Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Cross-education, which refers to the interlimb transfer of strength or motor skill following unilateral motor training, has demonstrated promise as a rehabilitation strategy for orthopaedic and neurological injuries, despite the limited number of clinical trials conducted. However, its application in anterior cruciate ligament reconstruction (ACLR) rehabilitation has recently been contested, primarily due to the perceived risk of increasing limb asymmetry.1 During ACLR rehabilitation, improved physical function is associated with the ability to restore compromised quadriceps strength and activation.2 Protocols that mitigate and restore quadriceps weakness and strength post-ACLR are a critical component of rehabilitation. Cross-education may attenuate the loss in neuromuscular function during disuse (online supplemental file), serve as an adjunct intervention for increasing quadriceps strength3 and enhance neuroplasticity in pathways known to be attenuated with ACLR (online supplemental file). This commentary reviews the potential role of cross-education in rehabilitation following ACLR and offers a summary of the physiological rationale for considering this intervention during early-stage ACLR rehabilitation.
Facilitating early strength
Current clinical recommendations after ACLR delay externally loaded open kinetic chain exercises until the fourth week after surgery.1 Although this is advocated to reduce swelling and facilitate the early stages of healing, this process causes a decline in neuromuscular function and strength. When implemented effectively (online supplemental file), cross-education may be an adjunct intervention to mitigate a decline in neuromuscular function and help restore quadriceps strength in the first 3 weeks …
Twitter @justinandrushko, @LindseyLepley, @goodall_stuart, @Tjerk_Zult, @DrNickCC
Contributors All authors contributed to the drafting and editing of the editorial.
Funding JWA is funded by a Canadian Institutes of Health Research (CIHR) postdoctoral fellowship and a Michael Smith Health Research British Columbia postdoctoral award.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.