Optimizing return to play: Double task vs. Traditional strength training for anterior cruciate ligament (ACL) rehabilitation

Abstract

The use of dual-task training to prevent anterior cruciate ligament (ACL) injuries or in the post-reconstruction rehabilitation process of the anterior cruciate ligament (ACLr) has aroused interest within the scientific community due to its possible impacts on strengthening, of the periarticular muscles. This research was to evaluate the effectiveness of a conventional strength purpose program (experimental group 1, G1; n= 5) compared to a strength training that incorporates decision making (experimental group 2, G2; n= 6), in team sports players who have undergone reconstruction anterior cruciate ligament (ACLr)cr. A randomized, controlled, single-blind clinical trial was conducted, in which athletes with ACLr were randomly assigned. An isometric evaluation of hip extension was performed in the position of 0º degrees of hip, knee flexion at both 90º and 15º and knee extension with 90º of hip flexion and the knee at 90º, as well as two types of unilateral jumps, the one-leg jump with countermovement (CMJu) and the medial distance jump (MHD). Both groups of participants received lower limb muscle strengthening exercises, performed twice a week for a period of 12 weeks. However, athletes in G2 performed in dual task, responding to light cues to perform exercise repetitions. In addition, both groups performed an additional set of exercises aimed at correcting detected asymmetries. The variables analyzed include hip extension, knee flexion at 15º and 90º, knee extension, CMJu and MHD. Nonparametric tests were performed for unrelated samples to compare healthy and injured knees. As a result, significant improvements were observed in hip extension (p=0.046) and knee flexion at 90º (p=0.028) and 15º (p=0.028) in the injured knee in G2. In conclusion, the findings suggest that the inclusion of dual-task decision-making activities may improve strength and jumping ability compared to traditional strength training for team sport athletes with ACLr.