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Background <p>Rehabilitation is pivotal in supporting return-to-sport (RTS) outcomes following anterior cruciate ligament reconstruction (ACLR); however, inconsistencies in intervention protocols, assessment metrics, and psychological support challenge clinical decision-making.</p> Objective <p>This systematic review and meta-analysis evaluated the clinical effectiveness of multidisciplinary rehabilitation strategies—including strength training, neuromuscular re-education, psychological readiness, blood flow restriction (BFR) therapy, and wearable sensor technologies—on functional recovery and RTS outcomes post-ACLR.</p> Methods <p>Based on bibliometric trends showing substantial growth in ACLR research, a comprehensive literature search of Scopus, PubMed, Web of Science, and IEEE Xplore databases from 2018 to 2024 was conducted. A total of 73 studies were included. Pooled standardized mean differences (SMDs) were computed using random-effects meta-analyses. Methodological quality and evidence strength were assessed via AMSTAR-2 and GRADE tools.</p> Results <p>Strength and neuromuscular training significantly enhanced quadriceps recovery and limb symmetry (SMD = 0.64; <i>p</i> &lt; 0.01), while BFR therapy showed large effects on hypertrophy and early function (SMD = 1.28; <i>p</i> &lt; 0.0001). Psychological readiness (e.g., ACL-RSI, IKDC) strongly predicted RTS (SMD = 0.82; <i>p</i> &lt; 0.0001). Wearable sensors and machine learning models improved gait tracking and RTS prediction (SMD = 0.46; <i>p</i> &lt; 0.0001), though protocol variability persisted.</p> Conclusion <p>Multimodal rehabilitation integrating physical, psychological, and technological domains optimizes RTS outcomes post-ACLR. Standardizing intervention criteria and validating sensor-based and AI-supported tools are essential next steps for evidence-based clinical translation.</p> <p><b>PROSPERO Registration: CRD</b>42024561002.</p>

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Evidence-Based Interventions and Functional Outcomes for Return to Sport After ACL Reconstruction: A Systematic Review and Meta-analysis

  • 期刊论文

  • 发表日期：

    2025年11月11日

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  • Ravinder Kumar,
  • Avishek Singh,
  • Vikram Singh

摘要

Background

Rehabilitation is pivotal in supporting return-to-sport (RTS) outcomes following anterior cruciate ligament reconstruction (ACLR); however, inconsistencies in intervention protocols, assessment metrics, and psychological support challenge clinical decision-making.

Objective

This systematic review and meta-analysis evaluated the clinical effectiveness of multidisciplinary rehabilitation strategies—including strength training, neuromuscular re-education, psychological readiness, blood flow restriction (BFR) therapy, and wearable sensor technologies—on functional recovery and RTS outcomes post-ACLR.

Methods

Based on bibliometric trends showing substantial growth in ACLR research, a comprehensive literature search of Scopus, PubMed, Web of Science, and IEEE Xplore databases from 2018 to 2024 was conducted. A total of 73 studies were included. Pooled standardized mean differences (SMDs) were computed using random-effects meta-analyses. Methodological quality and evidence strength were assessed via AMSTAR-2 and GRADE tools.

Results

Strength and neuromuscular training significantly enhanced quadriceps recovery and limb symmetry (SMD = 0.64; p < 0.01), while BFR therapy showed large effects on hypertrophy and early function (SMD = 1.28; p < 0.0001). Psychological readiness (e.g., ACL-RSI, IKDC) strongly predicted RTS (SMD = 0.82; p < 0.0001). Wearable sensors and machine learning models improved gait tracking and RTS prediction (SMD = 0.46; p < 0.0001), though protocol variability persisted.

Conclusion

Multimodal rehabilitation integrating physical, psychological, and technological domains optimizes RTS outcomes post-ACLR. Standardizing intervention criteria and validating sensor-based and AI-supported tools are essential next steps for evidence-based clinical translation.

PROSPERO Registration: CRD42024561002.