Effects on Lower Extremity Neuromuscular Control Exercises on Knee Proprioception, Muscle Strength, and Functional Level in Patients with ACL Reconstruction

Abstract

Objective The purpose of this study was to determine the effects of lower extremity motor control exercises on knee proprioception, muscle strength, and functional level in patients with anterior cruciate ligament reconstruction (ACL-R). Materials and Methods Thirty-two of the 57 patients with ACL-R using tibialis anterior allografts were divided into two groups. Group I: lower extremity motor control exercises were added to the standard rehabilitation program. Group II: standard rehabilitation program was applied. Effects of lower extremity motor control exercises on quadriceps and hamstring muscles strength, knee joint position sense, and hop test were evaluated. Results There were no differences in muscle strength and endurance of the quadriceps and hamstring between the operative and nonoperative sides in Group I (p > 0.05) while there were significant differences in strength of the quadriceps and hamstring between the operative and nonoperative sides in Group II (p < 0.05). There were significant differences in the endurance of the quadriceps and hamstring and knee joint position sense at 15°, 45°, and 75° between the operative sides of the patients in both groups (p < 0.05). Conclusions The neuromuscular control exercises program was found to be more effective in reducing the difference in strength while the standard program was found to be more effective in reducing the difference in endurance between the operated knee and the other knee. This study revealed that neuromuscular control exercises should also be used to improve knee proprioception sense following ACL-R.

The effects of proprioceptive training on anterior cruciate ligament reconstruction rehabilitation: A systematic review and meta-analysis

“…Proprioceptive training included balance training, agility drills, wall squats and stability exercises. Most included participants went through reconstruction surgery with autologous tendon 11,16,17,22–34 except 1 study 21 with allogeneic tendon reconstruction. Five studies 17,24,26–28 reported meniscus injuries and performed meniscus repair surgery.…”

“…16,17,21,33,34 two studies reported the loss to follow-up. 17,21 In addition, the results of methodological quality assessment using improved Jadad score were presented in Table 1. Five high-quality studies 16,17,21,33,34 with Jadad score ⩾ 4 and 12 low-quality studies 11,22–32 with Jadad score ⩽ 3 were obtained.…”

“…Knee proprioception : Three studies 17,21,34 involving 121 participants evaluated knee proprioception after training using the active angle reproduction, 21,34 and the TTDPM device. 17 The data of proprioception represented the difference between the actual obtained angle and the target angle.…”

“…Due to the different outcomes reported in high-quality studies, some main outcomes were not measured in this review according to the eligibility criteria. Kaya et al 21 found that proprioceptive training could significantly improve quadriceps and hamstring muscle strength after training 6 months. The study 33 with 40 participants and similar baselines, after training 6 months, showed that proprioceptive training had significant improvement in static baropodometry, swelling and gait assessments.…”

Joint Flexibility and Isometric Strength Parameters Are Not Relevant Determinants for Countermovement Jump Performance

“…After the standardized warm-up, the MVC tests for the knee extensors, knee flexors, and plantar flexors of the dominant leg were performed on an isokinetic dynamometer (CON-TREX ® Multijont, Duebendorf, Switzerland). For the knee extensor MVC, the participant was seated on the dynamometer with both hip and knee angles of 110° ([ 12 ]; 180° = anatomical zero [ 13 ]). For the knee flexor MVC, the participant was positioned supine on the dynamometer with hip and knee angles of 90° and 110°, respectively.…”