| Abstract ID |
| 20260113 |
| Category |
| Sports Medicine: Exercise Medicine |
| Preferable Presentation |
| Oral Presentation |
| Title |
| THE "REHABILITATION ADVANTAGE": A PILOT STUDY OF SUPERIOR CUTTING MECHANICS IN POST-ACLR ATHLETES COMPARED TO HEALTHY CONTROLS DESPITE EQUIVALENT SUBJECTIVE FUNCTION |
| Author |
|
| Presenter |
| kittinad kaewkul |
| Abstract |
| Background Return-to-sport decisions following anterior cruciate ligament reconstruction (ACLR) rely on subjective scores like the International Knee Documentation Committee (IKDC) index. However, subjective tools may fail to capture latent biomechanical deficits. The Cutting Movement Assessment Score (CMAS) is a validated, field-based tool identifying aberrant movement strategies—such as dynamic knee valgus and lateral trunk lean—associated with elevated knee abduction moments and ACL injury risk. Objectives This pilot study compared objective cutting movement quality between post-ACLR athletes and healthy controls with equivalent subjective readiness (IKDC ≥90). Study Design Matched-pair comparative pilot study. Methods Eight male athletes (aged 18–35 years) were enrolled: four with unilateral ACLR (≥2 years post-surgery) and four healthy controls matched by sex, age (±3 years), and sport (all IKDC ≥90). Participants performed maximal-effort 90-degree cutting tasks recorded via multi-angle high-speed video. Two blinded raters evaluated cutting mechanics using the 9-item CMAS (0–11 scale), assessing foot contact, hip/knee/trunk alignment, and valgus control. Approach speeds were monitored to control for velocity as a confounding variable. Results Approach speeds were homogeneous (ACLR: 3.6–3.8 m/s; Control: 3.4–3.8 m/s). Contrary to hypothesis, the ACLR cohort demonstrated superior cutting mechanics. Mean CMAS scores were lower (better) in ACLR (4.0 ± 0.82, median 3.5, range 3–6) versus control (5.5 ± 1.20, median 5.0, range 4–8), representing a 1.5-point mean difference. Risk stratification revealed 50% of post-ACLR athletes demonstrated low-to-moderate risk patterns, compared to 0% in controls. Conversely, 25% of controls exhibited high-risk mechanics versus 0% of ACLR athletes. Across all matched pairs, ACLR athletes outperformed controls (mean paired difference: -1.5 points). Movement fault prevalence was substantially higher in controls: excessive knee valgus (100% vs. 50%), lateral trunk lean (75% vs. 25%), and limited knee flexion (75% vs. 25%). Conclusions Despite equivalent subjective scores, post-ACLR athletes demonstrated objectively superior cutting mechanics compared to healthy controls. This "rehabilitation advantage" is attributable to systematic neuromuscular training and movement re-education inherent in structured ACL rehabilitation. Conversely, uninjured controls exhibited widespread movement dysfunction, representing a "healthy but at-risk" population vulnerable to primary ACL injury. Subjective functional measures alone are insufficient for comprehensive return-to-sport clearance or injury risk profiling. The CMAS is a practical, field-deployable tool exposing latent movement dysfunction invisible to self-reported measures. These findings suggest healthy, untrained athletes may benefit from neuromuscular movement re-education to mitigate injury risk and optimize knee health. Clinical Implications CMAS should be integrated into return-to-sport protocols and injury prevention programs. This study supports objective movement assessment for both post-injury rehabilitation and primary prevention contexts. |