No evidence of impaired proprioceptive function in subjects with anterior cruciate ligament reconstruction: a systematic review

Nakamae, Atsuo; Adachi, Nobuo; Ishikawa, Masakazu; Nakasa, Tomoyuki; Ochi, Mitsuo

doi:10.1136/jisakos-2016-000087

Cited by 14 publications

(10 citation statements)

References 38 publications

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“…Our results for known-groups validity are in line with 1 previous meta-analysis 87 but in contrast to a systematic review without meta-analysis, 73 finding that ACL-injured knees produced significantly greater AE (MD, 0.70 ) (see Figure 2) as compared with asymptomatic controls, regardless of whether ACLD and ACLR groups were combined or evaluated separately. In addition, our sensitivity analysis, which was limited to studies with an adequate or very good rating for RoB, showed even greater differences in errors (MD, 2.97 ) (see Figure 3).…”

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

Properties of Knee Joint Position Sense Tests for Anterior Cruciate Ligament Injury: A Systematic Review and Meta-analysis

Strong

Arumugam

Tengman

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Knee proprioception is believed to be deficient after anterior cruciate ligament (ACL) injury. Tests of joint position sense (JPS) are commonly used to assess knee proprioception, but their psychometric properties (PMPs) are largely unknown. Purpose: To evaluate the PMPs (reliability, validity, and responsiveness) of existing knee JPS tests targeting individuals with ACL injury. Study Design: Systematic review; Level of evidence, 4. Methods: PubMed, Allied and Complementary Medicine, CINAHL, SPORTDiscus, Web of Science, Scopus, CENTRAL, and ProQuest databases were searched to identify studies that assessed PMPs of knee JPS tests in individuals with ACL injury. The risk of bias for each included study was assessed and rated at the outcome level for each knee JPS test. Overall quality and levels of evidence for each PMP were rated according to established criteria. Meta-analyses with mean differences were conducted using random effects models when adequate data were available. Results: Included were 80 studies covering 119 versions of knee JPS tests. Meta-analyses indicated sufficient quality for known-groups and discriminative validity (ACL-injured knees vs knees of asymptomatic controls and contralateral noninjured knees, respectively), owing to significantly greater absolute errors for ACL-injured knees based on a strong level of evidence. A meta-analysis showed insufficient quality for responsiveness, which was attributed to a lack of significant change over time after diverse interventions with a moderate level of evidence. Statistical heterogeneity ( I 2 > 40%) was evident in the majority of meta-analyses. All remaining PMPs (reliability, measurement error, criterion validity, convergent validity, and other PMPs related to responsiveness) were assessed qualitatively, and they failed to achieve a sufficient quality rating. This was a result of either the study outcomes not agreeing with the statistical cutoff values/hypotheses or the level of evidence being rated as conflicting/unknown or based on only a single study. Conclusion: Knee JPS tests appear to have sufficient validity in differentiating ACL-injured knees from asymptomatic knees. Further evidence of high methodologic quality is required to ascertain the reliability, responsiveness, and other types of validity assessed here. We recommend investigations that compare the modifiable methodologic components of knee JPS tests on their PMPs to develop standardized evidence-based tests.

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Section: Discussionsupporting

confidence: 90%

“…However, the absolute differences in degrees of knee flexion were <1°, and differences versus asymptomatic controls are not always evident. 73 A major reason for the inconsistent results is likely the lack of standardized test procedures.…”

mentioning

confidence: 99%

Properties of Knee Joint Position Sense Tests for Anterior Cruciate Ligament Injury: A Systematic Review and Meta-analysis

Strong

Arumugam

Tengman

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…Whether knee joint proprioception is affected at all after ACL reconstruction is debatable as a recent meta-analysis found no evidence that proprioceptive function was impaired after ACL surgery compared to healthy controls (Nakamae et al 2017). Knee joint proprioception in the present study was not different before vs. after ACL reconstruction, supporting the idea that ACL surgery does not affect joint position sense.…”

