{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:17:10Z","timestamp":1785435430980,"version":"3.56.0"},"reference-count":50,"publisher":"International Journal of Sports Physical Therapy","issue":"12","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Background<\/jats:title>\n Patients who have undergone anterior cruciate ligament (ACL) reconstruction surgery are at high risk of re-injury and osteoarthritis due to increased impact during landing. The characteristics of patients after reconstruction surgery include significant co-contraction of the knee joint antagonistic muscles, decreased proprioception of the knee joint, and psychological anxiety. However, it is unclear whether these factors are related to shock absorption capacity during landing. The purpose of this study was to investigate whether neuromuscular control and sensory and psychological anxiety are associated with shock absorption capacity during single-leg landing from a 30 cm platform in patients who had undergone ACL reconstruction. It was hypothesized that patients with significant knee co-contraction, knee proprioceptive impairment, and psychological anxiety would have reduced shock absorption capacity during landing.<\/jats:p>\n <\/jats:sec>\n \n Study Design<\/jats:title>\n Descriptive Laboratory Study<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This study included 16 patients who had undergone ACL reconstruction surgery after sustaining a sports-related ACL injury involving landing movements. Patients with concomitant meniscal or cartilage injuries were excluded. The subjects performed single-leg landings on a force plate from a height of 30 cm, and the shock absorption capacity and magnitude of co-contraction of the quadriceps and hamstrings were measured, and a co-contraction index (CCI) was calculated. In addition, the degree of knee joint proprioception impairment was measured using a Joint-Position Sense test (JPS test), and the level of psychological anxiety related to return to sport was assessed using the Anterior Cruciate Ligament\u2013Return to Sport after Injury (ACL-RSI) scale. Multiple regression analysis was used to examine whether there was a relationship between outcomes and the shock absorption capacity during landing.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The participants consisted of 16 patients (6 males and 10 females) with a mean age of 21.1 \u00b1 2.4 years. Both the CCI and proprioceptive ability (JPS test) significantly influenced the loading rate during landing (R\u00b2 = 0.70, p < 0.01), with a greater effect observed for CCI (\u03b2 > JPS). No association was observed with the degree of psychological anxiety in the patients.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study demonstrated that greater co-contraction of the knee joint antagonist muscles and reduced proprioceptive ability were associated with decreased shock absorption capacity during single-leg landing in patients after ACL reconstruction.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 3<\/jats:p>\n <\/jats:sec>","DOI":"10.26603\/001c.147066","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T14:22:43Z","timestamp":1764598963000},"source":"Crossref","is-referenced-by-count":1,"title":["Analysis of Neuromuscular Control and Sensory and Psychological Anxiety Affecting Shock Absorption Capacity in Patients After Anterior Cruciate Ligament Reconstruction Surgery"],"prefix":"10.26603","volume":"20","author":[{"given":"Yoshinori","family":"Komatsu","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03e1t0653","id-type":"ROR","asserted-by":"publisher"}],"name":"Sendai Seiyo Gakuin College","department":["Department of Rehabilitation Science"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumiko","family":"Yamamoto","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/053d3tv41","id-type":"ROR","asserted-by":"publisher"}],"name":"International University of Health and Welfare"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11140","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"issue":"6","key":"ref1","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.1177\/0363546517716930","article-title":"The effects of injury prevention programs on the biomechanics of landing tasks: a systematic review with meta-analysis","volume":"46","author":"T. J. A. Lopes","year":"2018","journal-title":"Am J Sports Med"},{"issue":"6","key":"ref2","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1177\/19417381211063456","article-title":"Association of ankle dorsiflexion and landing forces in jumping athletes","volume":"14","author":"A. F. Martinez","year":"2022","journal-title":"Sports Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1408","DOI":"10.1097\/00005768-200209000-00002","article-title":"Landing adaptations after ACL reconstruction","volume":"34","author":"M. J. Decker","year":"2002","journal-title":"Med Sci Sports Exerc"},{"issue":"2","key":"ref4","doi-asserted-by":"publisher","first-page":"144","DOI":"10.4085\/1062-6050-334-16","article-title":"Hip and knee kinematics and kinetics during landing tasks after anterior cruciate ligament reconstruction: A systematic review and meta-analysis","volume":"53","author":"A. S. Lepley","year":"2018","journal-title":"J Athl