{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T06:55:28Z","timestamp":1793343328743,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,6,29]],"date-time":"2018-06-29T00:00:00Z","timestamp":1530230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,6,29]],"date-time":"2018-06-29T00:00:00Z","timestamp":1530230400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2019,1,30]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The aim of this study was to investigate the effects of concentric and eccentric cross\u2010education (CE) on quadriceps strength and knee function recoveries after anterior cruciate ligament (ACL) reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010eight patients (age: 29.5\u2009\u00b1\u20096.8 years, body mass index: 26.1\u2009\u00b1\u20093.2\u00a0kg\/m<jats:sup>2<\/jats:sup>) who had undergone ACL reconstruction with hamstring tendon autograft were included in the study. The patients were randomly divided into three groups when they reached four weeks post surgery: (1) concentric CE (<jats:italic>n<\/jats:italic>\u2009=\u200916); (2) eccentric CE (<jats:italic>n<\/jats:italic>\u2009=\u200916); and (3) control (<jats:italic>n<\/jats:italic>\u2009=\u200916). All groups followed the same post\u2010surgical rehabilitation program for their reconstructed limb. Additionally, the two experimental groups followed eight weeks of isokinetic training for the uninjured knee at 60\u00b0\/s for 3\u00a0days per week. Quadriceps maximum voluntary isometric strength (MVIC) was measured during the 4th week (pre\u2010training), 12th week (post training), and 24th week post surgery. The single\u2010leg hop distance and International Knee Documentary Committee (IKDC) scores were also evaluated during the 24th week post surgery. Analysis of variance was used for statistical analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Group\u2010by\u2010time interaction was significant for quadriceps MVICs for reconstructed and healthy limbs (<jats:italic>p<\/jats:italic>\u2009=\u20090.02). Quadriceps strength of both knees was greater in concentric and eccentric CE groups compared to control group during the 12th\u2010 and 24th weeks post surgery (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Strength gain was 28% and 31% in concentric and eccentric CE groups, respectively, when compared with the control group. Concentric and eccentric CE had similar effects on quadriceps strength recovery (n.s.). IKDC score, and single\u2010leg hop distances were not significantly different among groups (n.s.).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Concentric and eccentric quadricep strengthening of healthy limbs in early phases of ACL rehabilitation improved post\u2010surgical quadriceps strength recovery of the reconstructed limb. CE should be integrated into ACL reconstruction rehabilitation, especially in the early rehabilitative phases to restore quadriceps strength.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Randomized controlled trial, Level I.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-018-5040-1","type":"journal-article","created":{"date-parts":[[2018,6,29]],"date-time":"2018-06-29T11:21:36Z","timestamp":1530271296000},"page":"68-75","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":69,"title":["Cross\u2010education improves quadriceps strength recovery after ACL reconstruction: a randomized controlled trial"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2298-0807","authenticated-orcid":false,"given":"Gulcan","family":"Harput","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Physiotherapy and Rehabilitation, Faculty of Health 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Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leyla","family":"Eraslan","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences Hacettepe University Samanpazari 06100 Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egemen","family":"Turhan","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Orthopedics and Traumatology, Faculty of Medicine Hacettepe University Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volga Bayrakci","family":"Tunay","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences Hacettepe University Samanpazari 06100 Ankara 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February 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 June 2018","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2018","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with Ethical Standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by Hacettepe University Institutional Review Board (KA\/17157).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the 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