Computerized posturography in evaluation of proprioceptive-oriented rehabilitation after anterior cruciate ligament reconstruction
DOI:
https://doi.org/10.14739/mmt.2026.1.348523Keywords:
rehabilitation, arthroscopy, knee joint, anterior cruciate ligament, proprioception, computerized posturography, surgical proceduresAbstract
Knee joint injuries are among the most common injuries of the musculoskeletal system, with anterior cruciate ligament (ACL) ruptures representing the second most common knee pathology after meniscus tears. These injuries not only compromise knee stability but also predispose patients to chronic instability, secondary meniscal damage, and early development of osteoarthritis. The restoration of proprioception plays a critical role in regaining functional stability following ACL reconstruction.
Aim. The aim of this study is to assess biomechanical parameters of the knee joint function after ACL reconstruction using stabilometric assessment and to study the effectiveness of a rehabilitation program that includes balance and proprioception training.
Materials and methods. The study was conducted at Zaporizhzhia State Medical and Pharmaceutical University between September 2024 and April 2025. A total of 42 patients who underwent arthroscopic ACL autograft reconstruction were enrolled. All patients underwent MRI diagnostics and participated in structured rehabilitation. The main group received an enhanced program with targeted proprioceptive and balance exercises, while the control group followed the standard rehabilitation protocol. Computerized stabilometric assessment was used to quantify weight distribution and postural stability.
Results. Patients in the main group demonstrated significantly improved postural control. Weight distribution was more balanced (52.8 % dominant vs. 47.2 % injured limb, p < 0.05) compared with the control group (59.3 % vs. 40.7 %, p < 0.05). The mean stabilometric support coefficient reached 0.89 in the main group versus 0.71 in control group, indicating better restoration of stability and proprioception, p < 0.05.
Conclusions. Computerized posturography enabled objective assessment of postural control after ACL reconstruction. Six month after surgery, patients who underwent rehabilitation with additional balance and proprioceptive training demonstrated significantly more symmetrical weight distribution and better stabilometric stability parameters compared to those who received standard rehabilitation.
References
Webster KE, Hewett TE. Anterior cruciate ligament injury and knee osteoarthritis: an umbrella systematic review and meta-analysis. Clin J Sport Med. 2022;32(2):145-52. doi: https://doi.org/10.1097/JSM.0000000000000894
Huang L, You G, Li M, Xia Z, Yang S, Zhou X, et al. Outcomes of proprioceptive training on recovery after anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Am J Phys Med Rehabil. 2025;104(5):436-44. doi: https://doi.org/10.1097/PHM.0000000000002639
Stańczak M, Swinnen B, Kacprzak B, Pacek A, Surmacz J. Neurophysiology of ACL injury. Orthop Rev (Pavia). 2025;17:129173. doi: https://doi.org/10.52965/001c.129173
Wang W, Li X, Shi R, Wang C, Zhang K, Ren X, et al. Abnormal balance control mechanisms during dynamic reaching forward and quiet standing in patients with anterior cruciate ligament reconstruction. Front Physiol. 2023;14:1176222. doi: https://doi.org/10.3389/fphys.2023.1176222
Zhao Y, Chen Z, Li L, Wu X, Li W. Changes in proprioception at different time points following anterior cruciate ligament injury or reconstruction. J Orthop Surg Res. 2023 Jul 31;18(1):547. doi: https://doi.org/10.1186/s13018-023-04044-5
Figueroa D, Arce G, Espregueira-Mendes J, Maestu R, Mosquera M, Williams A, et al. Return to sport soccer after anterior cruciate ligament reconstruction: ISAKOS consensus. J ISAKOS. 2022;7(6):150-61. doi: https://doi.org/10.1016/j.jisako.2022.08.004
Prill R, Ma CB, Wong SE, Beaufils P, Monllau JC, Arhos EK, et al. The formal EU-US Meniscus Rehabilitation 2024 Consensus: An ESSKA-AOSSM-AASPT initiative. Part II-Prevention, non-operative treatment and return to sport. Knee Surg Sports Traumatol Arthrosc. 2025;33(8):3014-24. doi: https://doi.org/10.1002/ksa.12689
Brophy RH, Schafer KA, Knapik DM, Motley J, Haas A, Matava MJ, et al. Changes in Dynamic Postural Stability After ACL Reconstruction: Results Over 2 Years of Follow-up. Orthop J Sports Med. 2022;10(6):23259671221098989. doi: https://doi.org/10.1177/23259671221098989
Primorac D, Molnar V, Rod E, Jeleč Ž, Čukelj F, Matišić V, et al. Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations. Genes (Basel). 2020;11(8):854. doi: https://doi.org/10.3390/genes11080854
Petersen W, Taheri P, Forkel P, Zantop T. Return to play following ACL reconstruction: a systematic review about strength deficits. Arch Orthop Trauma Surg. 2014;134(10):1417-28. doi: https://doi.org/10.1007/s00402-014-1992-x
Chen S, Gu J, Shaharudin S. Effects of proprioceptive training intervention on knee function in patients with anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Ann Med. 2025;57(1):2542441. doi: https://doi.org/10.1080/07853890.2025.2542441
Wein F, Peultier-Celli L, van Rooij F, Saffarini M, Perrin P. No significant improvement in neuromuscular proprioception and increased reliance on visual compensation 6 months after ACL reconstruction. J Exp Orthop. 2021;8(1):19. doi: https://doi.org/10.1186/s40634-021-00338-x
Dhillon MS, Bali K, Prabhakar S. Proprioception in anterior cruciate ligament deficient knees and its relevance in anterior cruciate ligament reconstruction. Indian J Orthop. 2011;45(4):294-300. doi: https://doi.org/10.4103/0019-5413.80320
Howard JS, Fazio MA, Mattacola CG, Uhl TL, Jacobs CA. Structure, sex, and strength and knee and hip kinematics during landing. J Athl Train. 2011;46(4):376-85. doi: https://doi.org/10.4085/1062-6050-46.4.376
Jiang L, Zhang L, Huang W, Zeng Q, Huang G. The effect of proprioception training on knee kinematics after anterior cruciate ligament reconstruction: A randomized control trial. J Back Musculoskelet Rehabil. 2022;35(5):1085-1095. doi: https://doi.org/10.3233/BMR-210201
Ostojic M, Indelli PF, Lovrekovic B, Volcarenghi J, Juric D, Hakam HT, et al. Graft selection in anterior cruciate ligament reconstruction: a comprehensive review of current trends. Medicina (Kaunas). 2024;60(12):2090. doi: https://doi.org/10.3390/medicina60122090
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