Effects of Innovative Land-based Proprioceptive Training on Knee Joint Position Sense and Function in Athletes with Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Abstract

Background: Proprioceptive deficits are one of the most important challenges after anterior cruciate ligament reconstruction (ACLR). Objectives: The current study aimed to investigate the effects of incorporating innovative land-based proprioceptive training into the conventional accelerated land-based rehabilitation protocol, as compared to the conventional accelerated land-based rehabilitation protocol alone, on knee function and joint position sense in male athletes after ACLR. Methods: Thirty male athletes with ACLR were randomly assigned to two rehabilitation groups. The conventional therapy (CT) group (n = 15) received conventional rehabilitation for six weeks, and the proprioception training (PT) group (n = 15) received the same conventional rehabilitation in addition to 12 sessions of innovative land-based proprioceptive training. Outcomes included joint position sense (JPS) errors, International Knee Documentation Committee (IKDC) form, and Visual Analog Scale (VAS). Results: There were significant differences in absolute errors (AE) (FAE = 56.81, P < 0.001) and variable errors (VE) (FVE = 60.95, P < 0.001) between the two groups. No significant differences were found in constant error (CE), VAS, and IKDC score between the two groups (P > 0.05). Both groups showed significant changes in terms of AE, VE, VAS, and IKDC after the intervention (P < 0.05). Percent changes after the intervention for AE, VE, CE, VAS, and IKDC were greater in the PT group than in the CT group, which were 70.19%, 69.22%, 66.20%, 38.50%, and 39.61%, respectively. Conclusions: Innovative land-based proprioceptive training incorporated into the conventional accelerated rehabilitation protocol offers the improvement of proprioception efficiency for individuals with ACL reconstruction, and therefore, it could be useful for clinicians when designing rehabilitation protocols to ensure the optimal engagement of proprioception.