Impact of neuromuscular and visuo-motor training on landing biomechanics, functional performance, and psychological factors in female athletes with unilateral anterior cruciate ligament reconstruction: a simple parallel-group randomised controlled trial
Journal of Orthopaedic Surgery and Research · 31 Jul 2026
† Impact is the editorial-priority score. All scores are out of 100. Clinical is a stored clinical-importance score from the earlier method; it has not been recalculated.
Why it matters
Landing mechanics like knee valgus and reduced knee flexion are linked to reinjury risk after ACL reconstruction, so trials comparing rehab strategies targeting these mechanics are directly relevant to return-to-sport planning.
The evidence
This small trial randomised 45 female athletes with prior unilateral ACL reconstruction into neuromuscular training (NMT), visuo-motor training (VMT), or a control group, then measured landing biomechanics (hip/knee/ankle angles, knee valgus, ground reaction force), functional hop/balance tests, and fear of reinjury (ACL-RSI). Both NMT and VMT groups showed significant improvements across nearly every measured variable (e.g., knee valgus p=0.03–0.04, ACL-RSI p=0.001) with large effect sizes, but the two active interventions did not differ significantly from each other on any outcome.
A coherent primary effect estimate is unavailable. Clinical relevance does not estimate treatment benefit.
Why this rigour score?
RCT
Methods at a glance
Recorded assessment- Outcome assessors blindedNot reported
- Allocation concealedNot reported
- Random sequence generatedNot reported
- Intention-to-treat analysisNot reported
- Adequate statistical powerCalculation absent
- Prospective registrationNot reported
Not reported does not mean not done. Checks have different weights; this is not a count of boxes ticked.
How to read this assessment
The recorded methods are shown alongside the published score. A verified point-by-point calculation is not available for this version of the appraisal.
Checklist from the stored appraisal. “Not met” describes the recorded criterion; it does not always produce a deduction. This overview supports reading the full study.
For journal club
1.If NMT and VMT produce statistically indistinguishable improvements in landing mechanics and psychological readiness, how should a clinician choose between them for a given athlete returning to sport after ACLR?
2.Given that fear of reinjury (kinesiophobia) improved substantially with both interventions, should psychological readiness be assessed as routinely as biomechanical metrics before clearing athletes for return to sport?
Original publication title
Impact of neuromuscular and visuo-motor training on landing biomechanics, functional performance, and psychological factors in female athletes with unilateral anterior cruciate ligament reconstruction: a simple parallel-group randomized controlled trial