Train"},{"issue":"1","key":"ref5","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1249\/MSS.0000000000000389","article-title":"Dynamic knee joint mechanics after anterior cruciate ligament reconstruction","volume":"47","author":"S. B. Clarke","year":"2015","journal-title":"Med Sci Sports Exerc"},{"issue":"3","key":"ref6","doi-asserted-by":"publisher","first-page":"2325967118759522","DOI":"10.1177\/2325967118759522","article-title":"Energy absorption contribution and strength in female athletes at return to sport after anterior cruciate ligament reconstruction: Comparison with healthy controls","volume":"6","author":"M. E. Boo","year":"2018","journal-title":"Orthop J Sports Med"},{"issue":"6","key":"ref7","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1080\/14763141.2018.1510539","article-title":"Improvements in landing biomechanics following anterior cruciate ligament reconstruction in adolescent athletes","volume":"19","author":"N. M. Mueske","year":"2020","journal-title":"Sports Biomech"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1369","DOI":"10.1002\/jor.20440","article-title":"Knee instability after acute ACL rupture affects movement patterns during the mid-stance phase of gait","volume":"25","author":"W. J. Hurd","year":"2007","journal-title":"J Orthop Res"},{"issue":"3","key":"ref9","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.physio.2013.11.002","article-title":"The effects of ACL injury on knee proprioception: a meta-analysis","volume":"100","author":"N. Relph","year":"2014","journal-title":"Physiotherapy"},{"issue":"5","key":"ref10","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1177\/0363546519825499","article-title":"Smaller change in psychological readiness to return to sport is associated with second anterior cruciate ligament injury among younger patients","volume":"47","author":"A. L. McPherson","year":"2019","journal-title":"Am J Sports Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"573","DOI":"10.3928\/0147-7447-20000601-15","article-title":"Mechanisms of anterior cruciate ligament injury","volume":"23","author":"B. P. Boden","year":"2000","journal-title":"Orthopedics"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1016\/j.joca.2004.05.005","article-title":"Contral of front plane knee laxity during gait in patients with medial compartment knee osteoarthritis","volume":"12","author":"M. D. Lewek","year":"2004","journal-title":"Osteoarthritis Cartilage"},{"issue":"4","key":"ref13","doi-asserted-by":"publisher","first-page":"220","DOI":"10.3951\/sobim.47.4_220","article-title":"Differences in co-contraction of quadriceps and hamstrings due to softness of the landing motion -relationship between co-contraction and shock absorption capacity-","volume":"47","author":"K. Yoshinori","year":"2023","journal-title":"Soc Biomechanisms Japan"},{"issue":"1","key":"ref14","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1016\/j.knee.2018.10.014","article-title":"Hypoesthesia after anterior cruciate ligament reconstruction: The relationship between proprioception and vibration perception deficits in individuals greater than one year post-surgery","volume":"26","author":"C. A. Courtney","year":"2019","journal-title":"Knee"},{"issue":"10","key":"ref15","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1016\/j.clinbiomech.2015.08.019","article-title":"Prospectively identified deficits in sagittal plane hip-ankle coordination in female athletes who sustain a second anterior cruciate ligament injury after anterior cruciate ligament reconstruction and return to sport","volume":"30","author":"M. V. Paterno","year":"2015","journal-title":"Clin Biomech"},{"issue":"3","key":"ref16","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1177\/1941738115578131","article-title":"Anterior cruciate ligament reconstruction-not exactly a one-way ticket back to the preinjury level: a review of contextual factors affecting return to sport after surgery","volume":"7","author":"C. L. Ardern","year":"2015","journal-title":"Sports Health"},{"issue":"12","key":"ref17","doi-asserted-by":"publisher","first-page":"3682","DOI":"10.1007\/s00167-018-4950-2","article-title":"Greater fear of reinjury is related to stiffened jump-landing biomechanics and muscle activation in women after ACL reconstruction","volume":"26","author":"S. M. Trigsted","year":"2018","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"1","key":"ref18","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1177\/0363546515611886","article-title":"Comparison of patellar tendon and hamstring tendon anterior cruciate ligament reconstruction: a 15-year follow-up of a randomized controlled trial","volume":"44","author":"K. E. Webster","year":"2016","journal-title":"Am J Sports Med"},{"issue":"5","key":"ref19","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.1016\/j.arthro.2017.01.033","article-title":"Anatomic anterior cruciate ligament reconstruction via independent tunnel drilling: A systematic review of randomized controlled trials comparing patellar tendon and hamstring autografts","volume":"33","author":"M. C. Ciccotti","year":"2017","journal-title":"Arthroscopy"},{"issue":"1","key":"ref20","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s40634-023-00603-1","article-title":"Neuromuscular