Which assessments are used to analyze neuromuscular control by electromyography after an anterior cruciate ligament injury to determine readiness to return to sports? A systematic review

Abstract Background Adequate neuromuscular control of the knee could be one element to prevent secondary injuries after an anterior cruciate ligament (ACL) injury. To assess neuromuscular control in terms of time, amplitude and activity, electromyography (EMG) is used. However, it is unclear which a...

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Autores principales:	Angela Blasimann, Irene Koenig, Isabel Baert, Heiner Baur, Dirk Vissers
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Knee Anterior cruciate ligament injuries ACL Electromyography EMG Rehabilitation Sports medicine RC1200-1245
Acceso en línea:	https://doaj.org/article/2543d7adc6294f7d929a42091bbe1046
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spelling	oai:doaj.org-article:2543d7adc6294f7d929a42091bbe10462021-11-14T12:38:37ZWhich assessments are used to analyze neuromuscular control by electromyography after an anterior cruciate ligament injury to determine readiness to return to sports? A systematic review10.1186/s13102-021-00370-52052-1847https://doaj.org/article/2543d7adc6294f7d929a42091bbe10462021-11-01T00:00:00Zhttps://doi.org/10.1186/s13102-021-00370-5https://doaj.org/toc/2052-1847Abstract Background Adequate neuromuscular control of the knee could be one element to prevent secondary injuries after an anterior cruciate ligament (ACL) injury. To assess neuromuscular control in terms of time, amplitude and activity, electromyography (EMG) is used. However, it is unclear which assessments using EMG could be used for a safe return to sports (RTS). Therefore, we aimed to summarize EMG-related assessments for neuromuscular control of the knee in adult patients after an ACL injury to decide upon readiness for RTS. Methods This systematic review followed guidelines of Preferred Reporting of Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane recommendations. MEDLINE/PubMed, EMBASE, CINAHL, Cochrane Library, Physiotherapy Evidence Database (PEDro), SPORTDiscus and the Web of Science were searched from inception to March 2019 and updated in November 2020. Studies identifying electromyographic assessments for neuromuscular control during dynamic tasks in adult, physically active patients with an anterior cruciate ligament injury were eligible and qualitatively synthesized. Two independent reviewers used a modified Downs and Black checklist to assess risk of bias of included studies. Results From initially 1388 hits, 38 mainly cross-sectional, case-controlled studies were included for qualitative analysis. Most studies provided EMG outcomes of thigh muscles during jumping, running or squatting. Outcomes measures described neuromuscular control of the knee in domains of time, amplitude or activity. Risk of bias was medium to high due to an unclear description of participants and prior interventions, confounding factors and incompletely reported results. Conclusions Despite a wide range of EMG outcome measures for neuromuscular control, none was used to decide upon return to sports in these patients. Additional studies are needed to define readiness towards RTS by assessing neuromuscular control in adult ACL patients with EMG. Further research should aim at finding reliable and valid, EMG-related variables to be used as diagnostic tool for neuromuscular control. Moreover, future studies should aim at more homogenous groups including adequately matched healthy subjects, evaluate gender separately and use sport-specific tasks. Registration The protocol for this systematic review was indexed beforehand in the International Prospective Register of Systematic Reviews (PROSPERO) and registered as CRD42019122188.Angela BlasimannIrene KoenigIsabel BaertHeiner BaurDirk VissersBMCarticleKneeAnterior cruciate ligament injuriesACLElectromyographyEMGRehabilitationSports medicineRC1200-1245ENBMC Sports Science, Medicine and Rehabilitation, Vol 13, Iss 1, Pp 1-33 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Knee Anterior cruciate ligament injuries ACL Electromyography EMG Rehabilitation Sports medicine RC1200-1245
spellingShingle	Knee Anterior cruciate ligament injuries ACL Electromyography EMG Rehabilitation Sports medicine RC1200-1245 Angela Blasimann Irene Koenig Isabel Baert Heiner Baur Dirk Vissers Which assessments are used to analyze neuromuscular control by electromyography after an anterior cruciate ligament injury to determine readiness to return to sports? A systematic review
description	Abstract Background Adequate neuromuscular control of the knee could be one element to prevent secondary injuries after an anterior cruciate ligament (ACL) injury. To assess neuromuscular control in terms of time, amplitude and activity, electromyography (EMG) is used. However, it is unclear which assessments using EMG could be used for a safe return to sports (RTS). Therefore, we aimed to summarize EMG-related assessments for neuromuscular control of the knee in adult patients after an ACL injury to decide upon readiness for RTS. Methods This systematic review followed guidelines of Preferred Reporting of Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane recommendations. MEDLINE/PubMed, EMBASE, CINAHL, Cochrane Library, Physiotherapy Evidence Database (PEDro), SPORTDiscus and the Web of Science were searched from inception to March 2019 and updated in November 2020. Studies identifying electromyographic assessments for neuromuscular control during dynamic tasks in adult, physically active patients with an anterior cruciate ligament injury were eligible and qualitatively synthesized. Two independent reviewers used a modified Downs and Black checklist to assess risk of bias of included studies. Results From initially 1388 hits, 38 mainly cross-sectional, case-controlled studies were included for qualitative analysis. Most studies provided EMG outcomes of thigh muscles during jumping, running or squatting. Outcomes measures described neuromuscular control of the knee in domains of time, amplitude or activity. Risk of bias was medium to high due to an unclear description of participants and prior interventions, confounding factors and incompletely reported results. Conclusions Despite a wide range of EMG outcome measures for neuromuscular control, none was used to decide upon return to sports in these patients. Additional studies are needed to define readiness towards RTS by assessing neuromuscular control in adult ACL patients with EMG. Further research should aim at finding reliable and valid, EMG-related variables to be used as diagnostic tool for neuromuscular control. Moreover, future studies should aim at more homogenous groups including adequately matched healthy subjects, evaluate gender separately and use sport-specific tasks. Registration The protocol for this systematic review was indexed beforehand in the International Prospective Register of Systematic Reviews (PROSPERO) and registered as CRD42019122188.
format	article
author	Angela Blasimann Irene Koenig Isabel Baert Heiner Baur Dirk Vissers
author_facet	Angela Blasimann Irene Koenig Isabel Baert Heiner Baur Dirk Vissers
author_sort	Angela Blasimann
title	Which assessments are used to analyze neuromuscular control by electromyography after an anterior cruciate ligament injury to determine readiness to return to sports? A systematic review
title_short	Which assessments are used to analyze neuromuscular control by electromyography after an anterior cruciate ligament injury to determine readiness to return to sports? A systematic review
title_full	Which assessments are used to analyze neuromuscular control by electromyography after an anterior cruciate ligament injury to determine readiness to return to sports? A systematic review
title_fullStr	Which assessments are used to analyze neuromuscular control by electromyography after an anterior cruciate ligament injury to determine readiness to return to sports? A systematic review
title_full_unstemmed	Which assessments are used to analyze neuromuscular control by electromyography after an anterior cruciate ligament injury to determine readiness to return to sports? A systematic review
title_sort	which assessments are used to analyze neuromuscular control by electromyography after an anterior cruciate ligament injury to determine readiness to return to sports? a systematic review
publisher	BMC
publishDate	2021
url	https://doaj.org/article/2543d7adc6294f7d929a42091bbe1046
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Which assessments are used to analyze neuromuscular control by electromyography after an anterior cruciate ligament injury to determine readiness to return to sports? A systematic review

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