ASSESSMENT OF REHABILITATION PROTOCOLS ON RECOVERY TIME AND

PERFORMANCE OUTCOMES IN ATHLETES WITH ACL INJURIES

BULLET-POINT SUMMARY
1. Clean and organize the dataset, ensuring all variables are properly labeled and
formatted.
2. Conduct descriptive statistics to summarize the demographic and injury characteristics
of the participants.
3. For the association analysis:
 Calculate correlation coefficients (Pearson correlation coefficient) between the duration
of physical therapy sessions and recovery time, functional performance scores, and
objective measures of strength.
 Visualize relationships using scatter plots.
4. For the difference analysis:
 Conduct independent samples t-tests to compare recovery time, functional
performance scores, and subjective measures of pain and function between the
traditional physical therapy and neuromuscular training groups.
 Examine effect sizes via Cohen’s d to determine the magnitude of differences between
groups.
5. Consider potential confounding variables (e.g., age, severity of injury) and perform
additional analyses or adjustments if necessary.
6. Interpret the results, discussing the associations found in the association analysis and
the differences observed between the rehabilitation protocol groups.
7. Discuss the implications of the findings for sports rehabilitation practices and future
research directions.

JUSTIFICATION OF THE METHODS

The study involves assessing the effects of different rehabilitation protocols on recovery time
and performance outcomes in athletes with ACL injuries. It includes two main analyses: an
association analysis examining the relationship between the duration of physical therapy
sessions and recovery outcomes, and a difference analysis comparing outcomes between
athletes undergoing traditional physical therapy and those participating in a neuromuscular
training program.

Association Analysis:
For the association analysis, Pearson correlation coefficients can be used to assess the
strength and direction of relationships between continuous variables. It is described as the most
effective method for analyzing associations due to its reliance on covariance (Statistics
Solutions, 2021). This research question aligns well with the requirements for Pearson
correlation analysis: both the duration of physical therapy sessions and recovery outcomes
(such as recovery time, functional performance scores, and objective measures of strength) are
typically continuous variables; Pearson correlation measures the strength and direction of a
linear relationship between two continuous variables, aligning with the implied interest in
exploring if such a linear relationship exists between the duration of physical therapy sessions
and recovery outcomes; it provides information about both the strength and direction of the
relationship, which is pertinent to understanding the relationship between the duration of
physical therapy sessions and recovery outcomes, including variables such as recovery time,
functional performance scores, and objective measures of strength (Kent State University,
2018). Given these characteristics, Pearson correlation analysis emerges as an appropriate
statistical method for investigating the association between the duration of physical therapy
sessions and recovery outcomes as posed in the research question.
Justifying the use of correlation coefficients, previous research has consistently highlighted the
significant relationship between the duration of therapy services and functional outcomes
among patients with orthopedic diagnoses. For instance, Kirk-Sanchez and Roach (2001)
observed a significant correlation between the duration of physical therapy and occupational
therapy sessions and mobility outcomes at discharge in patients undergoing comprehensive
inpatient rehabilitation.
In the present research, normality is assessed using the Shapiro–Wilk test, which is a widely
used method and can be conducted in the Statistical Package for the Social Sciences (SPSS)
as required by this course (Mishra et al., 2019). Linearity, which is assumed by Pearson
correlation, can be inspected visually through scatter plots. Homoscedasticity refers to constant
variance of residuals across all levels of the independent variable and can be verified using
residual plots. Additionally, ensure that observations are independent of each other.

Difference Analysis
To explore whether there exists a significant difference in outcomes between athletes
undergoing traditional physical therapy and those engaging in a neuromuscular training
program, the t-test is employed as the analytical tool. The t-test can compare means between
two or more groups, respectively (Mishra et al., 2019).
The study design for comparing recovery time and performance outcomes between athletes
undergoing traditional physical therapy and those participating in a specialized neuromuscular
training program typically involves a comparative analysis. Specifically, a t-test could be utilized
to compare means between the two groups, assessing whether there are statistically significant
differences in the means of continuous outcome variables (such as recovery time or
performance scores) between the traditional therapy and neuromuscular training groups. In this
context, the t-test complies with all the requirements of the research question: firstly, the groups
being compared (traditional physical therapy and neuromuscular training program) consist of
independent observations, ensuring no overlap or dependence between them; secondly, the
distribution of the outcome variable (e.g., recovery time, functional performance scores) is
approximately normally distributed within each group to meet the assumption of normality,
essential for the t-test's validity; additionally, the variances of the outcome variable is
approximately equal between the two groups to satisfy the assumption of homogeneity of
variance, known as homoscedasticity, ensuring similar levels of variability; and lastly, the
outcome variable is measured on an interval or ratio scale, indicating continuous and
meaningful numerical values (www.jmp.com, n.d.).
Before applying the t-test, it is imperative to assess data assumptions. This includes checking if
the data follow a normal distribution, which, for this research, can be accomplished through the
Shapiro-Wilk test. Additionally, it is essential to evaluate whether the variances of recovery time
and performance outcomes are similar between the two groups (homogeneity of variance),
which can be assessed using Levene’s test or graphical methods. Furthermore, it is crucial to
ensure that observations within each group are independent.

PRESENTATION
Research Question 1 (Association): Is there a relationship between the duration of physical
therapy sessions and the rate of recovery in athletes with ACL injuries?

