Do Recreational Athletes Benefit From a Structured, High-Intensity Rehabilitation Program Post-ACL Reconstruction? A Randomized Clinical Trial

OBJECTIVE: To compare the effectiveness of a structured high-intensity program (Rouge & Or [R&O]), which focuses on athletics abilities to facilitate return to sport, with usual care during the later phase of anterior cruciate ligament (ACL) reconstruction rehabilitation, in terms of symptoms and disability, and return to sport among recreational athletes. METHODS: Sixty-six individuals, 3 months post-ACL reconstruction, were randomly assigned to the R&O program or usual care. The primary outcome was symptoms and disability, assessed using the Knee Outcome Survey–Activities of Daily Living Scale. The secondary outcomes were adverse events, pain, perceived level of change, psychological readiness to return to play, lower-limb strength, lower-limb functional performance, and rate of return to sport at preinjury level. Follow-ups were conducted at baseline and at 6, 9, and 12 months. A linear mixed model was used to compare the groups. RESULTS: While both groups showed progress on all outcomes ( P<.01), there were no significant between-group differences ( P>.05). There were no adverse events related to the completion of the 2 programs. CONCLUSION: The structured high-intensity program did not provide additional benefits compared to usual care. However, the R&O program was a standardized and safe intervention to guide recreational athletes following ACL reconstruction. JOSPT Open 2025;3(4):483-491. Epub 18 June 2025. doi:10.2519/josptopen.2025.0091