A Multi-Systems Approach to Human Movement after ACL Reconstruction: The Cardiopulmonary System

Int J Sports Phys Ther. 2021 Dec 1;17(1):60-73. doi: 10.26603/001c.29451. eCollection 2022.


The cardiopulmonary system plays a pivotal role in athletic and rehabilitative activities following anterior cruciate ligament reconstruction, along with serving as an important support for the functioning of other physiologic systems including the integumentary, musculoskeletal, and nervous systems. Many competitive sports impose high demands upon the cardiorespiratory system, which requires careful attention and planning from rehabilitation specialists to ensure athletes are adequately prepared to return to sport. Cardiopulmonary function following anterior cruciate ligament reconstruction (ACLR) can be assessed using a variety of methods, depending on stage of healing, training of the clinician, and equipment availability. Reductions in cardiovascular function may influence the selection and dosage of interventions that are not only aimed to address cardiopulmonary impairments, but also deficits experienced in other systems that ultimately work together to achieve goal-directed movement. The purpose of this clinical commentary is to present cardiopulmonary system considerations within a multi-physiologic systems approach to human movement after ACLR, including a clinically relevant review of the cardiopulmonary system, assessment strategies, and modes of cardiopulmonary training to promote effective, efficient movement.

Level of evidence: 5.

Keywords: anterior cruciate ligament; anterior cruciate ligament reconstruction; cardiopulmonary; movement system; rehabilitation.

Grants and funding

Dr. Severin receives funding support from the Foundation for Physical Therapy Promotion of Doctoral Studies (PODS) II Scholarship, The APTA Academy of Cardiovascular and Pulmonary Physical Therapy, and The Illinois Physical Therapy Foundation.