There is not yet a defined protocol ACL rehab, but it seems that in the acute rehabilitation phase should be used proprioception and muscle strengthening exercises with closed kinetic chain.

Reference: http://www.wjgnet.com/2218-5836/full/v5/i4/450.htm

Knee Injuries May Start With Strain On The Brain, Not The Muscles

(July 27, 2009) — research shows that training your brain may be just as effective as training your muscles in preventing ACL knee injuries, and suggests a shift from performance-based to prevention-based athletic training programs. The ACL, or anterior cruciate ligament, is one of the four major ligaments of the knee, and ACL injuries pose a rising public health problem as well as an economic strain on the medical system.

University of Michigan researchers studying ACL injuries had subjects perform one-legged squats to fatigue, then tested the reactions to various jumping and movement commands. Researchers found that both legs—not just the fatigued leg—showed equally dangerous and potentially injurious responses, said Scott McLean, assistant professor with the U-M School of Kinesiology. The fatigued subjects showed significant potentially harmful changes in lower body movements that, when preformed improperly, can cause ACL tears.

"These findings suggest that training the central control process—the brain and reflexive responses—may be necessary to counter the fatigue induced ACL injury risk," said McLean, who also has an appointment with the U-M Bone & Joint Injury Prevention Center.

McLean says that most research and prevention of ACL injuries focuses below the waist in a controlled lab setting, but the U-M approach looks a bit north and attempts to untangle the brain's role in movements in a random, realistic and complex sports environments.

The findings could have big implications for training programs, McLean said. Mental imagery or virtual reality technology can immerse athletes to very complex athletic scenarios, thus teaching rapid decision making. It might also be possible to train "hard wired" spinal control mechanisms to combat fatigue fallout.

In a related paper, McLean's group again tested the single leg landings of 13 men and 13 women after working the legs to fatigue. While both men and women suffer an epidemic of ACL injuries, women are two to eight times likelier to tear this ligament than men while playing the same sport. However, the study showed that men and women showed significant changes in lower limb mechanics during unanticipated single leg landings. Again, the findings point to the brain, McLean says.

During testing, a flashing light cued the subjects to jump in a certain direction, and the more fatigued the subjects became, the less likely they were able to react quickly and safely to the unexpected command.

The research suggests that training the brain to respond to unexpected stimuli, thus sharpening their anticipatory skills when faced with unexpected scenarios, may be more beneficial than performing rote training exercises in a controlled lab setting, which is much less random than a true competitive scenario. In this case, expanding the anticipated training to include shorter stimulus-response times could improve reaction time in random sports settings.

"If you expose them to more scenarios, and train the brain to respond more rapidly, you can decrease the likelihood of a dangerous response," he said. It's analogous to how a seasoned stick shift driver versus a novice learner might both respond to a sudden stall. The inexperienced driver might make a slow or even incorrect decision.

The paper below reviews muscle recruitment of both biceps femoris and semitendinosus for a dozen of exercises. According to the authors,given the distinct function of medial and lateral hamstrings muscles, different exercises recruiting differently both muscle may have implications in injury prevention and rehabilitation programs.

Zebis, M. K., et al. (2013). Kettlebell swing targets semitendinosus and supine leg curl targets biceps femoris: an EMG study with rehabilitation implications. Br J Sports Med, 47(18), 1192-1198

HAMSTRING and quads strengthening, ROM exercises and partial to full weight bearing exercises

The question per se is one but the explanation gives a second part in it.

Answering the main question (reconstruction ACL group):

Initially post op

RICE (Rest-Ice-Compression-Elevation).

1-2 weeks

Partial Weight Bearing (PWB) for 2 weeks

Regain as much strength of hamstrings and quadriceps as possible

Knee extensions

Static quadriceps exercises,

Heel slides to improve flexion knee

Bend in prone position

2-6 weeks

Off crutches - Full Weight Bearing (FWB)

Strengthening of quadriceps and hamstrings

Static cycling

Stretching of hamstrings and calf muscles

Proprioception

One leg stance

6-12 weeks

Knee extension

One leg squats

Cycling, swimming, jogging

3-6 months

Preparation of entry in sporting activities

6-9 months

Commence contact sports

The second part of the healthy uninjured men group

I believe that this is the control group of the study. As it is mentioned in a previous entry it will be necessary for care to be taken not to create fatigue to the members of the group as they may be injured.

