Outcomes following anterior cruciate ligament (ACL) reconstruction need improving, with poor return-to-sport rates and high risk of secondary re-injury. There is a need to improve rehabilitation strategies after ACL reconstruction, if we can support enhanced patient outcomes. This paper discusses how to optimise the mid-stage rehabilitation process after ACL reconstruction. Mid-stage is a difficult and vitally important stage of the functional recovery process and provides the foundation on which to commence late-stage rehabilitation training. Often many aspects of mid-stage rehabilitation (e.g. knee extensors isolated muscle strength) are not actually restored prior to return-to-sport. In addition, if we are to allow time for optimal late-stage rehabilitation and return-to-sport training, we need to optimise the mid-stage rehabilitation approach and complete it in a timely manner. This paper forms a key part of a strategy to optimise the ACL rehabilitation approach and considers factors more specific to mid-stage rehabilitation characterised in 3 areas: (1) muscle strength: muscle and joint specific, in particular at the knee level, with the knee extensors and flexors and distally with the triceps surae and proximally with the lumbo-pelvic-hip complex, as well as closed kinetic chain strength; (2) altered basic motor patterning (movement quality) and (3) fitness re-conditioning. In addition, the paper provides recommendations on how to implement these into practice, discussing training planning and programming and suggests specific screening to monitor work and when the athlete is able to progress to the next stage (e.g. late-stage rehabilitation criteria).

中文翻译：

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ACL重建后优化“中期”培训和测试流程

前交叉韧带（ACL）重建后的结果有待改善，运动返回率低，继发性再伤害的风险高。如果我们可以支持提高患者的预后，则有必要在ACL重建后改善康复策略。本文讨论了ACL重建后如何优化中期康复过程。中期是功能恢复过程中的一个困难且至关重要的阶段，它为开始后期康复培训提供了基础。通常，在恢复运动之前，实际上并没有恢复中期康复的许多方面（例如，膝伸肌孤立的肌肉力量）。此外，如果我们要留出时间进行最佳的后期康复和返回运动训练，我们需要优化中期康复方法并及时完成。本文构成了优化ACL康复方法的战略的关键部分，并考虑了针对以下三个方面的更具体的中期康复因素：（1）肌肉力量：肌肉和关节的特异性，特别是在膝关节水平，以及膝关节伸肌和屈肌，远端与肱三头肌，近端与腰-骨盆-髋关节复合体，以及闭合的动力学链强度；（2）更改了基本的运动模式（运动质量），并且（3）重新进行了适应性调整。此外，本文还提供了有关如何将其付诸实践的建议，讨论了训练计划和计划，并建议进行特定的筛查以监测工作情况以及运动员何时能够进入下一阶段（例如