Stofberg Jpj, van Aswegen Mariaan, Kramer Mark
Centre for Health and Human Performance (CHHP), North-West University, Potchefstroom, South Africa.
Physical Activity, Sport, and Recreation (PhASRec) Research Focus Area, North-West University, Potchefstroom, South Africa.
BMC Musculoskelet Disord. 2025 Aug 21;26(1):808. doi: 10.1186/s12891-025-09002-2.
BACKGROUND: Rehabilitation following successful ACL reconstruction (ACLR) requires restoring physical strength, neuromuscular function, and psychological readiness. However, the interplay between reactive agility, strength, and psychological confidence across rehabilitation phases remains unclear, particularly when compared to uninjured individuals. This study investigates the interrelationships between the reactive agility test (RAT), the isometric mid-thigh pull (IMTP), and the anterior cruciate ligament return-to-sport after injury (ACL-RSI) scale across three rehabilitation phases (Phase 4 [P4], return-to-play [RTP]1, and RTP2) following ACLR. The aim was to examine how reactive agility, strength, and psychological readiness evolve over time and compare ACLR participants to a healthy control group. METHODS: Fifteen ACLR participants (15-27 years old) and thirty healthy controls (18- 30 years old) completed RAT, isometric mid-thigh pull (IMTP), and ACL-RSI assessments. ACLR participants were assessed at three rehabilitation phases (P4, RTP1, and RTP2), while controls completed a single testing session. Repeated measures analyses were used to track mean changes in performance across rehabilitation phases, and between-group comparisons were conducted using independent samples tests. RESULTS: ACL-RSI scores improved significantly across phases (p = 0.001), exceeding the smallest worthwhile change (SWC), indicating progressive psychological recovery. Reactive agility improved, with faster left-side decision-making (split 2) from P4 to RTP1 (p = 0.037), while right-side agility remained stable but met the SWC threshold (1.1%). Limited between-group differences in total RAT times and sub-phases suggest ACLR participants regained agility comparable to controls. IMTP strength plateaued after RTP1, reinforcing the greater role of agility and cognitive factors within the RTP framework. CONCLUSIONS: Reactive agility and psychological confidence progressively improved post-ACLR, with decision-making speed recovering earlier than acceleration ability. Minimal between-group differences suggest rehabilitation effectively restores agility, but directional asymmetries and plateaued strength warrant targeted interventions. Future research should explore neurocognitive training to optimize RTP outcomes and minimize re-injury risk. TRIAL REGISTRATION: Clinical trial number not applicable.
背景:成功进行前交叉韧带重建(ACLR)后的康复需要恢复体力、神经肌肉功能和心理准备状态。然而,在整个康复阶段,反应敏捷性、力量和心理信心之间的相互作用仍不清楚,特别是与未受伤个体相比时。本研究调查了在ACLR后的三个康复阶段(第4阶段[P4]、重返比赛[RTP]1和RTP2)中,反应敏捷性测试(RAT)、等长中大腿拉力(IMTP)和前交叉韧带损伤后重返运动(ACL-RSI)量表之间的相互关系。目的是研究反应敏捷性、力量和心理准备状态如何随时间演变,并将ACLR参与者与健康对照组进行比较。 方法:15名ACLR参与者(15 - 27岁)和30名健康对照者(18 - 30岁)完成了RAT、等长中大腿拉力(IMTP)和ACL-RSI评估。ACLR参与者在三个康复阶段(P4、RTP1和RTP2)接受评估,而对照组完成一次测试。重复测量分析用于跟踪康复阶段的平均表现变化,组间比较采用独立样本检验。 结果:ACLR-RSI评分在各阶段显著改善(p = 0.001),超过最小有意义变化(SWC),表明心理逐渐恢复。反应敏捷性有所改善,从P4到RTP1左侧决策速度加快(分裂2)(p = 0.037),而右侧敏捷性保持稳定但达到SWC阈值(1.1%)。RAT总时间和子阶段的组间差异有限,表明ACLR参与者恢复的敏捷性与对照组相当。IMTP力量在RTP1后趋于平稳,强化了敏捷性和认知因素在RTP框架中的更大作用。 结论:ACLR后反应敏捷性和心理信心逐渐改善,决策速度比加速能力恢复得更早。组间差异最小表明康复有效地恢复了敏捷性,但方向不对称和力量平稳需要有针对性的干预。未来研究应探索神经认知训练,以优化RTP结果并最小化再次受伤风险。 试验注册:临床试验编号不适用。
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