Comparative Effects of Motor-Control Interventions on Neuromuscular and Biomechanical Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Network Meta-analysis.

Authors

Feng Liang, Ligang Ma, Jiguo Liang, Zheyu Xiong

Published in

Complementary therapies in medicine. Pages 103464. Oct 27, 2026. Epub Oct 27, 2026.

Abstract

Neuromuscular-control and biomechanical deficits may persist after anterior cruciate ligament reconstruction (ACLR). Comparative motor-control effects remain uncertain.
To compare motor-control interventions after ACLR.
Systematic review and network meta-analysis.
Seven databases were searched to 12 May 2026. Usual rehabilitation comprised conventional symptom control, motion, strengthening, gait, or functional training. Three neuromuscular-control outcomes underwent network meta-analysis; k ≥ 2 biomechanical comparisons were pooled and k = 1 estimates unpooled. RoB 2 assessed bias; CINeMA and GRADE assessed confidence.
Thirty-two trials enrolled 1437 participants. Proprioceptive training improved joint position sense versus usual rehabilitation (SMD 1.02, 95% CI 0.54-1.50; moderate CINeMA confidence); jump-landing control training yielded a favorable dynamic-balance estimate versus usual rehabilitation (1.19, 0.59-1.80; low CINeMA confidence) and was sensitive to exclusion of a late-phase multi-arm athlete trial; feedback-enhanced (0.88, 0.43-1.32) and proprioceptive training (0.59, 0.21-0.97) favored postural control (both low CINeMA confidence). Pooled estimates suggested that neuromuscular training may improve knee valgus and knee flexion kinematics during single-leg landing (1.51, 0.51-2.51; 1.07, 0.49-1.65); pooled gait biomechanical symmetry was inconclusive (-0.41, -0.87-0.05). Across networks, τ² ranged from 0.0275 to 0.1698; global tests detected no statistically clear inconsistency (P = 0.087-0.229), although sparse loop structures limited inference.
Moderate-confidence evidence supported proprioceptive training for improving joint position sense after ACLR. Other interventions may help balance and landing control, but their benefits are less certain. The evidence does not establish a single best approach across outcomes.

PMID:
42946095
Bibliographic data and abstract were imported from PubMed on 28 Oct 2026.

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