{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:42:15Z","timestamp":1792370535040,"version":"4.4.0"},"reference-count":33,"publisher":"National Athletic Trainers' Association","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,12,1]]},"abstract":"<jats:sec>\n                  <jats:title>Context:<\/jats:title>\n                  <jats:p>Persistent muscle weakness after anterior cruciate ligament (ACL) reconstruction may be due to underlying activation failure and arthrogenic muscle inhibition (AMI). Knee-joint cryotherapy has been shown to improve quadriceps function transiently in those with AMI, thereby providing an opportunity to improve quadriceps muscle activation and strength in patients with a reconstructed ACL.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>To compare quadriceps muscle function in patients with a reconstructed ACL who completed a 2-week intervention including daily cryotherapy (ice bag), daily exercises, or both.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design:<\/jats:title>\n                  <jats:p>Cross-sectional study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting:<\/jats:title>\n                  <jats:p>Laboratory.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients or Other Participants:<\/jats:title>\n                  <jats:p>A total of 30 patients with reconstructed ACLs who were at least 6 months post-index surgery and had measurable quadriceps AMI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Intervention(s):<\/jats:title>\n                  <jats:p>The patients attended 4 supervised visits over a 2-week period. They were randomly assigned to receive 20 minutes of knee-joint cryotherapy, 1 hour of therapeutic rehabilitation exercises, or cryotherapy followed by exercises.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure(s):<\/jats:title>\n                  <jats:p>We measured quadriceps Hoffmann reflex, normalized maximal voluntary isometric contraction torque, central activation ratio using the superimposed-burst technique, and patient-reported outcomes before and after the intervention period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>After the 2-week intervention period, patients who performed rehabilitation exercises immediately after cryotherapy had higher normalized maximal voluntary isometric contraction torques (P = .002, Cohen d effect size = 1.4) compared with those who received cryotherapy alone (P = .16, d = 0.58) or performed exercise alone (P = .16, d = 0.30).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>After ACL reconstruction, patients with AMI who performed rehabilitation exercises immediately after cryotherapy experienced greater strength gains than those who performed cryotherapy or exercises alone.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4085\/1062-6050-49.3.39","type":"journal-article","created":{"date-parts":[[2014,10,9]],"date-time":"2014-10-09T18:51:05Z","timestamp":1412880665000},"page":"733-739","source":"Crossref","is-referenced-by-count":62,"title":["Quadriceps Muscle Function After Rehabilitation With Cryotherapy in Patients With Anterior Cruciate Ligament Reconstruction"],"prefix":"10.4085","volume":"49","author":[{"given":"Joseph M.","family":"Hart","sequence":"first","affiliation":[{"name":"University of Virginia, Charlottesville;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Kuenze","sequence":"first","affiliation":[{"name":"University of Virginia, Charlottesville;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Diduch","sequence":"first","affiliation":[{"name":"University of Virginia, Charlottesville;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.","family":"Ingersoll","sequence":"first","affiliation":[{"name":"Central Michigan University, Mt Pleasant"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","reference":[{"issue":"1","key":"2020060411213736700_i1062-6050-49-6-733-b01","doi-asserted-by":"crossref","first-page":"87","DOI":"10.4085\/1062-6050-45.1.87","article-title":"Quadriceps activation following knee injuries: a systematic review","volume":"45","author":"Hart","year":"2010","journal-title":"J Athl 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