The Effects of Neuromuscular Training on Knee Biomechanics During Jump-Landing Among College Basketball Players Post ACL Reconstruction and Rehabilitation

Basketball players often injure the anterior cruciate ligament (ACL), a key structure that stabilizes the knee. Even after surgery and standard rehabilitation, many athletes continue to have problems with knee stability, movement control, and performance during jumping and landing. These issues increase the risk of re-injury and can limit their ability to return to competition.

Neuromuscular training (NMT) is a type of exercise program that focuses on improving balance, muscle coordination, and movement patterns. It uses activities such as jump-landing drills, balance tasks, agility exercises, and core training. Previous research shows that NMT can help athletes land more safely, reduce harmful knee movements, and improve sport performance. However, little is known about its long-term benefits in college basketball players who are more than one year post-ACL surgery.

This study aims to evaluate whether a 12-week NMT program, added to standard basketball training, can improve knee biomechanics, stability, and performance in college basketball players with a history of ACL reconstruction. Thirty participants will be randomly assigned to either an NMT group or a control group. Both groups will complete basketball training, but only the NMT group will receive the additional neuromuscular exercises.

Knee movement will be measured using 3D motion capture and force plates, and performance will be tested through vertical jumps and other sport-specific tasks. The main outcomes will include knee angles during landing, ground reaction forces, dynamic stability, and jump height.

The expected outcome is that athletes who undergo NMT will demonstrate safer landing strategies, better knee control, and improved performance compared to those who only receive standard basketball training. These findings may help coaches and healthcare providers design safer, more effective rehabilitation programs for athletes after ACL surgery.

Study Overview

• Status: Not yet recruiting
• Conditions: Knee Injuries; Athletic Performance; Physical Fitness; Basketball Players; Anterior Cruciate Ligament Reconstruction Rehabilitation; Biomechanical Data; Neuromuscular Training
• Intervention / Treatment: Behavioral: Neuromuscular Training (NMT)

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: JINFA GU, PhD candidate; Phone Number: +86 1560001310 +60 111232 608; Email: GUJINFA@student.usm.my

Study Locations

• China
  • Hebei
    • Chengde, Hebei, China, 067000
      • Chengde Medical University, Affiliated Hospital
      • Contact: Jin fa Gu, PhD; Phone Number: +86 15600013102; Email: gujinfa@student.usm.my

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:Male college basketball players

Age 18-25 years

History of anterior cruciate ligament (ACL) reconstruction surgery at least 12 months before enrollment

Cleared by physician for sports participation

Willing to provide informed consent and comply with study procedures

Exclusion Criteria:Previous ACL injury on the contralateral knee

Other major lower-limb injuries (e.g., meniscus, cartilage, fractures) in the past 12 months

Current knee pain, swelling, or instability that prevents safe participation

Neurological, cardiovascular, or systemic conditions that may affect training safety

Participation in another structured neuromuscular training program within the past 6 months

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Neuromuscular Training (NMT) plus Standard Basketball Training; Participants in this arm will receive a 12-week neuromuscular training (NMT) program in addition to their regular basketball training. The NMT program will include balance tasks, jump-landing drills, agility exercises, and core strengthening. Sessions will be conducted in parallel with standard basketball practice.	Behavioral: Neuromuscular Training (NMT); The neuromuscular training (NMT) program is a 12-week behavioral intervention performed 2-3 times per week in addition to regular basketball training. It includes balance tasks, jump-landing drills, agility exercises, and core strengthening to improve knee stability and movement control after ACL reconstruction
No Intervention: Standard Basketball Training; Participants in this arm will continue their usual basketball training program for 12 weeks without additional neuromuscular training. Training content and schedule will follow standard team practice routines. This arm will serve as a comparator to evaluate the added effect of NMT.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Peak knee valgus angle during single-leg jump-landing (degrees)	Knee valgus angle will be measured using 3D motion capture during a standardized single-leg jump-landing task. The primary endpoint is the peak knee valgus angle (°) during the landing phase, averaged across 3 successful trials.	Baseline (pre-intervention) and 12 weeks (post-intervention)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time to stabilization after landing (seconds)	Dynamic postural stability will be evaluated using force platform data during a standardized single-leg jump-landing task. The endpoint is time to stabilization (TTS, s) following landing, averaged across 3 successful trials.	Baseline (pre-intervention) and 12 weeks (post-intervention)
Center of pressure displacement after landing, medial-lateral (millimeters)	Center of pressure (COP) displacement will be quantified from force platform data during a standardized single-leg jump-landing task. The endpoint is COP displacement in the medial-lateral direction (mm), averaged across 3 successful trials.	Baseline (pre-intervention) and 12 weeks (post-intervention)
Peak knee flexion angle during single-leg jump-landing (degrees)	Peak knee flexion angle during the landing phase will be measured using 3D motion capture during a standardized single-leg jump-landing task. The endpoint is the peak knee flexion angle (°), averaged across 3 successful trials.	Baseline (pre-intervention) and 12 weeks (post-intervention)
Center of pressure displacement after landing, anterior-posterior (millimeters)	Center of pressure (COP) displacement will be quantified from force platform data during a standardized single-leg jump-landing task. The endpoint is COP displacement in the anterior-posterior direction (mm), averaged across 3 successful trials.	Baseline (pre-intervention) and 12 weeks (post-intervention)
Countermovement jump height (centimeters)	Explosive lower-limb power will be assessed using a countermovement jump (CMJ) on a force platform. The endpoint is jump height (cm) calculated from flight time, averaged across 3 successful trials.	Baseline (pre-intervention) and 12 weeks (post-intervention)
Squat jump height (centimeters)	Explosive lower-limb power will be assessed using a squat jump (SJ) on a force platform. The endpoint is jump height (cm) calculated from flight time, averaged across 3 successful trials.	Baseline (pre-intervention) and 12 weeks (post-intervention)
Knee flexion angle at initial contact during single-leg jump-landing (degrees)	Knee flexion angle at initial ground contact will be measured using 3D motion capture during a standardized single-leg jump-landing task. The endpoint is the knee flexion angle at initial contact (°), averaged across 3 successful trials.	Baseline (pre-intervention) and 12 weeks (post-intervention)
Peak vertical ground reaction force during single-leg jump-landing (Newtons)	Vertical ground reaction force (vGRF) will be measured using force platforms during a standardized single-leg jump-landing task. The endpoint is peak vGRF (N) during landing, averaged across 3 successful trials.	Baseline (pre-intervention) and 12 weeks (post-intervention)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percentage of prescribed neuromuscular training (NMT) sessions completed	Adherence will be assessed as the percentage of prescribed NMT sessions completed over the 12-week intervention period. A session will be considered completed if the participant attends and completes the full planned session.	Throughout the 12-week intervention period
Number of participants with ≥1 intervention-related adverse event	Safety will be assessed as the number of participants with ≥1 intervention-related adverse event during the 12-week intervention period.	Throughout the 12-week intervention period

Collaborators and Investigators

• Sponsor: Universiti Sains Malaysia

Study record dates

Study Major Dates

• Study Start (Estimated): December 10, 2025
• Primary Completion (Estimated): March 5, 2026
• Study Completion (Estimated): May 15, 2026

Study Registration Dates

• First Submitted: December 15, 2025
• First Submitted That Met QC Criteria: December 30, 2025
• First Posted (Estimated): January 2, 2026

Study Record Updates

• Last Update Posted (Actual): January 7, 2026
• Last Update Submitted That Met QC Criteria: January 6, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries; Leg Injuries; Knee Injuries
• Other Study ID Numbers: USM/JEPeM/KK/25030307

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No