Evidence map›Paper›PMID 32707098›Full record

SynthesisJournal of sport and health science2021

How does anterior cruciate ligament reconstruction affect the functioning of the brain and spinal cord? A systematic review with meta-analysis.

Kazandra M Rodriguez, Riann M Palmieri-Smith, Chandramouli Krishnan

Open access · diamondAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of sport and health science, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed
5.9field-weighted citation impact, top 3% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 69 citations in OpenAlex.

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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

3 authors at 2 institutions in 1 country.

Kazandra M RodriguezSchool of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA.
Riann M Palmieri-SmithSchool of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Orthopaedic Surgery, Michigan Medicine, Ann Arbor, MI 48109, USA.
Chandramouli KrishnanSchool of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI 48108, USA; Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; Michigan Robotics Institute, University of Michigan, Ann Arbor, MI 48109, USA. Electronic address: mouli@umich.edu.
Michigan Medicine · USUniversity of Michigan–Ann Arbor · US

Funding

Functional Resistance Training during Gait: A Novel Intervention to Improve Knee Function after ACL ReconstructionR21HD092614 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI KRISHNAN, CHANDRAMOULI, PALMIERI-SMITH, RIANN MARIE · 2017 to 2018
$428k
NICHD NIH HHS R21 HD092614
6 · The paper itself

Abstract

objectiveTo examine the effect of anterior cruciate ligament (ACL) reconstruction on spinal-reflex and corticospinal excitability of the quadriceps muscle.

methodsA comprehensive electronic database search was performed to identify studies that objectively measured Hoffmann reflex to muscle response ratio, motor threshold, and motor evoked potentials after ACL reconstruction. Pooled standardized mean differences (SMDs) were computed using a random effects meta-analysis model.

resultsA total of 13 studies were eligible for analysis. The Hoffmann reflex to muscle response ratio was significantly higher on both the reconstructed and non-reconstructed legs when compared with the healthy control leg (SMD = 0.28, 95% confidence interval (95%CI): 0.08-0.49, p = 0.006 and SMD = 0.22, 95%CI: 0.04-0.40, p = 0.016, respectively) but did not differ between legs (SMD = 0.10, 95%CI: -0.01 to 0.21, p = 0.078). The motor threshold was significantly higher on both the reconstructed (SMD = 0.76, 95%CI: 0.40-1.12, p < 0.001) and non-reconstructed legs (SMD = 0.47, 95%CI: 0.00-0.95, p = 0.049) when compared with the legs of healthy controls. The reconstructed leg also had a higher motor threshold when compared with the non-reconstructed leg (SMD = 0.20, 95%CI: 0.06-0.34, p = 0.005). These changes were paralleled by bilateral reductions in quadriceps strength (ACL reconstructed: SMD = -0.78, 95%CI: -1.07 to -0.49, p < 0.001; non-reconstructed: SMD = -0.32, 95%CI: -0.63 to -0.01, p = 0.042) and quadriceps voluntary activation (ACL reconstructed: SMD = -0.73, 95%CI: -0.97 to -0.50, p < 0.001; non-reconstructed: SMD = -0.55, 95%CI: -0.82 to -0.27, p < 0.001) when compared with healthy controls.

conclusionThere is increased excitability of the spinal-reflex pathways and reduced excitability of the corticospinal pathways following ACL reconstruction. These changes are paralleled by reductions in quadriceps strength and voluntary activation, suggesting that rehabilitation interventions should focus on normalizing the excitability of neural pathways to effectively address quadriceps dysfunction after ACL reconstruction.

Indexed as

Anterior Cruciate Ligament ReconstructionBiasBrainConfidence IntervalsEvoked Potentials, MotorHumansMuscle ContractionMuscle StrengthPyramidal TractsQuadriceps MuscleReflexSensory ThresholdsSpinal CordACLRCortical excitabilityH-reflexTMSTranscranial magnetic stimulation

Identifiers

PMID32707098
PMCPMC7987657
OpenAlexW3043991598

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.