In comparing different rehab programmes there is no real evidence shown until this point. Such things like the strengthening training only in closed chains is not evident proven.

One of the main thing is to make sure to have more time just high acitve sportsmen are want to invest. Most of the accellerated rehabilitated having more trouble with ongoing injuries und loss of training and competition time.

Also a key point is to make sure the 3D-imagination of the knee joint in the injuried person itself. That´s why the single leg stabilisation exercise are so important.

Dear George, yours recommendations are very useful and include: restore normal range of motion and developing of muscle strength.

Attached you will find an evidence based practice description of how to treat ACLD or ACLR individuals. The research covers most of the concerns involved in treating these patients and provides you with the ability to produce your own "protocol" based on peer-reviewed scientific papers from most of the past 40 years. 

As previous injury is the number one factor in further injury, some form of movement screening should be performed before going back to the chosen sport/activity. Athletes should not move on to the next level of development until they are competent at all levels of rehab and movement.

este articulo te puede servir 

http://cdeporte.rediris.es/revista/revista29/art%20LCA66.htm

ACL reconstruction is a reconstructive surgery and for this purpose two different approaches usually used.

Open Reconstruction

arthroscopic Reconstruction

and the two different tensdons are used for reconstruction

tendon of Semi-membranosis and patellar tendon. In case of pateller tendon bone to bone graft is used while in case of semimembranosis screws and bone grafts are used for tendon fixation.

So in both cases different protols for rehbilitation are currently used. The protocol presented here by Mr. George Zafiropoulos I agreed only I disagree with him when he used to induct knee flexion in pron position which according to my experience cause knee swelling again and take the ptient back to the intial posion. So in my opinion open chain knee flexion exercise in prone posion should be added after four weeks and before that if kneeflexion is to be added other than heel slide is by swiss ball and in supine posion or add wall slides.

In the next portion of protocol should be same as described by Mr. George Zafiropoulos.  Agility training should be added after six months and after nine month contact sports activity should be started but care must be taken and proprioception assessment is essential to start sports.

Thanks

Hope your question is answered.

Dr. zahid Mehmood Bhatti

Physical therapist.

UHS, Lahore.

Dear Marcelo,

functionel propriceptive training (squats, lounges) with 50-60% of 1RM, including vibration plate exercises will reprogam the nervous system. This in combination with visualize movement will bring the best result.

In case of joint effusion cycling training with low force in nociceptive free amplitud of movement will be indicatet to stimulate synoviocyte hyaluronic acid synthesis

greets

axel steilen

Marcelo Guimarães Silva

The following paper and video comprising exercises that will help you

best regards

hamdy

http://www.uwhealth.org/files/uwhealth/docs/pdf/acl_rehab_protocol.pdf

http://www.physio-pedia.com/Anterior_Cruciate_Ligament_%28ACL%29_Rehabilitation

https://books.google.com.eg/books?hl=ar&lr=&id=gHstJtTgTPoC&oi=fnd&pg=PP2&dq=exercises+to+a+patient+in+post-surgical+rehabilitation+of+ACL+injury&ots=HzzK8ywvxD&sig=jFNNuEY_kV2-CW8YqDAkeWdvkTs&redir_esc=y#v=onepage&q=exercises%20to%20a%20patient%20in%20post-surgical%20rehabilitation%20of%20ACL%20injury&f=false

http://www.sportsinjuryclinic.net/sport-injuries/knee-pain/acl-injury/rehabilitation-acl-injury

http://www.kneeclinic.info/rehab_markdecarlo.php

http://www.ouh.nhs.uk/patient-guide/leaflets/files%5C121210acl.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953314/

https://www.youtube.com/watch?v=UxklUobyTq8

https://www.youtube.com/watch?v=BPpmiLXJeDY

https://www.youtube.com/watch?v=dSyEUh8jgYQ