Effects of National Academy of Sports Medicine (NASM)-Based Corrective Exercises and Knee-Focused Neuromuscular Training on Return-to-Sport Tests and Lower Limb Muscle Electrical Activity in Young Volleyball Players Following Anterior Cruciate Ligament Reconstruction

Effects of National Academy of Sports Medicine (NASM)‑Based Corrective Exercise and Knee‑Oriented Neuromuscular Training on Return‑to‑Sport Performance and Lower Extremity Muscle Activity in Young Volleyball Athletes After ACL Reconstruction

A randomized clinical study, single-blind, parallel-group, 45 elderly randomized to 2 intervention groups and a control group through web-based randomization

Following physician evaluation and eligibility screening, participants provided written consent and were assigned to either an intervention or control group. In this single‑blind study, the outcome assessor was unaware of group allocation. The 8‑week program (three 60‑min sessions/week) was conducted at Kharazmi University's Movement Analysis Laboratory

Inclusion Criteria: Being within the age range of 18 to 30 years. Having a history of unilateral anterior cruciate ligament (ACL) . At least 6 months and at most 24 months having passed since the ACL reconstruction surgery. Absence of severe pain, acute inflammation, or significant range of motion limitation at the time of testing. Having adequate functional range of motion of the knee joint, particularly full functional flexion and extension. Exclusion Criteria: Bilateral ACL reconstruction or a history of ACL rupture in the contralateral limb; or meniscal tear requiring recent intervention. History of other knee surgery within the past 6 months; recent arthroscopy; or active pain/swelling that prevents participation in exercises. Neurological, cardiovascular, or metabolic diseases

Group 1: NASM corrective exercises (3 sessions per week for 8 weeks). Group 2: Knee‑focused neuromuscular training (3 sessions per week for 8 weeks). Control group: No training.

Lower limb muscle Electromyography, Return‑to‑sport functional tests

In this study, simple randomization was used to assign participants to three groups (two intervention groups and one control group). The randomization sequence was generated using SPSS statistical software and sealed envelopes were used to ensure allocation concealment. Thus, there was no bias or side effects in the group allocation process. How to create a random sequence: A list of numbers from 1 to 45 (the total number of participants) is prepared. Using a randomization tool (such as random.org or a random number table), each number is completely randomly assigned to one of three groups (A: intervention 1, B: intervention 2, C: control). Result: A random sequence such as [A, C, B, A, B, C, ...] up to 45 people. How subjects are entered: Participants are entered in the order they register (first, second, etc.). Each person is assigned based on their position in the sequence (e.g., person 1 to A, person 2 to C, etc.). To ensure concealment, the sequence is placed in sealed envelopes and opened sequentially.

In this study, the outcome assessor is blind to the groups’ randomization and interventions receiving by participants. in this way, during the evaluation before and after the intervention protocol, they do not make mistakes in their judgments in favor of a specific therapeutic intervention.

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