activity of the lower-extremities during running, landing and changing-of-direction movements in individuals with anterior cruciate ligament reconstruction: a review of electromyographic studies","volume":"10","author":"J. D. Georgoulis","year":"2023","journal-title":"J Exp Orthop"},{"issue":"9","key":"ref21","first-page":"2394","article-title":"Clinical effect of combined therapy with capacitive and resistive electric transfer in athletes after anterior cruciate ligament reconstruction","volume":"23","author":"M. Avramova","journal-title":"J Phys Educ Sport"},{"issue":"4","key":"ref22","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1007\/s00167-012-2011-9","article-title":"Changing sagittal plane body position during single-leg landings influences the risk of non-contact anterior cruciate ligament injury","volume":"21","author":"Y. Shimokochi","year":"2013","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"2416","DOI":"10.1007\/s10439-019-02318-w","article-title":"EMG-Informed musculoskeletal modeling to estimate realistic knee anterior shear force during drop vertical jump in female athletes","volume":"47","author":"A. Navacchia","year":"2019","journal-title":"Ann Biomed Eng"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0059029","article-title":"Effects of perturbations to balance on neuromechanics of fast changes in direction during locomotion","volume":"8","author":"A. S. Oliveira","year":"2013","journal-title":"PLos One"},{"key":"ref25","first-page":"135","article-title":"Quantitative assessment of co-contraction at the ankle joint in walking","volume":"25","author":"K. Falconer","year":"1985","journal-title":"Electromyogr Clon Neurophysiol"},{"issue":"3","key":"ref26","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1123\/jab.27.3.215","article-title":"Preferential quadriceps activation in female athletes with incremental increases in landing intensity","volume":"27","author":"K. R. Ford","year":"2011","journal-title":"J Appl Biomech"},{"issue":"3","key":"ref27","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/j.knee.2012.06.010","article-title":"A systematic review to determine the reliability of knee joint position sense assessment measures","volume":"20","author":"T. O. Smith","year":"2013","journal-title":"Knee"},{"issue":"6","key":"ref28","doi-asserted-by":"publisher","first-page":"23259671211007878","DOI":"10.1177\/23259671211007878","article-title":"Properties of knee joint position sense tests for anterior cruciate ligament injury: a systematic review and meta-analysis","volume":"9","author":"A. Strong","year":"2021","journal-title":"Orthop J Sports Med"},{"issue":"2","key":"ref29","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.physio.2013.11.002","article-title":"The effects of ACL injury on knee proprioception: a meta-analysis","volume":"15","author":"N. Relph","year":"2014","journal-title":"Phys Ther Sport"},{"issue":"1","key":"ref30","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.jshs.2014.10.004","article-title":"Assessing proprioception: A critical review of methods","volume":"5","author":"J. Han","year":"2016","journal-title":"J Sport Health Sci"},{"issue":"1","key":"ref31","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.ptsp.2007.09.003","article-title":"Development and preliminary validation of a scale to measure the psychological impact of returning to sport following anterior cruciate ligament reconstruction surgery","volume":"9","author":"K. E. Webster","year":"2008","journal-title":"Phys Ther Sport"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.knee.2021.10.020","article-title":"Neuromuscular and biomechanical landing alterations persist in athletes returning to sport after anterior cruciate ligament reconstruction","volume":"33","author":"A. Smeets","year":"2021","journal-title":"Knee"},{"issue":"5","key":"ref33","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1007\/s00167-003-0403-6","article-title":"In vivo anterior cruciate ligament strain behaviour during a rapid deceleration movement: case report","volume":"11","author":"G. Cerulli","year":"2003","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"12","key":"ref34","doi-asserted-by":"publisher","first-page":"2325967118812819","DOI":"10.1177\/2325967118812819","article-title":"Progression of the psychological ACL-RSI score and return to sport after anterior cruciate ligament reconstruction: a prospective 2-year follow-up study from the french prospective anterior cruciate ligament reconstruction cohort study","volume":"6","author":"M. Sadeqi","year":"2018","journal-title":"Orthop J Sports Med"},{"issue":"11","key":"ref35","doi-asserted-by":"publisher","first-page":"A1","DOI":"10.2519\/jospt.2017.0303","article-title":"Knee stability and movement coordination impairments: knee ligament sprain revision 2017","volume":"47","author":"D. S. Logerstedt","year":"2017","journal-title":"J Orthop Sports Phys Ther"},{"issue":"6","key":"ref36","first-page":"433","article-title":"Development of Japanese version of the anterior cruciate ligament-return to sport after Injury scale","volume":"44","author":"H. Kenji","year":"2017","journal-title":"Phys Ther Japan"},{"issue":"3","key":"ref37","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/j.knee.2016.02.018","article-title":"The