Bafrouei Mostafa Jalili, Mousavi Seyed Hamed, Khorramroo Fateme, Zwerver Johannes
Department of Sport Injuries and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran.
Spots Valley, Department of Sports Medicine, Gelderse Vallei Hospital, Ede, The Netherlands.
Sci Rep. 2025 Jul 26;15(1):27299. doi: 10.1038/s41598-025-13568-1.
Core exercises (CE) are often included in rehabilitation programs following anterior cruciate ligament reconstruction (ACLR) to enhance recovery and functional outcomes. This systematic review aimed to evaluate the impact of CE on performance outcomes, pain management, and lower-limb biomechanics in individuals after an ACLR. A comprehensive search was conducted in PubMed, Web of Science, Scopus, and Embase from inception to May 3, 2025. Two independent reviewers screened studies reporting the effects of CE on pain and function in individuals with ACLR. The primary outcomes were: pain intensity, measured using the Visual Analogue Scale (VAS), Knee injury and Osteoarthritis Outcome Score-Pain subscale (KOOS-Pain), and Hospital for Special Surgery (HSS) score. functional outcomes, including self-reported function (International Knee Documentation Committee [IKDC] score, Lysholm score, Tegner activity scale), performance-based tests (single-leg hop tests), and range of motion (ROM). Lower-limb biomechanics, assessed via gait analysis, KT-1000 arthrometer, and joint reaction force analysis. The methodological quality of included studies was assessed using the Physiotherapy Evidence Database (s) scale. Meta-analysis was conducted using a random-effects model, and mean differences with 95% confidence intervals (CIs) were calculated in RevMan 5.4. Ten studies with a total of 463 participants were included. The meta-analysis suggested strong evidence of non-significant changes in VAS, KOOS-pain, and HSS scores between the CE and the traditional exercise groups. The meta-analysis demonstrated strong evidence of significant improvement in IKDC score and hop test score, along with moderate evidence of significant improvement in Lysholm and Tegner scores between the CE and the traditional exercise groups. The result of biomechanical outcomes revealed limited improvements in gait parameters. CE may offer significant benefits for functional performance, especially in IKDC scores, when combined with lower-limb strengthening programs, but their effects on pain relief and biomechanics are less consistent. Future research should focus on standardized protocols and follow-up periods to further explore the role of CE in ACLR rehabilitation.
核心训练（CE）通常被纳入前交叉韧带重建（ACLR）后的康复计划中，以促进恢复并改善功能预后。本系统评价旨在评估核心训练对ACLR术后个体的运动表现、疼痛管理和下肢生物力学的影响。从数据库建库至2025年5月3日，在PubMed、科学网、Scopus和Embase中进行了全面检索。两名独立评审员筛选了报告核心训练对ACLR个体疼痛和功能影响的研究。主要结局指标包括：疼痛强度，采用视觉模拟量表（VAS）、膝关节损伤和骨关节炎疗效评分-疼痛子量表（KOOS-Pain）以及特种外科医院（HSS）评分进行测量；功能结局，包括自我报告的功能（国际膝关节文献委员会[IKDC]评分、Lysholm评分、Tegner活动量表）、基于表现的测试（单腿跳测试）以及活动范围（ROM）；下肢生物力学，通过步态分析、KT-1000关节测量仪和关节反应力分析进行评估。采用物理治疗证据数据库（PEDro）量表评估纳入研究的方法学质量。使用随机效应模型进行荟萃分析，并在RevMan 5.4中计算95%置信区间（CI）的平均差异。纳入了10项研究，共463名参与者。荟萃分析表明，有强有力的证据显示核心训练组和传统运动组之间VAS、KOOS-疼痛和HSS评分无显著变化。荟萃分析表明，有强有力的证据显示核心训练组和传统运动组之间IKDC评分和单腿跳测试评分有显著改善，同时有中等强度的证据显示Lysholm和Tegner评分有显著改善。生物力学结局结果显示步态参数改善有限。当与下肢强化计划相结合时，核心训练可能对功能表现有显著益处，尤其是在IKDC评分方面，但其对疼痛缓解和生物力学的影响不太一致。未来的研究应聚焦于标准化方案和随访期，以进一步探索核心训练在ACLR康复中的作用。
