EFFECTIVENESS OF BILATERAL NEUROMUSCULAR TRAINING IN COMBINATION WITH CONVENTIONAL REHABILITATION ON STRENGTH, POWER, BALANCE, AND AGILITY IN YOUNG ADULTS POST-ACL RECONSTRUCTION: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Knee stability following an ACL injury is usually restored through an anterior cruciate ligament reconstruction (ACLR). However, after conventional rehabilitation, ACLR people still have residual deficits in muscle strength, lower limb power, balance, and agility. Overcoming musculoskeletal dysfunction through effective rehabilitation may result from bilateral neuromuscular training that enhances sensorimotor control, proprioception, and performance. Objective: This study aimed to compare the effectiveness of Bilateral Neuromuscular Training combined with Conventional Rehabilitation versus Conventional Rehabilitation alone on muscle strength, lower limb power, dynamic balance, and agility in individuals following ACL reconstruction. Methods: A randomized controlled trial on 48 participants with ACL reconstruction was conducted. Twenty-four patients were chosen for both the conventional rehabilitation and the bilateral neuromuscular training groups. The measures that were observed were muscle strength, lower limb power, Y-Balance Test (dynamic balance), and agility at pre-intervention, post-intervention, and follow-up. To analyze the data, repeated-measures ANOVA, independent-samples t-tests, and paired-samples t-tests were completed at an alpha level of p < .05. Results: Time-related improvements were reported in all evaluation measures in both intervention groups (p < .001). Improvements in muscle strength, lower limb power, and agility at follow-up were significantly greater in the Bilateral Neuromuscular Training group than the Conventional Rehabilitation group. A bilateral neuromuscular training approach enhances functionality and recovery compared to all other training modes. Within-group analyses showed improvement in both groups at all assessment periods. Conclusion: Bilateral neuromuscular training is an effective addition to conventional therapy for ACL reconstruction. Adding bilateral neuromuscular exercise into postoperative rehabilitation increases strength, lower limb power, balance, and agility, thus improving functional recovery and supporting a safer return to sport and activities of daily living.