Eccentric cross-exercise after anterior cruciate ligament reconstruction: Novel case series to enhance neuroplasticity

Lindsey K. Lepley, Dustin R. Grooms, Julie P. Burland, Steven M. Davi, Jennifer L. Mosher, Marc L. Cormier, Adam S. Lepley

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Objectives: Substantial changes in neural function are historically present after anterior cruciate ligament reconstruction (ACLR), and are not rectified with traditional rehabilitation. Cross-exercise is a potential means to enhance neural excitability and improve recovery after ACLR. Hence our purpose, was to detail changes in brain activation, neural excitability and patient-reported outcomes in a cohort that completed an 8-week quadriceps-focused eccentric cross-exercise training program immediately following ACLR. Design: Case series. Setting: University. Particpants: Five patients participated in an 8-week (24-session) eccentric cross-exercise intervention after ACLR. Main outcome measures: Brain activation, neural activity and patient-reported outcomes were evaluated within 2 weeks post-ACLR and again at 10-weeks post-ACLR after the intervention. Each cross-exercise session consisted of 4 sets of 10 isokinetic eccentric contractions at 60 deg/sec with the noninvolved limb. Results: Following the intervention, patients demonstrated a facilitated spinal reflexive and muscle activity response from the motor cortex during a time when these measures are known to be depressed. Patients also demonstrated a reduce dependence on frontal cortex activity to generate quadriceps contractions. Further patients reported significant reductions in pain and symptoms and greater knee function. Conclusions: Eccentric cross-exercise after ACLR helps to facilitate positive adaptations in neural function and patient reported outcomes.

Original languageEnglish
Pages (from-to)55-65
Number of pages11
JournalPhysical Therapy in Sport
Volume34
DOIs
StatePublished - Nov 2018

Bibliographical note

Funding Information:
Funding was provided by the New England Chapter of the American College of Sports Medicine New Investigator Award to Dr. Lindsey Lepley.

Publisher Copyright:
© 2018 Elsevier Ltd

Keywords

  • Anterior cruciate ligament
  • Brain activation
  • Eccentric
  • Functional magnetic resonance imaging
  • Negative work
  • Spinal and corticospinal excitability
  • Transcranial magnetic stimulation

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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