Incorporating Internal and External Training Load Measurements in Clinical Decision Making After ACL Reconstruction: A Clinical Commentary

# Background and Purpose Poor outcomes after anterior cruciate ligament reconstruction (ACLr), including the relatively high risk of suffering a subsequent ACL injury, suggest the need to optimize rehabilitation and return-to-sport testing. The purpose of this commentary is to introduce clinicians...

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Autores principales:	Jeffrey B Taylor, Kevin R Ford, Robin M Queen, Elizabeth C Owen, Angela Spontelli Gisselman
Formato:	article
Lenguaje:	EN
Publicado:	North American Sports Medicine Institute 2021
Materias:	Sports medicine RC1200-1245
Acceso en línea:	https://doaj.org/article/fda848e7b50546ee8ccc81fbd4b58393
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spelling	oai:doaj.org-article:fda848e7b50546ee8ccc81fbd4b583932021-12-02T17:43:25ZIncorporating Internal and External Training Load Measurements in Clinical Decision Making After ACL Reconstruction: A Clinical Commentary10.26603/001c.211522159-2896https://doaj.org/article/fda848e7b50546ee8ccc81fbd4b583932021-04-01T00:00:00Zhttps://ijspt.scholasticahq.com/article/21152-incorporating-internal-and-external-training-load-measurements-in-clinical-decision-making-after-acl-reconstruction-a-clinical-commentary.pdfhttps://doaj.org/toc/2159-2896# Background and Purpose Poor outcomes after anterior cruciate ligament reconstruction (ACLr), including the relatively high risk of suffering a subsequent ACL injury, suggest the need to optimize rehabilitation and return-to-sport testing. The purpose of this commentary is to introduce clinicians to the concept of monitoring training load during rehabilitation, to review methods of quantifying internal and external loads, and to suggest ways that these technologies can be incorporated into rehabilitation progressions and return-to-sport decisions after anterior ACLr. # Description of Topic with Related Evidence Quantifying and identifying the effects of training load variables, external (distance, impacts, decelerations) and internal (heart rate, heart rate variability) workload, during rehabilitation can indicate both positive (improved physical, physiological, or psychological capacity) or negative (heightened risk for injury or illness) adaptations and allow for the ideal progression of exercise prescription. When used during return-to-sport testing, wearable technology can provide robust measures of movement quality, readiness, and asymmetry not identified during performance-based testing. # Discussion / Relation to Clinical Practice Researchers have reported the actual in-game demands of men and women of various ages and competition levels during multi-directional sport. Wearable technology can provide similar variables during rehabilitation, home exercise programs, and during on-field transition back to sport to ensure patients have met the expected fitness capacity of their sport. Additionally, clinicians can use internal load measures to objectively monitor patient’s physiological responses to rehabilitation progressions and recovery rather than relying on subjective patient-reported data. # Level of Evidence 5Jeffrey B TaylorKevin R FordRobin M QueenElizabeth C OwenAngela Spontelli GisselmanNorth American Sports Medicine InstitutearticleSports medicineRC1200-1245ENInternational Journal of Sports Physical Therapy, Vol 16, Iss 2 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sports medicine RC1200-1245
spellingShingle	Sports medicine RC1200-1245 Jeffrey B Taylor Kevin R Ford Robin M Queen Elizabeth C Owen Angela Spontelli Gisselman Incorporating Internal and External Training Load Measurements in Clinical Decision Making After ACL Reconstruction: A Clinical Commentary
description	# Background and Purpose Poor outcomes after anterior cruciate ligament reconstruction (ACLr), including the relatively high risk of suffering a subsequent ACL injury, suggest the need to optimize rehabilitation and return-to-sport testing. The purpose of this commentary is to introduce clinicians to the concept of monitoring training load during rehabilitation, to review methods of quantifying internal and external loads, and to suggest ways that these technologies can be incorporated into rehabilitation progressions and return-to-sport decisions after anterior ACLr. # Description of Topic with Related Evidence Quantifying and identifying the effects of training load variables, external (distance, impacts, decelerations) and internal (heart rate, heart rate variability) workload, during rehabilitation can indicate both positive (improved physical, physiological, or psychological capacity) or negative (heightened risk for injury or illness) adaptations and allow for the ideal progression of exercise prescription. When used during return-to-sport testing, wearable technology can provide robust measures of movement quality, readiness, and asymmetry not identified during performance-based testing. # Discussion / Relation to Clinical Practice Researchers have reported the actual in-game demands of men and women of various ages and competition levels during multi-directional sport. Wearable technology can provide similar variables during rehabilitation, home exercise programs, and during on-field transition back to sport to ensure patients have met the expected fitness capacity of their sport. Additionally, clinicians can use internal load measures to objectively monitor patient’s physiological responses to rehabilitation progressions and recovery rather than relying on subjective patient-reported data. # Level of Evidence 5
format	article
author	Jeffrey B Taylor Kevin R Ford Robin M Queen Elizabeth C Owen Angela Spontelli Gisselman
author_facet	Jeffrey B Taylor Kevin R Ford Robin M Queen Elizabeth C Owen Angela Spontelli Gisselman
author_sort	Jeffrey B Taylor
title	Incorporating Internal and External Training Load Measurements in Clinical Decision Making After ACL Reconstruction: A Clinical Commentary
title_short	Incorporating Internal and External Training Load Measurements in Clinical Decision Making After ACL Reconstruction: A Clinical Commentary
title_full	Incorporating Internal and External Training Load Measurements in Clinical Decision Making After ACL Reconstruction: A Clinical Commentary
title_fullStr	Incorporating Internal and External Training Load Measurements in Clinical Decision Making After ACL Reconstruction: A Clinical Commentary
title_full_unstemmed	Incorporating Internal and External Training Load Measurements in Clinical Decision Making After ACL Reconstruction: A Clinical Commentary
title_sort	incorporating internal and external training load measurements in clinical decision making after acl reconstruction: a clinical commentary
publisher	North American Sports Medicine Institute
publishDate	2021
url	https://doaj.org/article/fda848e7b50546ee8ccc81fbd4b58393
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Incorporating Internal and External Training Load Measurements in Clinical Decision Making After ACL Reconstruction: A Clinical Commentary

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