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Table 1 Therapy/intervention regimen for both study arms. Standard/Classic rehabilitation strategies were conducted according to grade-A guidelines [27, 28]. The secondary preventive Stop-X program follows the recommendations in [24,25,26]

From: Effectiveness of a home-based re-injury prevention program on motor control, return to sport and recurrence rates after anterior cruciate ligament reconstruction: study protocol for a multicenter, single-blind, randomized controlled trial (PReP)

Wound-healing phase and/or time post surgery

Therapy goal

Classic

Stop-X

Inflammation phase

Reduction of inflammation

Brace: range of motion restriction 0–0-90° at 20-kg partial knee load

Manual therapeutic, passive closed kinematic chain mobilization; hip and ankle integrated

Measures against post-operative swelling and temperature increase, home-based measures for auto-mobilization (under compression)

Trunk and scapula control; non-affected-side static motor control, i.e., single-leg stance

Proliferation phase

Approximately weeks 3–12 post reconstruction

Pain reduction and mobilization [27, 29]

Knee-joint mobilization in restricted range of movement, patellar mobilization

Stretching: Mm. ischiocruales, M. gastrocnemius, M. iliopsoas, M. tractusiliotibialis

Motor control of trunk and scapula; non-affected-side static motor control, i.e., single-leg stance

Approximately after week 7 post reconstruction

Brace: range of motion unrestricted

Onset of motor-control training

Open kinetic (dorsal only) chain

Approximately after week 10 post reconstruction

Corrective exercise with the aim to prepare for return to sport (RTS) level I

Single-leg dynamic-stabilizing/motor-control exercises

Eccentric knee mobilization open frontal kinetic chain

Remodeling phase

Level I function: Approximately after week 13 post reconstruction

Functional enhancement and recurrence prevention

Closed and open kinetic chain (ventral and dorsal)

Based on functional criteria, not time based.

Information, risk assessment, correction of risky movement characteristics; teaching of basic preventive strategies; total program at/after RTS clearance

Running exercises/agility exercises

Straight on running, hip external rotation, change of direction runs

Running with sagittal plane distance and vertical-jump components.

Self-perturbed balance exercises

Single-leg stance with (individually and combined) ball bouncing/unstable surface/passing a ball

Jumping exercises/plyometrics vertical and distance

Strengthening exercises

Russian hamstrings

Dynamic and side planks with/without heel raising

Hip abduction

One-legged squats

Strength endurance training for (in particular) the ischiocrural muscles

Dynamic-stabilizing motor-control exercises, including jump landings on unstable surfaces

Level II function: Approximately months 4–6 post reconstruction

Dynamic-stabilizing motor-control exercises, including single (affected) leg jump landings on unstable surfaces

Onset of impact exercises

Level III function: Approximately after month 7 post reconstruction

Dynamic exercises (frontal plane)

Side-cutting maneuvers

Level IV function: Not before 10th month post reconstruction

Dynamic multi-directional stabilization