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Rehabilitation strenght variability after ACL reconstruction : a scoping review
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Objetivo: A variabilidade da força é uma componente fundamental na reabilitação da reconstrução do ligamento cruzado anterior (R-LCA), influenciando o controlo neuromuscular e o retorno ao desporto. Esta revisão teve como objetivo analisar os construtos utilizados para avaliar a variabilidade da força e avaliar as metodologias aplicadas na pesquisa sobre a R-LCA. Métodos: De acordo com as diretrizes do Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA-2020), foi realizada uma pesquisa nas bases de dados MEDLINE, CINAHL, PEDro, B-On e Cochrane Library por estudos publicados nos últimos dez anos. Foram incluídos estudos que investigaram a variabilidade da força utilizando constructos relacionados com produção de força. Após análise do abstract e do texto completo, onze artigos corresponderam aos critérios de inclusão. As características dos estudos, os constructos relacionados com variabilidade da força e os instrumentos utilizados foram extraídos de forma independente por dois revisores. Resultados: Foram identificados quatro constructos principais: coeficiente de variação (CV), contração voluntária máxima (CVM), taxa de produção de força (TPF) e torque máximo (TM). O CV foi o constructo mais frequentemente relatado, tanto em contrações isométricas quanto dinâmicas. Métodos lineares, incluindo CV, CVM, TPF e TM, predominaram nos estudos incluídos, fornecendo avaliações baseadas na magnitude da variabilidade. No entanto, métodos não lineares, como análise de entropia e fractal, foram raramente utilizados, apesar do seu potencial para revelar adaptações neuromusculares ao longo do tempo. A falta de padronização na avaliação da variabilidade limita a determinação do constructo clinicamente mais relevante. Conclusões: A avaliação da variabilidade da força permanece inconsistente na pesquisa sobre R-LCA. Estudos futuros devem integrar métodos lineares e não lineares para aprimorar a compreensão e melhorar as estratégias de reabilitação. Protocolos padronizados podem contribuir para melhorar a reabilitação da R-LCA, diferenciando padrões de variabilidade adaptativos de padrões de variabilidade mal adaptativos e, deste modo, melhorar os desfechos no retorno à prática.
Purpose: Strength variability is a critical factor in anterior cruciate ligament reconstruction (ACLR) rehabilitation, influencing neuromuscular control and return-tosport outcomes. This scoping review aimed to analyse the constructs used to assess strength variability and evaluate the methodologies applied in ACLR research. Methods: Following the Preferred Reporting Items for Systematic reviews and MetaAnalyses 2020 statement (PRISMA- 2020), a search was conducted in MEDLINE, CINAHL, PEDro, B-On, and Cochrane Library for studies published in the last ten years. Eligible studies examined strength variability through constructs related to force production of individuals who regularly engage in sports or physical activity. After screening and fulltext analysis, eleven articles met the inclusion criteria. Study characteristics, constructs related to strength variability and instruments used were extracted independently by 2 reviewers. Results: Four primary constructs were identified: coefficient of variation (CV), maximal voluntary contraction (MVC) or MVC-S (strength), rate of force development (RFD), and peak torque (PT). CV was the most frequently reported metric in isometric and dynamic contractions. Linear methods, including CV, MVC, RFD, and PT, dominated the reviewed studies, providing magnitude-based variability assessments. However, non-linear methods, such as entropy-based and fractal analysis, were rarely utilized despite their potential to reveal neuromuscular adaptation over time. The lack of standardization in variability assessment limits the ability to determine the most clinically meaningful construct. Conclusions: Strength variability assessment remains inconsistent in ACLR research. Future studies should integrate both linear and non-linear methods to enhance understanding and improve rehabilitation strategies. Standardized protocols may help refine ACLR rehabilitation by distinguishing between adaptive and maladaptive variability patterns, ultimately improving return-to-sport outcomes.
Purpose: Strength variability is a critical factor in anterior cruciate ligament reconstruction (ACLR) rehabilitation, influencing neuromuscular control and return-tosport outcomes. This scoping review aimed to analyse the constructs used to assess strength variability and evaluate the methodologies applied in ACLR research. Methods: Following the Preferred Reporting Items for Systematic reviews and MetaAnalyses 2020 statement (PRISMA- 2020), a search was conducted in MEDLINE, CINAHL, PEDro, B-On, and Cochrane Library for studies published in the last ten years. Eligible studies examined strength variability through constructs related to force production of individuals who regularly engage in sports or physical activity. After screening and fulltext analysis, eleven articles met the inclusion criteria. Study characteristics, constructs related to strength variability and instruments used were extracted independently by 2 reviewers. Results: Four primary constructs were identified: coefficient of variation (CV), maximal voluntary contraction (MVC) or MVC-S (strength), rate of force development (RFD), and peak torque (PT). CV was the most frequently reported metric in isometric and dynamic contractions. Linear methods, including CV, MVC, RFD, and PT, dominated the reviewed studies, providing magnitude-based variability assessments. However, non-linear methods, such as entropy-based and fractal analysis, were rarely utilized despite their potential to reveal neuromuscular adaptation over time. The lack of standardization in variability assessment limits the ability to determine the most clinically meaningful construct. Conclusions: Strength variability assessment remains inconsistent in ACLR research. Future studies should integrate both linear and non-linear methods to enhance understanding and improve rehabilitation strategies. Standardized protocols may help refine ACLR rehabilitation by distinguishing between adaptive and maladaptive variability patterns, ultimately improving return-to-sport outcomes.
Descrição
Mestrado em Treino de Alto Rendimento. Universidade de Lisboa. Faculdade de Motricidade Humana
Palavras-chave
ACLR Coefficient of variation Linear methods Maximal voluntary contraction Neuromuscular control Non-linear methods Peak torque Rate of force developmentPeak torque Rate of force development Rehabilitation Strength variability Coeficiente de variação Contração voluntária máxima Controlo neuromuscular Métodos lineares Métodos não lineares Reabilitação R-LCA Taxa de produção de força