Test Learning Effects Influence Coordinative but Not Strength-Related Tasks in Patients Six Months After Anterior...

Background: A comprehensive rehabilitation program is recommended following anterior cruciate ligament reconstruction (ACLR) to restore function, strength and lower limb stability. Despite advancements in surgical techniques, high reinjury rates highlight the need to refine rehabilitation strategies. This study investigates performance across various physically demanding tasks and compares outcomes between the injured and uninjured leg, using a modified Back in Action (BIA) test battery. It is hypothesized that due to test learning effects patients exhibit faster improvement in coordinatively demanding tasks compared to strength-related tasks. Methods: Thirty-two patients (aged 18-40) following primary unilateral ACLR participated in a prospective cross-sectional study within the context of a larger trial. Participants completed a modified BIA test battery, including stability, countermovement jump (CMJ), drop landing, speedy jumps, and quick-feet test (QFT). Each test was conducted in three sets, with three immediate repetitions. Self-reported outcomes were also collected. Results: Patients showed significant within-session improvements in coordinative tasks, with 32% in the injured and 26% in the uninjured limb during the speedy jumps [p < 0.05]. No significant learning effects were observed in strength-related tasks (drop landing, stability test, CMJ). Patients with lower baseline performance exhibited greater improvement than patients with higher performance level from baseline. Furthermore, a correlation between self-assessed abilities and actual performance was identified. Conclusions: This study showed that improvement of coordinative tasks after Return to Sport (RTS) testing of ACLR patients are rather affected by test learning effects. In contrast, this phenomenon is not seen in strength-related tasks. Rehabilitation programs should integrate both types of exercises while considering individual baseline abilities. Tailoring rehabilitation to individual needs, establishing sport-specific rehabilitation programs and incorporating self-assessment tools can enhance patient-centered care and reduce reinjury risks.