Effectiveness of Proprioceptive and Plyometric Training on Joint Stability in Athletes Following ACL Injury v1

Background: Anterior cruciate ligament (ACL) injury is among the most common sports-related injuries and is associated with reduced joint stability, impaired functional performance, and psychological barriers to returning to sport. Although conventional physiotherapy focusing on strengthening and mobility is widely used, recent evidence suggests that proprioceptive and plyometric training may provide additional benefits by enhancing neuromuscular control, balance, and confidence. However, limited randomized controlled trials have comprehensively examined their combined effectiveness on joint stability and return-to-sport readiness in athletes following ACL injury.Objective: The purpose of this randomized controlled trial is to evaluate the effectiveness of proprioceptive and plyometric training, when combined with conventional physiotherapy, in improving joint stability, reducing pain, enhancing functional outcomes, and promoting psychological readiness for return to sport in athletes following ACL injury.Methods: A total of 62 athletes with unilateral ACL reconstruction will be recruited and randomly assigned into two groups: (i) intervention group (n = 31), receiving proprioceptive and plyometric training in addition to conventional physiotherapy, and (ii) control group (n = 31), receiving conventional physiotherapy alone. The intervention will be carried out over 8 weeks, with supervised sessions two days per week. The primary outcome will be joint stability assessed by the Star Excursion Balance Test (SEBT). Secondary outcomes will include pain measured by the Visual Analog Scale (VAS), postural control assessed by the Berg Balance Scale (BBS), knee function evaluated using the International Knee Documentation Committee (IKDC) subjective score, functional return to sport measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and psychological readiness assessed using the ACL–Return to Sport after Injury (ACL-RSI) scale. Outcomes will be measured at baseline and after the intervention.Expected Results: It is anticipated that athletes in the intervention group will demonstrate greater improvements in joint stability, pain reduction, balance, knee function, and psychological readiness compared to the control group. Proprioceptive and plyometric training are expected to enhance neuromuscular control and confidence, thereby facilitating safer and earlier return to sport.Conclusion: This study will provide valuable evidence on the role of proprioceptive and plyometric training in post-ACL rehabilitation. If effective, these approaches may be recommended as integral components of physiotherapy programs to optimize recovery, reduce re-injury risk, and improve long-term athletic performance.Keywords: ACL injury, proprioceptive training, plyometric training, joint stability, rehabilitation, SEBT, IKDC, WOMAC, ACL-RSI.