Background: Injury and reconstruction of anterior cruciate ligament are followed by atrophy and reduced volitional activation of neuro-motor centres, thus causing weakness of quadriceps femoris muscle. The latter is primarily due to arthrogenic muscle inhibition. The purpose of this review was to determine the effect of standard rehabilitation and specific therapeutic procedures on central activation of quadriceps femoris muscle in individuals after anterior cruciate ligament rupture. Methods: The review included randomized controlled trials and cohort studies from PubMed database. Results: Seven studies have been included in the review. Three studies measured changes in central activation ratio of the quadriceps femoris muscle after standard rehabilitation protocol and four after specific physiotherapeutic protocols. There is no direct evidence regarding efficiency of standard physiotherapeutic protocol on the improvements of central activation ratio, but evidences exist regarding beneficial effects of eccentric exercise, cryotherapy and transcutaneous electrical stimulation before and during resistance exercise. Conclusions: Eccentric exercise as well as cryotherapy and TENS applied to the injured joint before or during exercise can improve volitional activation of quadriceps femoris muscle, thus contributing to the increase in its strength. Further high quality studies on larger population are needed for more solid findings.
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