Section: Discussionmentioning

confidence: 99%

Cross-education does not accelerate the rehabilitation of neuromuscular functions after ACL reconstruction: a randomized controlled clinical trial

et al. 2018

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PurposeCross-education reduces quadriceps weakness 8 weeks after anterior cruciate ligament (ACL) surgery, but the long-term effects are unknown. We investigated whether cross-education, as an adjuvant to the standard rehabilitation, would accelerate recovery of quadriceps strength and neuromuscular function up to 26 weeks post-surgery.MethodsGroup allocation was randomized. The experimental (n = 22) and control (n = 21) group received standard rehabilitation. In addition, the experimental group strength trained the quadriceps of the non-injured leg in weeks 1–12 post-surgery (i.e., cross-education). Primary and secondary outcomes were measured in both legs 29 ± 23 days prior to surgery and at 5, 12, and 26 weeks post-surgery.ResultsThe primary outcome showed time and cross-education effects. Maximal quadriceps strength in the reconstructed leg decreased 35% and 12% at, respectively, 5 and 12 weeks post-surgery and improved 11% at 26 weeks post-surgery, where strength of the non-injured leg showed a gradual increase post-surgery up to 14% (all p ≤ 0.015). Limb symmetry deteriorated 9–10% more for the experimental than control group at 5 and 12 weeks post-surgery (both p ≤ 0.030). One of 34 secondary outcomes revealed a cross-education effect: Voluntary quadriceps activation of the reconstructed leg was 6% reduced for the experimental vs. control group at 12 weeks post-surgery (p = 0.023). Both legs improved force control (22–34%) and dynamic balance (6–7%) at 26 weeks post-surgery (all p ≤ 0.043). Knee joint proprioception and static balance remained unchanged.ConclusionStandard rehabilitation improved maximal quadriceps strength, force control, and dynamic balance in both legs relative to pre-surgery but adding cross-education did not accelerate recovery following ACL reconstruction.

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“…These results are consistent with those of the current study. In contrast, a review study by Nakamae et al suggested no evidence on a difference between the proprioception of the injured group and ACL tear after reconstruction and the non-injured group [17]. Besides, Kaya et al, assessed the effect of knee ACL reconstruction on improving the knee joint proprioception of individuals with a torn ligament [18].…”

Section: Resultsmentioning

confidence: 99%

Investigating Knee Joint Position Sense After Anterior Cruciate Ligament Reconstruction in Male Soccer Players

Rashid3

Dehcheshmeh

Daneshmandi

et al. 2020

PTJ

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Purpose: Anterior Cruciate Ligament (ACL) injury is the most common knee ligament injury during exercise, with a frequency of 36.9 per 100000 individuals. The characteristics of this injury are proprioception dysfunction. The present study aimed to investigate the knee proprioception after the reconstruction of ACL in soccer players. Methods: The study sample of this study was 20 elite male soccer players with an ACL injury experiencing post-reconstruction. The knee joint position sense of the study subjects was measured by Isokinetic (Gymnex model) at 30°, 45°, and 60° between the operated and non-operated knee. An Independent Samples t-test was used to compare the mean scores of the measured variables at the significance level of P≤0.05. Results: The obtained results suggested that the mean value of the angle reproduction test at 30° on the operated knee was significantly more than that of the non-operated knee (P=0.003). Moreover, the mean value of a passive angle reproduction test was significantly more than that of the active angle test in the operated knee (P=0.001). There was no significant difference between the mean value of 45° angle repair results in the non-operated and operated knee (P=0.99). The difference between active and passive tests in the operated knee on 45° was significant; the study subjects demonstrated higher mean scores in the active test (P=0.02). Additionally, the half-value in angle reproduction in 60° in the operated knee was significantly less than that of the non-operated knee (P=0.01). Eventually, there was no significant difference between the results of the test at this angle in the passive and active angle reproduction in the affected knee (P=0.22). Conclusion: The obtained data revealed that the knee joint position sense of the operated knee joint, compared to the non-operated knee in elite soccer players, along with the reconstruction of the ACL, was weaker than those of the non-operated knee.

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No evidence of impaired proprioceptive function in subjects with anterior cruciate ligament reconstruction: a systematic review

Cited by 14 publications

References 38 publications

Properties of Knee Joint Position Sense Tests for Anterior Cruciate Ligament Injury: A Systematic Review and Meta-analysis

Properties of Knee Joint Position Sense Tests for Anterior Cruciate Ligament Injury: A Systematic Review and Meta-analysis

Cross-education does not accelerate the rehabilitation of neuromuscular functions after ACL reconstruction: a randomized controlled clinical trial

Investigating Knee Joint Position Sense After Anterior Cruciate Ligament Reconstruction in Male Soccer Players

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