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

Abstract

Objective: To determine the effectiveness of proprioceptive training on knee function and proprioception following anterior cruciate ligament reconstruction. Data sources: PubMed, EMBASE, The Cochrane Library, Ovid, EBMSCO- host, ScienceDirect, CNKI, VIP, WanFang Data and CBM were searched until 2nd October 2020. Review methods: Trials with proprioceptive training for patients with anterior cruciate ligament reconstruction were included. Study screening, data extraction, risk of bias and quality assessments were performed independently by two researchers. We performed a stratified analysis based on the quality of the study. Sensitivity analyses were performed if the heterogeneity was high. Results: Seventeen trials with 878 participants were included, and 12/17 with low quality. After stratified analysis, the pooled effect of high-quality studies showed significant improvement for proprioceptive training group in range of motion ( P < 0.05, I2 = 0%), but no differences in Cincinnati knee rating system score ( P > 0.05, I2 = 83%), hop test ( P>0.05, I2 = 0%) and proprioception ( P = 0.17, I2 = 77%) compared to conventional training group; while the pooled effect of low-quality studies showed significant differences in knee functional improvement ( P < 0.00001, I2 = 69%), but no difference in proprioception ( P > 0.05, I2 = 84%) between two groups. The pooled effect of all studies showed a significant benefit in both function and proprioception. Conclusion: The effects of proprioceptive training on knee functional and proprioceptive improvement after anterior cruciate ligament reconstruction is mixed. It is more likely that proprioceptive training in high-quality studies has few detectable effects and that low-quality studies show an effect because of an unconscious bias. A large well designed high-quality study needs to be undertaken in the future.

Similar Outcomes and Satisfaction of the Proprioceptive versus Standard Training on the Knee Function and Proprioception, Following the Anterior Cruciate Ligament Reconstruction

“…They also had lower values of strength and endurance parameters of the knee extensors. These results are similar to those presented in the literature on the assessment of proprioception and knee function [10]. In our opinion, a low self-esteem was associated with worse knee function (lower values of the strength and the endurance parameters in the isokinetic study).…”

“…Nowadays, proprioceptive training has been demonstrated in the world and has been widely used for patients with an ACL reconstruction [8,9]. Recent trends in ACL rehab are consistently using proprioceptive training with mixed results [10]. Therefore, further work is required to provide evidence.…”

The efficacy of 5 rehabilitation treatments after anterior cruciate ligament reconstruction

“…After searching Chinese and English databases, a total of 2844 related articles were retrieved. Two researchers screened the literatures by reading abstracts and full texts, and a total of 12 articles were included in this study [7–18] . The study selection flow is shown in Figure 1.…”

“…The training of proprioception is mainly aimed at balancing function, flexibility and agility. At present the main training methods are: closed power bicycle chain, the balance on the balance board to adjust and control, stability of joint training, visual feedback action program, curve surrounded exercise training on foot, knee, lateral span jumping exercises, different direction and speed of running transformation training such as lateral run, run back, variable speed run, reverse layup, “S” shape run, etc [12] . Although current proprioception training after ACL reconstruction is rich and varied, its specificity and sensitivity still need to be further studied.…”

The Effects of Transcranial Direct Current Stimulation (tDCS) and Biofeedback on Proprioception and Functional Balance in Athletes with ACL-deficiency

“…In recent years, attention to understanding the mechanisms related to neuromuscular control and dynamic stability of the knee in patients with ACL defects has been increasing (12,13). In the rehabilitation process, however, improving proprioceptive and neuromuscular control is one of the little-known issues (14). Today, the use of new technologies such as neurofeedback, biofeedback, and transcranial direct current stimulation (tDCS) as safe and painless methods have been considered to improve brain function, proprioception, and balance (15)(16)(17).…”