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J Athl Train. 1999 Apr-Jun; 34(2): 194–201.
PMCID: PMC1322908

Reactive Neuromuscular Training for the Anterior Cruciate Ligament-Deficient Knee: A Case Report

Gray Cook, MSPT, OCS, CSCS, Lee Burton, MS, ATC, CSCS, and Keith Fields, MS, CSCS

Abstract

Objective:

To demonstrate the response to a proprioceptive training model during a 1-week rehabilitation regime. The techniques were demonstrated on a college-aged female basketball player who had injured her anterior cruciate ligament (ACL) several weeks earlier. The athlete was tested, trained, and then retested during her semester break.

Background:

The ACL injury has become a fairly common occurrence in the world of athletics. Knowing this, the athletic trainer is constantly searching for ways to improve the rehabilitative process. New research demonstrates that rehabilitation should be based on proprioception. The ACL not only serves a mechanical role by limiting passive knee mobility but also serves a sensory role through the mechanoreceptors deep in its tissue, which communicate with the neuromuscular system to provide proprioceptive feedback during training and competition.

Differential Diagnosis:

Partial or complete tear of the ACL.

Treatment:

The athlete was treated with a rehabilitation protocol based on proprioception, which uses reactive neuromuscular training.

Uniqueness:

Our rehabilitation focused on the muscular imbalances about the hip, knee, and ankle. The athlete achieved dramatic decreases in muscular imbalances about the hip and knee in only 1 week of rehabilitation through reactive neuromuscular training.

Conclusions:

The athlete had significant gains in strength over her brief period of therapy. However, these gains can be viewed only as neuromuscular changes and not strictly as gains in strength. The athlete returned to postseason competition under the supervision of her surgeon, who later recommended surgical reconstruction at the completion of the basketball season with rehabilitation during the offseason.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.6M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
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  • Beynnon BD, Johnson RJ. Anterior cruciate ligament injury rehabilitation in athletes. Biomechanical considerations. Sports Med. 1996 Jul;22(1):54–64. [PubMed]
  • Barrack RL, Skinner HB, Buckley SL. Proprioception in the anterior cruciate deficient knee. Am J Sports Med. 1989 Jan-Feb;17(1):1–6. [PubMed]
  • Fridén T, Roberts D, Zätterström R, Lindstrand A, Moritz U. Proprioception in the nearly extended knee. Measurements of position and movement in healthy individuals and in symptomatic anterior cruciate ligament injured patients. Knee Surg Sports Traumatol Arthrosc. 1996;4(4):217–224. [PubMed]
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  • BENDER JA, PIERSON JK, KAPLAN HM, JOHNSON AJ. FACTORS AFFECTING THE OCCURRENCE OF KNEE INJURIES. J Assoc Phys Ment Rehabil. 1964 Sep-Oct;18:130–134. [PubMed]
  • Petersen P, Petrick M, Connor H, Conklin D. Grip strength and hand dominance: challenging the 10% rule. Am J Occup Ther. 1989 Jul;43(7):444–447. [PubMed]

Articles from Journal of Athletic Training are provided here courtesy of National Athletic Trainers Association