Outcomes of proprioceptive training on recovery after anterior cruciate ligament reconstruction: A systematic review and meta-analysis

Abstract Objective The study was designed to explore the effect of proprioceptive training in contrast to conventional training among individuals following anterior cruciate ligament reconstruction (ACLR). It includes joint position sense (JPS), subjective functional outcomes (Cincinnati, Knee injury Osteoarthritis Outcome Score, International Knee Documentation Committee knee form), muscle strength, pain, and kinesthesia. Methods PubMed, EMBASE, The Cochrane Library, and Web of Science databases were searched. Quality assessment was performed through the Cochrane Risk of Bias tool and GRADE system. The standardized mean deviation (SMD) was selected as the effect size. Results Fifteen studies and 537 participants were included. Compared with conventional training, proprioceptive training may significantly enhance passive JPS (SMD = -1.87 [95%CI: -2.39 to -1.34]) and single-leg hop function test performance (SMD = 0.29 [95%CI 0.04 to 0.54]). Data also indicated that proprioceptive training can moderately improve subjective functional outcomes (SMD = 0.61 [95%CI, 0.23 to 0.99]). However, there were no significant effects on active JPS, muscle strength and VAS. Conclusion Proprioceptive training has the potential to yield beneficial effects on knee passive JPS, hop functional test and subjective functional outcomes in patients after ACLR. However, its impact on enhancing knee active JPS and kinesthesia may not be statistically significant.