Contractile rate of force development after anterior cruciate ligament reconstruction - a comprehensive review and meta-analysis

Review written by Sam Blanchard info

Key Points

  1. While many studies have examined muscle strength deficits following ACL reconstruction, less is known about rate of force development (RFD) deficits post-op.
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It is commonplace for ACL reconstruction (ACLR) rehabilitation programs to include resistance training as a means of regaining strength. There are different forms of objective measures for assessing hamstring and quadriceps strength. Typically, a dynamometer is used to obtain a measure of maximum muscle strength with comparison to the uninjured limb to determine a limb symmetry index (LSI). Previous research suggests that up to 50% of people do not achieve hamstring and quadriceps strength >90% LSI at 9 months post-op.

Less is known about how rapidly muscles can produce force (rate of force development; RFD) following ACLR. The authors of this study sought to understand more about RFD limb symmetry following ACLR, but also compared to healthy controls.

Up to 50% of people do not achieve hamstring and quadriceps strength >90% limb symmetry index at 9 months post ACL reconstruction.
Ensure you achieve a healthy, ‘quiet’ joint that has full range and minimal to no pain or swelling before beginning RFD exercises.


Adhering to PRISMA guidelines, a comprehensive literature search was conducted, looking for studies that included variations of ACLR and RFD. 10 studies were included for a systematic review. A total of 246 participants (109 females, 137 males) were included, ranging

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