The effect of proprioception training on knee kinematics after anterior cruciate ligament reconstruction

Background Proprioception is essential for the normal movement of joint knees. The degree of functional recovery after ACL reconstruction is related with the degree of postoperative recovery of proprioception. The current study aimed to investigate the effect of proprioception training on functional level of activity and knee kinematics after anterior cruciate ligament reconstruction.

Methods Forty patients who underwent ACL reconstruction between January 2017 and June 2019 were included. The patients were divided into proprioception group (n=20) and control group (n=20). All the patients followed common postoperative rehabilitation program. The proprioception group were given proprioception enhancement program besides common postoperative rehabilitation program. All the patients were assessed preoperatively, 6 months and 1 year after operation. The lymsolm scores, hop distances, and knee kinematics during unanticipated jump–cut maneuver were compared at different follow-up time points.

Results There were no significant differences preoperative and postoperative Lysholm scores between two groups.  After surgery, the proprioception group showed significantly higher hop distance (133.9 ± 26.2 cm) when compared with the control group (81.2 ± 17.2 cm, P=0.026) in 6-months and one-year follow-up (153.1 ± 19.3 vs 105.8 ± 20.7cm, P=0.034). For knee joint kinematics, the proprioception training group showed reduced knee abduction (valgus) angles and external rotations, and increased knee flexion when compared with the common training group.

Conclusions We conclude that proprioceptive rehabilitation training enhance the kinematic performance and single leg hop distance in ACL-reconstructed populations during jump-stop, unanticipated cut maneuver. The findings will be scientific evidences to help clinicians and physiotherapists to evaluate the patients' readiness for exercises and sports, especially in the cases of loading and extreme rotation conditions.