Neuromuscular adaptations to plyometric exercises in late-phase ACL reconstruction rehabilitation: A case report

Postanterior cruciate ligament (ACL) reconstruction rehabilitation poses significant challenges in restoring optimal neuromuscular function and athletic performance.This study aimed to evaluate the therapeutic efficacy of a structured plyometric exercise protocol on muscle strength, dynamic balance, and functional outcomes in young athletes who underwent ACL reconstruction. A single-case study of a 16-year-old male soccer athlete who underwent right anterior cruciate ligament (ACL) reconstruction was conducted. The intervention comprised three sessions of progressive plyometric exercises over a seven-day period. Outcomes were assessed via a modified sphygmomanometer test for muscle strength, the Y balance test for dynamic balance, and the Tegner Lysholm knee scoring scale for functional ability. Knee flexor strength improved from 50 to 100 mmHg (100% increase), and extensor strength increased from 110 to 130 mmHg (18.2% increase). The dynamic balance composite score increased from 88% to 108%. The functional performance on the Tegner-Lysholm scale improved from 90 to 95 points, primarily because of reduced pain scores. This case demonstrates that a structured plyometric exercise protocol may effectively improve muscle strength, dynamic balance, and functional performance during late-stage ACL rehabilitation. These findings suggest the potential utility of return-to-sport protocols, although large-scale investigations are warranted.