O impacto da intervenção fisioterapêutica pré-operatória em pacientes com lesão de LCA: evolução funcional pós-operatória

Abstract

Injuries to the Anterior Cruciate Ligament are increasingly common in doctors' and physiotherapists' offices, frequently affecting males and especially football athletes. After trauma, the knee undergoes adaptations and is subject to secondary injuries, with early treatment and the time taken for surgery being important so that structures such as the lateral/medial meniscus and cartilage are not affected. Physiotherapy aims to prevent new injuries, establish the patient's functionality, seeking to restore ROM, reduce edema and pain, restore the gradual muscular strength of the limb, promote functional and proprioceptive preparation. Therefore, it is important that studies are carried out to verify the effects of pre operative rehabilitation in patients in whom surgery can be awaited, so that the limb is prepared for surgical intervention and so that post-operative rehabilitation is even more efficient and progressive. This study aimed to analyze the impact of preoperative physiotherapeutic intervention on patients with ACL injuries and their postoperative functional evolution, through a literature review. The search strategy used the Health Descriptors (DeCS) of the words Anterior Cruciate Ligament Injuries, Preoperative Rehabilitation, and Physiotherapy in the databases, PubMed, PEDro, Lilacs and Scielo between August/2023 and October/2023. In the PEDro, Scielo and Lilacs databases, covering all types of studies in the search, the articles found did not correspond to the inclusion criteria of the current study. 61 results were found in PUBMED, without limiting the type of study, in which after reading the title and abstract it was observed that among the articles found that met the profile of the current study, those that were not systematic reviews were already being analyzed in the reviews found, 56 results being excluded. After reading the remaining 5 articles in full, they were included in the present research. The studies scored low/moderate methodological quality. Preoperative physiotherapy has positive results that can be analyzed in the long term, compared to patients who received only postoperative physiotherapy, demonstrating that prehabilitation showed a difference in quadriceps muscle strength, improved symmetry in excursions of the knee, improvement in functional performance and single-leg jumping between 12 weeks and 6 months postoperatively (greater results, compared to the group receiving only postoperative physiotherapy).