Evidence map›Paper›PMID 29796857›Full record

Trial reportEuropean journal of applied physiology2018

Cross-education does not accelerate the rehabilitation of neuromuscular functions after ACL reconstruction: a randomized controlled clinical trial.

Tjerk Zult, Alli Gokeler, Jos J A M van Raay, Reinoud W Brouwer, Inge Zijdewind, Jonathan P Farthing, Tibor Hortobágyi

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of applied physiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07333092 (Investigation of the Effects of Proprioceptive Exercises on Balance, Kinesiophobia, and Functionality After Anterior Cruciate Ligament Surgery), which is not on this map. Cited by 25 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT07333092 narecruitingnot on this mapstarted 2026, after this paper: background citation

Investigation of the Effects of Proprioceptive Exercises on Balance, Kinesiophobia, and Functionality After Anterior Cruciate Ligament Surgery: A Randomized Controlled Trial

TypeinterventionalSponsorUskudar UniversityRan2026 to 2026Enrolled50ConditionsAnterior Cruciate Ligament Injuries, Anterior Cruciate Ligament RuptureArmscontrol, exercise
3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Tjerk ZultCenter for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. tjerk.zult@anglia.ac.uk.
Alli GokelerCenter for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Jos J A M van RaayDepartment of Orthopedic Surgery, Martini Hospital, Groningen, The Netherlands.
Reinoud W BrouwerDepartment of Orthopedic Surgery, Martini Hospital, Groningen, The Netherlands.
Inge ZijdewindDepartment of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Jonathan P FarthingCollege of Kinesiology, University of Saskatchewan, Saskatoon, Canada.
Tibor HortobágyiCenter for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Funding

Start-up fund from University Medical Center Groningen 653013
6 · The paper itself

Abstract

purposeCross-education reduces quadriceps weakness 8 weeks after anterior cruciate ligament (ACL) surgery, but the long-term effects are unknown. We investigated whether cross-education, as an adjuvant to the standard rehabilitation, would accelerate recovery of quadriceps strength and neuromuscular function up to 26 weeks post-surgery.

methodsGroup allocation was randomized. The experimental (n = 22) and control (n = 21) group received standard rehabilitation. In addition, the experimental group strength trained the quadriceps of the non-injured leg in weeks 1-12 post-surgery (i.e., cross-education). Primary and secondary outcomes were measured in both legs 29 ± 23 days prior to surgery and at 5, 12, and 26 weeks post-surgery.

resultsThe primary outcome showed time and cross-education effects. Maximal quadriceps strength in the reconstructed leg decreased 35% and 12% at, respectively, 5 and 12 weeks post-surgery and improved 11% at 26 weeks post-surgery, where strength of the non-injured leg showed a gradual increase post-surgery up to 14% (all p ≤ 0.015). Limb symmetry deteriorated 9-10% more for the experimental than control group at 5 and 12 weeks post-surgery (both p ≤ 0.030). One of 34 secondary outcomes revealed a cross-education effect: Voluntary quadriceps activation of the reconstructed leg was 6% reduced for the experimental vs. control group at 12 weeks post-surgery (p = 0.023). Both legs improved force control (22-34%) and dynamic balance (6-7%) at 26 weeks post-surgery (all p ≤ 0.043). Knee joint proprioception and static balance remained unchanged.

conclusionStandard rehabilitation improved maximal quadriceps strength, force control, and dynamic balance in both legs relative to pre-surgery but adding cross-education did not accelerate recovery following ACL reconstruction.

Indexed as

Recovery of FunctionAdultAnterior Cruciate LigamentAnterior Cruciate Ligament InjuriesExercise TherapyFemaleHumansMaleMuscle, SkeletalForce controlMaximal voluntary forcePostural stabilityProprioceptionStrength trainingTwitch interpolation

Identifiers

PMID29796857
PMCPMC6060748

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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.