Athlete Duration of PT Recovery Time Functional Quadriceps

Sessions (weeks/months) Performance Strength
(minutes) Score
1 30 12 weeks 85% (single-leg hop Good
test)
2 40 14 weeks 90% (single-leg hop Excellent
test)
3 50 16 weeks 80% (single-leg hop Fair
test)
… … … … …
50 60 20 weeks 95% (single-leg hop Very good
test)

Notes:

 Recovery time can be measured in either weeks or months, depending on clinical

practice.
 Functional performance scores are based on the single-leg hop test, where higher
percentages indicate better performance.
 Quadriceps strength is categorized as “Good,” “Fair,” “Excellent,” or “Very good.”

There are four dependent variables under consideration: duration of physical therapy sessions,
rate of recovery, functional performance score, and quadriceps strength. Each of these
variables boasts over 30 data points, ensuring that the sample size meets the necessary
criterion for robust analysis.

Research Question 2 (Difference): Are there differences in recovery time and performance
outcomes between athletes undergoing traditional physical therapy and those participating in a
specialized neuromuscular training program following ACL reconstruction surgery?

Group Sample Mean Recovery Time Functional Performance Pain (VAS

Size (n) (weeks/months) (Agility Score) Score)
1 30 X weeks/months Y Z
2 30 A weeks/months B C
This dataset is suitable for a t-test application as it involves comparing the means of two
independent groups: athletes undergoing traditional physical therapy versus those in a
specialized neuromuscular training program following ACL reconstruction surgery. With 30
athletes in each group and variables including recovery time, functional performance, and pain
scores, the setup meets the requirements for statistical analysis. The t-test is ideal for assessing
differences between group means, aligning perfectly with the research question's aim to
compare recovery time and performance outcomes between the two treatment groups.

REFERENCES

 Kirk-Sanchez, N.J. and Roach, K.E. (2001). Relationship between duration of therapy
services in a comprehensive rehabilitation program and mobility at discharge in patients
with orthopedic problems. Physical therapy, 81(3), pp.888–895.
doi:https://doi.org/10.1093/ptj/81.3.888.
 Kent State University (2018). SPSS Tutorials: Pearson Correlation. [online] Kent.edu.
Available at: https://libguides.library.kent.edu/SPSS/PearsonCorr.
 Statistics Solutions (2021). Pearson’s Correlation Coefficient. [online] Statistics
Solutions. Available at: https://www.statisticssolutions.com/free-resources/directory-of-
statistical-analyses/pearsons-correlation-coefficient/.
 Mishra, P., Pandey, C.M., Singh, U., Sahu, C., Keshri, A. and Gupta, A. (2019).
Descriptive Statistics and Normality Tests for Statistical Data. Annals of Cardiac
Anaesthesia, 22(1), pp.67–72. doi:https://doi.org/10.4103%2Faca.ACA_157_18.
 www.jmp.com. (n.d.). The t-Test. [online] Available at:
https://www.jmp.com/en_ph/statistics-knowledge-portal/t-test.html.

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 APPENDIX
Research Topic: The Effects of Different Rehabilitation Protocols on Recovery Time and
Performance in Athletes with ACL Injuries
Research Question 1 (Association): Is there a relationship between the duration of physical
therapy sessions and the rate of recovery in athletes with ACL injuries?
Research Question 2 (Difference): Are there differences in recovery time and performance
outcomes between athletes undergoing traditional physical therapy and those participating in a
specialized neuromuscular training program following ACL reconstruction surgery?

Data Set:
Participant Demographics:

 Age
 Gender
 Sport(s) played
 Level of competition (e.g., amateur, collegiate, professional)
Injury Characteristics:

 Type and severity of ACL injury

 Previous injuries
 Time since injury
Rehabilitation Protocol:

 Duration of physical therapy sessions (in minutes)

 Frequency of sessions per week
 Length of rehabilitation program (in weeks)
 Type of rehabilitation program (traditional physical therapy vs. neuromuscular training)
Outcome Measures:

 Recovery time (measured in weeks/months until return to sport)

 Functional performance tests (e.g., single-leg hop test, agility tests)
 Objective measures of strength and range of motion (e.g., isokinetic dynamometry,
goniometry)
 Subjective measures of pain and function (e.g., visual analog scale, patient-reported
outcome measures)
Study Design:
1. Association Analysis:
 Dependent Variables:
1. Recovery time (weeks/months until return to sport)
2. Functional performance scores (e.g., single-leg hop test)
3. Objective measures of strength (e.g., quadriceps strength)
 Independent Variable:
1. Duration of physical therapy sessions (in minutes)
 Participants: Athletes (n = 50) with ACL injuries undergoing physical therapy.
 Procedure: Participants' recovery time and performance outcomes will be measured
and correlated (Pearson’s Correlation) with the duration of physical therapy sessions
they attend.
2. Difference Analysis:

 Dependent Variables:
1. Recovery time (weeks/months until return to sport)
2. Functional performance scores (e.g., agility tests)
3. Subjective measures of pain and function (e.g., visual analog scale)
 Independent Variable:
1. Rehabilitation Protocol:
a. Group 1: Traditional physical therapy (n = 30)
b. Group 2: Neuromuscular training program (n = 30)
 Participants: Athletes (n = 60) with ACL injuries randomly assigned to either the
traditional physical therapy or neuromuscular training group.
 Procedure: Participants' recovery time, functional performance, and subjective
measures will be assessed after completing their respective rehabilitation protocols.
Differences between the groups will be analyzed using appropriate statistical tests (t-
test).