{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T19:00:04Z","timestamp":1793300404055,"version":"4.5.0"},"reference-count":30,"publisher":"Journal of Orthopaedic & Sports Physical Therapy (JOSPT)","issue":"9","content-domain":{"domain":["www.jospt.org"],"crossmark-restriction":true},"short-container-title":["Journal of Orthopaedic &amp; Sports Physical Therapy"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p> To investigate corticospinal and spinal reflexive excitability and quadriceps strength in healthy athletes and athletes after anterior cruciate ligament reconstruction (ACLR) over the course of rehabilitation. <\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p> Prospective cohort study. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Eighteen athletes with ACLR and 18 healthy athletes, matched by sex, age, and activity, were tested at (1) 2 weeks after surgery, (2) the \u201cquiet knee\u201d time point, defined as full range of motion and minimal effusion, and (3) return to running, defined as achieving a quadriceps index of 80% or greater. We measured (1) corticospinal excitability, using resting motor threshold (RMT) and motor-evoked potential amplitude at a stimulator intensity of 120% of RMT (MEP<jats:sub>120<\/jats:sub>) to the vastus medialis, (2) spinal reflexive excitability, calculating the ratio of the maximal Hoffmann reflex to the maximal M-wave to the vastus medialis, and (3) isometric quadriceps strength. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> The ACLR group had higher RMTs in the nonsurgical limb and higher MEP<jats:sub>120<\/jats:sub> in the surgical limb at all time points. The healthy-athlete group did not have interlimb differences. The RMT was positively associated with quadriceps strength 2 weeks after surgery; MEP<jats:sub>120<\/jats:sub> was associated with quadriceps strength at all time points. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Compared to healthy athletes, athletes after ACLR had altered corticospinal excitability that did not change from 2 weeks after surgery to the time of return to running. J Orthop Sports Phys Ther 2020;50(9):516\u2013522. 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