Functional rehabilitation strategies for enhancing neuromuscular control after ACL reconstruction: A systematic review.

Hong Kong physiotherapy journal : official publication of the Hong Kong Physiotherapy Association Limited = Wu li chih liao · 2026 · Systematic Review · PT
Minbong Kang, Byoungha Hwang, Hankyu Park

Nine small trials suggest jump training and aquatic exercises improve muscle coordination after ACL surgery, and blood flow restriction may protect early strength. Most findings rest on a single trial, so treat these as promising, not proven.

Key findings

1

An 8-week postoperative jump training programme produced approximately a 50% decrease in the quadriceps–hamstring co-contraction index during landing, and the improvement was maintained at follow-up.

2

Preoperative blood flow restriction (BFRT) preconditioning preserved quadriceps endurance and increased RMS EMG amplitude at 4 weeks post-surgery, whereas postoperative high-load BFRT added no neuromuscular benefit beyond conventional strengthening.

3

Postoperative aquatic proprioceptive training, combined with accelerated land-based rehabilitation, significantly improved activation similarity and sensorimotor output compared with land-based rehabilitation alone.

MethodologyResultsClinical Relevance

Single-blind randomized controlled trial. Sixty-four participants were randomized across two intervention arms and assessed at twelve weeks for the primary outcome…

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