{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T11:00:57Z","timestamp":1765882857052,"version":"3.48.0"},"reference-count":59,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,6,4]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to summarise the existing literature about enhancing muscle strength, lower limb function and self-reported function by electrical stimulation (ES) relative to conventional physical therapy following anterior cruciate ligament reconstruction (ACLR), and to assess the comprehensive treatment effects of ES via meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review, meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study systematically searched five electronic databases (PubMed, Web of Science, Scopus, Embase and Chinese National Knowledge Infrastructure), covering records from their inception until February 2024, adhering to a predefined search strategy. Two independent reviewers extracted and synthesised the relevant data using RevMan software (V.5.3). Due to identified heterogeneity, a random-effects model was applied for the meta-analysis. The meta-analysis calculated the effect sizes concerning lower limb function outcomes as standardised mean differences (SMD) with 95% CIs. The methodological quality of the included studies was assessed by the Physiotherapy Evidence Database scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 15 studies involving 1583 patients (between the ages of 15 and 50 years) were included. Meta-analysis results indicated that the ES group could improve the lower limb comprehensive function compared with the control group (CG) based on four clinical tests: the muscle strength (SMD=0.55, 95%\u2009CI 0.14 to 0.95, p=0.008, I\n                      <jats:sup>2<\/jats:sup>\n                      =74%), the range of motion (SMD=1.10, 95%\u2009CI 0.40 to 1.79, p=0.002, I\n                      <jats:sup>2<\/jats:sup>\n                      =89%), the Lysholm scale (SMD=1.05, 95%\u2009CI 0.36 to 1.73, p=0.003, I\n                      <jats:sup>2<\/jats:sup>\n                      =91%) and the visual analogue scale (SMD=0.87, 95%\u2009CI 0.38 to 1.37, p=0.006, I\n                      <jats:sup>2<\/jats:sup>\n                      =75%). However, there were no significant differences between the CG and the ES group in terms of leg circumference (SMD=0.61, 95%\u2009CI \u22120.78 to 2.00, p=0.39, I\n                      <jats:sup>2<\/jats:sup>\n                      =87%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adjunctive ES has the potential to enhance early-phase ACLR rehabilitation outcomes, particularly by improving muscle strength, lower limb function and self-reported function, despite the use of different ES modalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42024549752.<\/jats:p>\n                  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