The effect of proprioception training on knee kinematics after anterior cruciate ligament reconstruction: A randomized control trial

Abstract

BACKGROUND:

Proprioception is essential for the normal movement of knee joints. How proprioception training affects the postoperative knee functional recovery after anterior cruciate ligament (ACL) reconstruction remains unknown.

OBJECTIVE:

This study investigated the effect of proprioception training on the knee joint kinematics of patients after ACL reconstruction (ACLR).

METHODS:

The randomized controlled study was performed at the Department of Orthopaedics and Traumatology of Guangdong Provincial People’s Hospital between December 2019 and April 2021. Forty-five patients who underwent ACLR were randomly divided into a proprioception group ( $n=$ 23) and a control group ( $n=$ 22). The patients were randomly divided into an experimental group and a control group according to whether the final digits of their ID numbers were odd or even. All patients followed a common postoperative rehabilitation program. The outcome measures included the patients Lysholm scores, hop distances, and knee kinematics during unanticipated jump-cut maneuvering measured at different follow-up times. Knee joint kinematics were described as the positional and orientational changes of the femur relative to the tibia.

RESULTS:

After surgery, the proprioception group did not exhibit significantly higher hop distances than the control group at the 6-month (114.8 $\pm$ 19.0 vs. 105.9 $\pm$ 20.7 cm, $p=$ 0.137, 95% CI: $-$ 3.13 to 22.03 cm) and 1-year follow-ups (143.1 $\pm$ 19.3 vs. 133.9 $\pm$ 26.2 cm, $p=$ 0.216, 95% CI: $-$ 5.57 to 23.87 cm). For knee joint kinematics, the members of the proprioception training group exhibited significantly reduced knee abduction (valgus) angles and external rotation and significantly increased knee flexion compared to those in the common training group.

CONCLUSIONS:

The results suggested that proprioceptive rehabilitation training enhances knee joint functional performance and shows altered knee joint kinematics in ACL-reconstructed populations during unanticipated jump-cut maneuvering compared with the common rehabilitation training.