Hajouj (2020) Effects of Innovative Aquatic Proprioceptive Training on Knee Proprioception in Athletes with Anterior Cruciate Ligament Reconstruction A Randomized Controlled Trial

Aquatic Proprioceptive Training and Knee Proprioception Post-ACLR

This randomized controlled trial by Hajouj et al. investigates the impact of innovative Aquatic Proprioceptive Training (APT) on knee proprioception in athletes who underwent Anterior Cruciate Ligament Reconstruction (ACLR). The study hypothesized that incorporating APT into conventional land-based rehabilitation would yield better functional outcomes.

Study Design and Methodology

Thirty-eight male athletes, post-ACLR, participated. They were divided into two groups: the Conventional Therapy (CT) group and the Hydrotherapy (HT) group, each comprising 19 athletes. While the CT group underwent standard land-based rehabilitation for six weeks, the HT group received an additional 12 sessions of APT. Key outcomes measured included joint position sense (JPS) errors, pain levels (VAS), and International Knee Documentation Committee (IKDC) scores.

Findings and Implications

The results were significant. Improvements in proprioception, evidenced by reduced JPS errors, were more pronounced in the HT group. This group also showed greater enhancements in VAS and IKDC scores, suggesting a superior overall recovery. These findings highlight the efficacy of APT in enhancing knee proprioception and overall rehabilitation post-ACLR. The aquatic environment’s unique properties, such as buoyancy and resistance, likely contributed to these improved outcomes.


This study underscores the potential of Aquatic Proprioceptive Training as a beneficial addition to ACLR rehabilitation protocols. Given the improved proprioception and knee function observed in the HT group, APT could be a critical component in the rehabilitation of athletes post-ACLR. Its adoption in clinical practices might optimize recovery and functional outcomes in such patients.

Keywords: Aquatic Proprioceptive Training, Knee Proprioception, Athletes, Anterior Cruciate Ligament Reconstruction, Randomized Controlled Trial, Rehabilitation, Joint Position Sense, Pain Levels, International Knee Documentation Committee Scores, Hydrotherapy, Conventional Therapy, Recovery

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