effects of knee direction, physical activity and age on knee joint position sense","volume":"23","author":"N. Relph","year":"2016","journal-title":"Knee"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1694695","DOI":"10.1155\/2019\/1694695","article-title":"Effects on lower extremity neuromuscular control exercises on knee proprioception, muscle strength, and functional level in patients with ACL reconstruction","volume":"15","author":"D. Kaya","year":"2019","journal-title":"Biomed Res Int"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"422","DOI":"10.4085\/1062-6050-52.3.05","article-title":"Quadriceps function and hamstrings co-activation after anterior cruciate ligament reconstruction","volume":"52","author":"D. N. Pamukoff","year":"2017","journal-title":"J. Athl. Train."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1152\/jappl.1992.73.3.911","article-title":"Adaptations in coactivation after isometric resistance training","volume":"73","author":"B. Carolan","year":"1992","journal-title":"J Appol Physiol"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1016\/j.gaitpost.2009.12.005","article-title":"Effects of age and walking speed on coactivation and cost of walking in healthy adults","volume":"31","author":"D. S. Peterson","year":"2010","journal-title":"Gait Posture"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.physio.2023.12.005","article-title":"Use of electromyographic biofeedback in rehabilitation following anterior cruciate ligament reconstruction: a systematic review and meta-analysis","volume":"123","author":"J. Anan\u00edas","year":"2024","journal-title":"Physiotherapy"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1134702","DOI":"10.3389\/fspor.2023.1134702","article-title":"Effects of a proprioceptive focal stimulation (Equistasi\u00ae) on reducing the biomechanical risk factors associated with ACL injury in female footballers","volume":"5","author":"S. Fabiola","year":"2023","journal-title":"Front Sports Act Living"},{"issue":"7","key":"ref44","doi-asserted-by":"publisher","first-page":"1567","DOI":"10.1177\/0363546514530088","article-title":"Incidence of second ACL injuries 2 years after primary ACL reconstruction and return to sport","volume":"42","author":"M. V. Paterno","year":"2014","journal-title":"Am J Sports Med"},{"issue":"10","key":"ref45","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1589\/jpts.25.1239","article-title":"Effects of closed kinetic chain exercises on proprioception and functional scores of the knee after anterior cruciate ligament reconstruction","volume":"25","author":"C. Sung-Hyoun","year":"2013","journal-title":"J Phys Ther Sci"},{"issue":"7","key":"ref46","doi-asserted-by":"publisher","first-page":"1861","DOI":"10.1177\/0363546515621554","article-title":"Risk of secondary injury in younger athletes after anterior cruciate ligament reconstruction: a systematic review and meta-analysis","volume":"44","author":"A. J. Wiggins","year":"2016","journal-title":"Am J Sports Med"},{"issue":"5","key":"ref47","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1007\/s00167-013-2466-3","article-title":"Long-term follow-up of ACL reconstruction with hamstring autograft","volume":"22","author":"J. R. S. Leiter","year":"2014","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"1","key":"ref48","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1186\/s13018-022-03136-y","article-title":"Comparison of the knee joint reaction force between individuals with and without acute anterior cruciate ligament rupture during walking","volume":"17","author":"H. A. Aghdam","year":"2022","journal-title":"J Orthop Surg Res"},{"issue":"1","key":"ref49","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1002\/jor.25025","article-title":"Vertical ground reaction force 2 years after anterior cruciate ligament reconstruction predicts 10-year patient-reported outcomes","volume":"40","author":"J. C. Erhart-Hledik","year":"2022","journal-title":"J Orthop Res"},{"issue":"7","key":"ref50","doi-asserted-by":"publisher","first-page":"23259671211016424","DOI":"10.1177\/23259671211016424","article-title":"Association of jump-landing biomechanics with tibiofemoral articular cartilage composition 12 months after ACL reconstruction","volume":"9","author":"S. J. Pfeiffer","year":"2021","journal-title":"Orthop J Sports Med"}],"container-title":["International Journal of Sports Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ijspt.scholasticahq.com\/article\/147066-analysis-of-neuromuscular-control-and-sensory-and-psychological-anxiety-affecting-shock-absorption-capacity-in-patients-after-anterior-cruciate-ligame","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T14:22:44Z","timestamp":1764598964000},"score":1,"resource":{"primary":{"URL":"https:\/\/ijspt.scholasticahq.com\/article\/147066-analysis-of-neuromuscular-control-and-sensory-and-psychological-anxiety-affecting-shock-absorption-capacity-in-patients-after-anterior-cruciate-ligame"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":50,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.26603\/001c.147066","relation":{},"ISSN":["2159-2896"],"issn-type":[{"value":"2159-2896","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,1]]}}}