Evidence map›Paper›PMID 40841946›Full record

ArticleBMC musculoskeletal disorders2025

Dynamic change of direction, isometric strength, and psychological readiness in final phase ACLR athletes: an integrated approach.

Jpj Stofberg, Mariaan van Aswegen, Mark Kramer

Abstract read
In one paragraph

Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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.

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

2 citing papers in PubMed.

  1. Review
  2. Article
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.

Jpj StofbergCentre for Health and Human Performance (CHHP), North-West University, Potchefstroom, South Africa. jean.stofberg@nwu.ac.za.ORCID http://orcid.org/0000-0001-7189-1881
Mariaan van AswegenPhysical Activity, Sport, and Recreation (PhASRec) Research Focus Area, North-West University, Potchefstroom, South Africa.ORCID http://orcid.org/0000-0002-6477-8044
Mark KramerPhysical Activity, Sport, and Recreation (PhASRec) Research Focus Area, North-West University, Potchefstroom, South Africa.ORCID http://orcid.org/0000-0003-2237-7549

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRehabilitation following successful ACL reconstruction (ACLR) requires restoring physical strength, neuromuscular function, and psychological readiness. However, the interplay between reactive agility, strength, and psychological confidence across rehabilitation phases remains unclear, particularly when compared to uninjured individuals. This study investigates the interrelationships between the reactive agility test (RAT), the isometric mid-thigh pull (IMTP), and the anterior cruciate ligament return-to-sport after injury (ACL-RSI) scale across three rehabilitation phases (Phase 4 [P4], return-to-play [RTP]1, and RTP2) following ACLR. The aim was to examine how reactive agility, strength, and psychological readiness evolve over time and compare ACLR participants to a healthy control group.

methodsFifteen ACLR participants (15-27 years old) and thirty healthy controls (18- 30 years old) completed RAT, isometric mid-thigh pull (IMTP), and ACL-RSI assessments. ACLR participants were assessed at three rehabilitation phases (P4, RTP1, and RTP2), while controls completed a single testing session. Repeated measures analyses were used to track mean changes in performance across rehabilitation phases, and between-group comparisons were conducted using independent samples tests.

resultsACL-RSI scores improved significantly across phases (p = 0.001), exceeding the smallest worthwhile change (SWC), indicating progressive psychological recovery. Reactive agility improved, with faster left-side decision-making (split 2) from P4 to RTP1 (p = 0.037), while right-side agility remained stable but met the SWC threshold (1.1%). Limited between-group differences in total RAT times and sub-phases suggest ACLR participants regained agility comparable to controls. IMTP strength plateaued after RTP1, reinforcing the greater role of agility and cognitive factors within the RTP framework.

conclusionsReactive agility and psychological confidence progressively improved post-ACLR, with decision-making speed recovering earlier than acceleration ability. Minimal between-group differences suggest rehabilitation effectively restores agility, but directional asymmetries and plateaued strength warrant targeted interventions. Future research should explore neurocognitive training to optimize RTP outcomes and minimize re-injury risk.

trial registrationClinical trial number not applicable.

Indexed as

Anterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionAthletesIsometric ContractionMuscle StrengthReturn to SportAdolescentAdultFemaleHumansMaleYoung AdultACLRIsometric strengthPsychological readinessReactive agilitySmallest worthwhile change

Identifiers

PMID40841946
PMCPMC12369174

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.