BACKGROUND: While anterior cruciate ligament (ACL) tears are commonly managed with ACL reconstruction (ACL-R), 35% of ACL-R individuals fail to return to the preinjury elite sport level. Persistent neuromuscular deficits in the hamstrings and quadriceps have been observed. It has been proposed that aquatic therapy can be used to optimize neuromuscular control after ACL-R.
OBJECTIVE: (1) To compare muscle activity in ACL-R individuals during aquatic treadmill (ATM) running at different water depths and (2) to compare muscle activity during ATM running between ACL-R and healthy individuals.
METHODS: A total of 38 participants, including 18 ACL-R individuals (mean postoperative time [SD] = 25.8 [25.0] mo) and 20 healthy individuals were recruited. Muscle activity of biceps femoris (BF), rectus femoris (RF), tibialis anterior, and medial gastrocnemius during land treadmill and ATM running at mid-shin, mid-thigh, and waist levels were recorded using surface electromyography (sEMG).  The sEMG signals of the selected muscles were normalized and expressed in % Maximal Voluntary Contraction (%MVC). Muscle activity of the ACL-R, ACL-contralateral, and healthy control limbs at different water depths was compared.
RESULTS: Among the 3 groups, the ACL-R group demonstrated the most prominent percentage increase of 101.97% (P = .001) at mid-shin level, 139.66% (P = .001) at mid-thigh level, and 141.97% (P < .001) at waist level, respectively, in %MVC when compared to land. In the ACL-R group, muscle activity of BF in the stance phase (BFSt) was significantly higher than the control group on land at all water depths. Muscle activity of RF in the swing phase (RFSw) in the ACL-R group significantly increased in all water depths immersion when compared to land, respectively.
CONCLUSIONS: This study showed an increasing trend in muscle activity of BFSt and RFSw in ACL-R individuals during ATM running at increased water depths. ATM running could be implemented as neuromuscular training in rehabilitation after ACL-R.

This study analysed the landing performance and muscle activity of athletes in forefoot strike (FFS) and rearfoot strike (RFS) patterns. Ten male college participants were asked to perform two foot strikes patterns, each at a running speed of 6 km/h. Three inertial sensors and five EMG sensors as well as one 24 G accelerometer were synchronised to acquire joint kinematics parameters as well as muscle activation, respectively. In both the FFS and RFS patterns, according to the intraclass correlation coefficient, excellent reliability was found for landing performance and muscle activation. Paired t tests indicated significantly higher ankle plantar flexion in the FFS pattern. Moreover, biceps femoris (BF) and gastrocnemius medialis (GM) activation increased in the pre-stance phase of the FFS compared with that of RFS. The FFS pattern had significantly decreased tibialis anterior (TA) muscle activity compared with the RFS pattern during the pre-stance phase. The results demonstrated that the ankle strategy focused on controlling the foot strike pattern. The influence of the FFS pattern on muscle activity likely indicates that an athlete can increase both BF and GM muscles activity. Altered landing strategy in cases of FFS pattern may contribute both to the running efficiency and muscle activation of the lower extremity. Therefore, neuromuscular training and education are required to enable activation in dynamic running tasks.

The purpose of this randomized controlled trial was to evaluate the efficacy of a 10-week neuromuscular training (NMT) program on the postural control of elite youth competitive ballroom dancers. Forty-two dancers (21 couples) were randomly assigned to either the NMT group (n = 22) or the control group (CG; n = 20). Participants in NMT underwent a three-sessions-per-week NMT program for 10 weeks. Testing at baseline and after the 10 weeks intervention included the Y-balance test (YBT) and Modified-Balance Error Scoring System (M-BESS). Results of YBT indicated that NMT participants demonstrated increased reach in the posterolateral and posteromedial directions for the right and left lower limb, whereas no significant change was found in the anterior direction for both limbs. Results of Modified-Balance Error Scoring System (M-BESS) showed that NMT participants displayed significantly decreased errors of the double-leg floor (p = 0.026), single-leg foam (p = 0.010), double-leg foam (p = 0.003), tandem floor (p = 0.031), and tandem foam (p = 0.038), while no significant change was found in single-leg floor performance (p = 0.476). CG participants did not exhibit any significant change during the 10-week period. In summary, the study affirmed that the 10-week NMT program enhanced the postural control performance of youth ballroom dancers and showed effects on ballroom dance-specific performance and lower-limb injury prevention. The results suggest that NMT may be a valuable addition to ballroom dance training regimens.

The aims of this study were to determine an effective knee function rehabilitation program for athletes undergoing partial medial meniscectomy. Participants were randomly assigned to neuromuscular training (NT) or strength training (ST) group and subjected to functional assessments before surgery and again at 4, and 8 weeks post hoc. Functional knee assessment, such as Lysholm knee scoring, star excursion balance, and BTE PrimusRS isokinetic performance tests were evaluated in each group. All postoperational symptoms were significantly improved after 4 and 8 weeks of NT and ST. Both NT and ST programs showed effective knee function recovery seen as an increase in muscular strength and endurance. However, the NT program showed the most significant functional improvement of dynamic balance and coordination.