National Physical Therapy Examination (NPTE) Practice Exam

What should NOT be included in the treatment plan for a post-ACL reconstruction patient during the early healing phase?

1. Passive knee extension

2. Open-chain quadriceps contractions at full extension

3. Safe ambulation with crutches

4. Cold therapy for swelling management

The correct answer is: Open-chain quadriceps contractions at full extension

In the early healing phase following an anterior cruciate ligament (ACL) reconstruction, the focus is on protecting the surgical site while promoting healing and regaining range of motion. Engaging in open-chain quadriceps contractions at full extension is not appropriate during this phase, as it can place undue stress on the knee joint, particularly on the healing surgical site. The quadriceps muscle works to extend the knee fully, which can potentially lead to excessive load on the newly reconstructed ACL and compromise the integrity of the repair. In contrast, passive knee extension is generally included in the treatment plan to help restore range of motion and prevent stiffness without overloading the knee. Safe ambulation with crutches is essential for promoting mobility while protecting the knee during the early recovery phase. Cold therapy is beneficial for managing swelling and pain, aiding in the overall rehabilitation process. Therefore, emphasizing controlled, safe exercises and modalities is critical, while avoiding activities that could jeopardize the healing process, such as open-chain exercises at full knee extension.