Examination of Corticospinal and Spinal Reflexive Excitability During the Course of Postoperative Rehabilitation After Anterior Cruciate Ligament Reconstruction.
Ryan Zarzycki, Susanne M Morton, Charalambos C Charalambous and 3 others
PMID 32741329WHAT IT FOUND
After ACLR, athletes showed altered brain-to-muscle signaling to the quadriceps, especially in the opposite leg.
These changes were linked to quadriceps strength and did not appear to change across the tested rehabilitation points.
Key findings
01The nonsurgical limb had a higher resting motor threshold than the surgical limb and than the matched healthy limb.
02The surgical limb had higher motor evoked potential amplitude than the nonsurgical limb and than the matched healthy limb.
03Spinal reflex excitability did not differ between groups or over time, while surgical limb quadriceps strength was positively associated with resting motor threshold at 2 weeks and negatively associated with motor evoked potential amplitude at all time points.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study did not measure excitability before injury or surgery, so it cannot tell whether differences were caused by the ACL injury, the reconstruction, or rehabilitation. The sample was small: 18 athletes after ACLR and 18 healthy athletes, and some data were excluded (3 nonsurgical MEP assessments and 5 H/M assessments). The sample included only Level I/II athletes aged 18 to 30, and graft type was not controlled. The outcomes were laboratory measures of excitability and strength, not symptoms, function, or reinjury outcomes. No intervention was tested, so the study cannot show that any treatment changes excitability or strength.
The easy way to misread this
Do not conclude that current rehabilitation caused the altered excitability or that changing excitability will improve strength. The study did not measure athletes before injury or surgery, and it observed standard criterion-based rehabilitation rather than testing a treatment.