, isometric; MST, manual strength test; MTT, modified thomas test; ROM, range of motion; STR, strength.