Are lower limb symmetry and self-reported symptoms associated with functional and neuromuscular outcomes in Brazilian adults with anterior cruciate ligament reconstruction? A cross-sectional study

Introduction: After anterior cruciate ligament (ACL) reconstruction, determining readiness to return to participation is challenging. The understanding of which neuromuscular performance parameters are associated with limb symmetry and self -reported symptoms may be useful to improve monitoring the rehabilitation towards adequate decision -making to return. Objectives: To compare the ACL-operated and injury -free lower limbs regarding functional performance; and to investigate whether lower limb strength and functional performance are associated with self -reported symptoms and functional lower limb symmetry. Method: Thirty-four participants were included. Functional performance was assessed by using the Y -Balance test, Single -leg Hop, and Functional Movement Screen. An isokinetic dynamometer was used to evaluate the strength levels in open and closed kinetic chains. The functional lower limb symmetry was calculated considering the single -leg hop test results for each lower limb. Results: There were no differences in dynamic balance (Y -Balance) between the operated and injury -free limbs. The operated limb presented a worst performance in the single -leg hop. Self -reported symptoms prevalence and lower limb symmetry were associated with knee extension strength and functional performance (Y -Balance). Conclusion: Individuals submitted to ACL-reconstruction presented worse functional performance in the operated limb compared to the injury -free limb. Both knee strength and dynamic balance were associated with limb symmetry and self -reported symptoms.