SynthesisJournal of athletic training
Disinhibitory interventions and voluntary quadriceps activation: a systematic review.
Synthesis in Journal of athletic training. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of ZILRETTA Injection on Neuromuscular Function, Gait Biomechanics and Physical Performance
Quadriceps Activation Comparative Analysis Based on Positioning of the Ankle During Supine Straight Leg Raise and Quad Set
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Assessment of Quadriceps Corticomotor and Spinal-Reflexive Excitability in Individuals with a History of Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.Sports medicine (Auckland, N.Z.) · 2021Pooled it
- Pooled it
- Effects of Focal Knee Joint Cooling on Static and Dynamic Strength of the Quadriceps: Innovative Approach to Muscle Conditioning.International journal of environmental research and public health · 2021Trial
- The immediate effects of passive hip joint mobilization on hip abductor/external rotator muscle strength in patients with anterior knee pain and impaired hip function. A randomized, placebo-controlled crossover trial.The Journal of manual & manipulative therapy · 2021Trial
- Repetitive transcranial magnetic stimulation improves cognitive function of Alzheimer's disease patients.Oncotarget · 2017Trial
- Cerebellar and Subcortical Connectivity Associated with Arthrogenic Muscle Inhibition After Acute ACL Rupture in Males: A Clinical and fMRI Study.Sports medicine - open · 2026Article
- Prospective evaluation of spinal reflex excitability and perceived ankle instability following acute lateral ankle sprain in collegiate basketball players.BMC sports science, medicine & rehabilitation · 2025Article
- Current Rehabilitation Principles Following Meniscus Repairs.Current reviews in musculoskeletal medicine · 2025Review
- Why Should Return to Sport Be Delayed by up to Two Years After ACL Reconstruction? A Narrative Review of the Biological, Surgical and Rehabilitation Evidence.Journal of clinical medicine · 2025Review
- Advances in Research on Brain Structure and Activation Characteristics in Patients with Anterior Cruciate Ligament Reconstruction: A Systematic Review.Brain sciences · 2025Review
- Posterior Medial Meniscus Root Tears: Clinical Implications, Surgical Management, and Post-operative Rehabilitation Considerations.International journal of sports physical therapy · 2025Article
- Ultrasound-guided gluteal nerves electrical stimulation to enhance strength and power in individuals with chronic knee pain: a randomized controlled pilot trial.Frontiers in medicine · 2024Article
- Quadriceps Dysfunction Following Joint Preservation Surgery: A Review of the Pathophysiologic Basis and Mitigation Strategies.Current reviews in musculoskeletal medicine · 2023Review
- Clinic and Home-Based Exercise with Blood Flow Restriction Resolves Thigh Muscle Atrophy after Anterior Cruciate Ligament Reconstruction with the Bone-Patellar Tendon-Bone Autograft: A Case Report.Healthcare (Basel, Switzerland) · 2023Article
- Altered Knee Loading Following Primary ACL Repair versus ACL Reconstruction.International journal of sports physical therapy · 2023Article
- Early Activation of Quadriceps With Pressure Biofeedback for the Prevention of Arthrogenic Muscle Inhibition Following Lower Limb Orthopedic Surgeries: A Proof of Concept Clinical Trial.Journal of chiropractic medicine · 2022Article
- Return to sports after ACL injury 5 years from now: 10 things we must do.Journal of experimental orthopaedics · 2022Review
- Spinal Reflex Excitability of Lower Leg Muscles Following Acute Lateral Ankle Sprain: Bilateral Inhibition of Soleus Spinal Reflex Excitability.Healthcare (Basel, Switzerland) · 2022Article
- Preoperative muscle thickness influences muscle activation after arthroscopic knee surgery.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- Somatosensory perturbations influence cortical activity associated with single-limb balance performance.Experimental brain research · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the effects of various therapeutic interventions on increasing voluntary quadriceps muscle activation.
backgroundDecreased voluntary quadriceps activation is commonly associated with knee injury. Recently, research has focused on developing specific disinhibitory interventions to improve voluntary quadriceps activation; yet, it remains unknown which interventions are most effective in promoting this improvement. DATA SOURCES: We searched Web of Science from January 1, 1965 through September 27, 2012, using the key words quadriceps activation and transcutaneous electrical nerve stimulation, transcranial magnetic stimulation, cryotherapy, focal joint cooling, joint mobilization, joint mobilisation, joint manipulation, manual therapy, and neuromuscular electrical stimulation. STUDY SELECTION: Studies evaluating the effect of disinhibitory interventions on volitional quadriceps activation were used in our review. Standardized effect sizes (Cohen d) and 95% confidence intervals (CIs) were calculated from voluntary quadriceps activation means and standard deviations measured at baseline and at all available postintervention time points from each study. DATA SYNTHESIS: Ten studies were grouped into 5 categories based on intervention type: manual therapy (4 studies), transcutaneous electrical nerve stimulation (2 studies), cryotherapy (2 studies), neuromuscular electrical stimulation (2 studies), and transcranial magnetic stimulation (1 study). Transcutaneous electrical nerve stimulation demonstrated the strongest immediate effects (d = 1.03; 95% CI = 0.06, 1.92) and long-term effects (d = 1.93; 95% CI = 0.91, 2.83). Cryotherapy (d = 0.76; 95% CI = -0.13, 1.59) and transcranial magnetic stimulation (d = 0.54; 95% CI = -0.33, 1.37) had moderate immediate effects in improving voluntary quadriceps activation, whereas manual therapy (d = 0.38; 95% CI = -0.35, 1.09) elicited only weak immediate effects. Neuromuscular electrical stimulation produced weak negative to strong positive effects (range of d values = -0.50 to 1.87) over a period of 3 weeks to 6 months.
conclusionsTranscutaneous electrical nerve stimulation demonstrated the strongest and most consistent effects in increasing voluntary quadriceps activation and may be the best disinhibitory intervention for improving the same.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.