Effects of proprioceptive training intervention on knee function in patients with anterior cruciate ligament reconstruction: a systematic review and meta-analysis

This study aimed to systematically evaluate the impact of proprioceptive training on the rehabilitation of patients after anterior cruciate ligament reconstruction (ACLR) including subjective knee functional scores, knee proprioception, knee range of motion, flexion strength and single-leg hopping ability. PubMed, Web of Science, Cochrane Library, Embase, and China National Knowledge Infrastructure were searched for randomized controlled trials (RCTs) on proprioceptive training for ACLR patients from the inception of the databases to December 2, 2024. The Cochrane Risk of Bias tool was used to assess, Grading of Recommendations Assessment, Development and Evaluation evaluated evidence levels, and the effect size combination, subgroup analysis, and sensitivity analysis were performed using Stata 17. Thirteen studies with a total of 529 patients were included. The meta-analysis indicated that proprioceptive training significantly improved subjective knee functional scores (Hedge’s <i>g</i> = 0.58, 95% CI: 0.26 to 0.9, <i>p</i> = 0.00), single-leg hopping ability (Hedge’s <i>g</i> = 0.44, 95% CI: 0.15 to 0.72, <i>p</i> = 0.00), and knee proprioception (Hedge’s <i>g</i> = −0.8, 95% CI: −1.33 to −0.28, <i>p</i> = 0.00) in ACLR patients. However, proprioceptive training did not have a significant effect on knee range of motion or flexion strength. Proprioceptive training improves subjective knee functional scores, single-leg hopping ability and proprioception but does not significantly enhance knee range of motion or flexion strength in ACLR patients. Proprioceptive training enhanced subjective functional scores, and single-leg hopping ability, and knee proprioceptive function in ACLR patients.Proprioceptive training did not affect knee range of motion or knee flexion strength.The sample size significantly moderates the effects of proprioceptive training on improving knee proprioception. Future research should focus on the impact of sample size. Proprioceptive training enhanced subjective functional scores, and single-leg hopping ability, and knee proprioceptive function in ACLR patients. Proprioceptive training did not affect knee range of motion or knee flexion strength. The sample size significantly moderates the effects of proprioceptive training on improving knee proprioception. Future research should focus on the impact of sample size.