A concern with this trial, however, is the description of the control group as conventional therapy. The description of the activities includes mostly passive, non-goal directed movement; this would not be considered

typical by many therapists. At this stage in upper limb research there are proven interventions that selleck inhibitor can be used as comparison in order to determine a truly superior treatment. In this trial though the amount of time spent in therapy was equivalent, the repetition of the activities were not; if this had been comparable the conclusion of ‘more effective’ could be made. The conclusion is thus difficult to accept. There is mounting evidence that high repetitions of active, goal directed interventions are necessary for improved upper limb function and therefore need to be a key ingredient in conventional rehabilitation. “
“Summary of: Frobell RB, et al (2013) Treatment for acute anterior cruciate ligament tear: five year outcome of randomized trial. BMJ 346: f232. doi: 10.1136/bmj.f232. [Prepared by Nicholas Taylor, CAP

Co-ordinator.] Question: Doesearly find more anterior ligament (ACL) reconstruction plus early rehabilitation improve outcomes 5 years after injury in patients with an ACL ligament tear compared with rehabilitation with the option of delayed surgery? Design: Randomised, controlled trial included blinded outcome assessment. Setting: Two hospitals in Sweden. Participants: Adults aged 18 to 36 years with an ACL tear not more than 4 weeks old to a previously uninjured knee were included. Key exclusion were playing professional sport, being less than moderately active, and having a full thickness meniscal lesion. Randomisation of 121 participants allocated 62 to the early ACL reconstruction group and 59 to a group having the option of delayed ACL reconstruction if needed. Interventions: Both groups received a similar rehabilitation program supervised

by physiotherapists in outpatient clinics with goals for attaining range of motion, muscle function, Rutecarpine and functional performance. In addition, the intervention group had ACL reconstruction surgery within 10 weeks of injury. The comparison group with the option of delayed reconstruction had ACL reconstruction surgery when presenting with symptomatic knee instability. Outcome measures: The primary outcome was the change in the Knee Injury and Osteoarthritis Outcome score (KOOS) at 5 years. The KOOS comprises an overall score and 5 subscales (pain, symptoms, activities of daily living, sport and recreation, and knee related quality of life) scored from 0 to 100 with higher scores indicating better results. Secondary outcome measures included the short-form health survey (SF-36), the Tegner Activity Scale, and radiographic osteoarthritis. Results: 120 participants completed the study.