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Volume 13
Issue 19
10.3390/healthcare13192480
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Review

Think Outside the Block: Rehabilitation Continuum After ACL Reconstruction with Adaptive Macro-Blocks—A Narrative Review

by
Giandomenico Campardo
1,
Roberto Ricupito
2,
Carlotta Vercesi
3,
Firas Mourad
4,5,6,
Georgios Kakavas
7 and
Florian Forelli
8,9,10,*
1
Giandomenico Campardo, Private Clinic, via S. Marco 10, 33170 Pordenone, Italy
2
Restart Physiotherapy, via Felice Grossi Gondi 35, 00162 Rome, Italy
3
Centro Dello Sport—Swiss Olympic Clinica Ars Medica, 6925 Manno, Switzerland
4
Department of Health, LUNEX University of Applied Sciences, 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg
5
Luxembourg Health & Sport Sciences Research Institute A.s.b.l., 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg
6
Facoltà Dipartimentale di Medicina e Chirurgia, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
7
Fysiotek Spine & Sports Lab, 17562 Athens, Greece
8
Haute-Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, 2800 Delémont, Switzerland
9
Orthopaedic Surgery Department, Clinic of Domont, Ramsay Healthcare, OrthoLab, 95330 Domont, France
10
Société Française des Masseurs—Kinésithérapeutes du Sport Lab, 93380 Pierrefite sur Seine, France
*
Author to whom correspondence should be addressed.
Healthcare 2025, 13(19), 2480; https://doi.org/10.3390/healthcare13192480 (registering DOI)
Submission received: 22 May 2025 / Revised: 22 September 2025 / Accepted: 26 September 2025 / Published: 29 September 2025
(This article belongs to the Special Issue Advances in Physical Therapy for Sports-Related Injuries and Pain)
Versions Notes

Abstract

Background: Conventional rehabilitation after anterior cruciate ligament reconstruction often follows a rigid, phase-based model. This structure may overlook individual differences in healing, neuromuscular control, and psychological readiness, leading to low return-to-sport rates and a high risk of reinjury. Methods: This narrative review proposes a flexible rehabilitation framework based on overlapping progression blocks. Inspired by principles of strength and conditioning, motor learning, and cognitive training, this model emphasizes continuous, individualized development instead of fixed timelines. Results: The proposed model integrates essential components—such as joint mobility, muscle activation, motor control, and psychological factors—throughout the entire recovery process. Functional testing is redefined as a dynamic and ongoing diagnostic tool that helps clinicians identify areas needing further development, rather than acting as a simple pass/fail gateway. Progression is guided by demonstrated readiness rather than time or phase completion. Conclusions: Rehabilitation using adaptive, overlapping progression blocks offers a more holistic and responsive approach. It allows for better personalization, supports safer decision-making, and improves the transition back to sport through sustained development of physical and cognitive capacities.
Keywords: anterior cruciate ligament; rehabilitation model; progression blocks; motor control; return to sport anterior cruciate ligament; rehabilitation model; progression blocks; motor control; return to sport

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MDPI and ACS Style

Campardo, G.; Ricupito, R.; Vercesi, C.; Mourad, F.; Kakavas, G.; Forelli, F. Think Outside the Block: Rehabilitation Continuum After ACL Reconstruction with Adaptive Macro-Blocks—A Narrative Review. Healthcare 2025, 13, 2480. https://doi.org/10.3390/healthcare13192480

AMA Style

Campardo G, Ricupito R, Vercesi C, Mourad F, Kakavas G, Forelli F. Think Outside the Block: Rehabilitation Continuum After ACL Reconstruction with Adaptive Macro-Blocks—A Narrative Review. Healthcare. 2025; 13(19):2480. https://doi.org/10.3390/healthcare13192480

Chicago/Turabian Style

Campardo, Giandomenico, Roberto Ricupito, Carlotta Vercesi, Firas Mourad, Georgios Kakavas, and Florian Forelli. 2025. "Think Outside the Block: Rehabilitation Continuum After ACL Reconstruction with Adaptive Macro-Blocks—A Narrative Review" Healthcare 13, no. 19: 2480. https://doi.org/10.3390/healthcare13192480

APA Style

Campardo, G., Ricupito, R., Vercesi, C., Mourad, F., Kakavas, G., & Forelli, F. (2025). Think Outside the Block: Rehabilitation Continuum After ACL Reconstruction with Adaptive Macro-Blocks—A Narrative Review. Healthcare, 13(19), 2480. https://doi.org/10.3390/healthcare13192480

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