{
  "abstract": "Background/Objectives: Residual sensorimotor deficits may persist after anterior cruciate ligament reconstruction (ACLR), even after clearance for unrestricted sport. This study compared unilateral postural control between individuals after ACLR and healthy controls under visual deprivation and cognitive dual-task conditions and examined associations between dual-task cost and time since reconstruction and return to activity. Methods: This cross-sectional study included 35 physically active adults 9–24 months after primary unilateral ACLR and 35 age-, sex-, body mass index-, and activity-matched controls. Force-platform posturography measured center-of-pressure (COP) path length, ellipse area, and mean velocity during unilateral stance with eyes open, eyes closed, and concurrent serial subtraction. COP path-length dual-task cost (DTC) was compared between groups and limbs. Correlation and multiple linear regression analyses examined associations with postoperative and return-to-activity duration. Results: Eyes-closed COP path length was greater in reconstructed limbs than in control reference limbs (720.00 ± 118.00 versus 552.00 ± 92.00 mm; p < 0.001). Reconstructed-limb DTC exceeded control reference-limb DTC (17.45 ± 10.20% versus 6.97 ± 6.80%; p < 0.001; Cohen’s d = 1.21) and contralateral-limb DTC (11.00 ± 8.40%; p < 0.001). Longer time since ACLR (r = −0.38; p = 0.024) and return to unrestricted activity (r = −0.44; p = 0.008) were associated with lower DTC. Both associations remained significant in a two-predictor regression model (adjusted R2 = 0.20). Conclusions: Postural-control differences persisted after ACLR despite clearance for unrestricted activity and were more evident under visual deprivation and cognitive loading. These cross-sectional associations support further investigation of dual-task posturography in postoperative assessment. The clinical significance and predictive value of these static posturographic measures for return-to-sport readiness and subsequent injury risk remain to be established.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopedic Surgery, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia",
    "Department of Orthopedic Surgery, College of medicine, King Saud University, Riyadh 11461, Saudi Arabia",
    "Program of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61423, Saudi Arabia",
    "Physical Therapy for Musculoskeletal Disorders and Its Surgery, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt",
    "Department of Surgery, College of Medicine, Najran University, Najran 11001, Saudi Arabia",
    "Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt",
    "Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Science, Jouf University, Sakaka 72388, Saudi Arabia",
    "Department of Physical Therapy, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Shaker Hassan S. Alshehri"
    },
    {
      "affs": [
        1
      ],
      "name": "Nizar Algarni"
    },
    {
      "affs": [
        2
      ],
      "name": "Batool Abdulelah Alkhamis"
    },
    {
      "affs": [
        2
      ],
      "name": "Ghada Mohamed Koura",
      "orcid": "0000-0002-1135-0263"
    },
    {
      "affs": [
        3
      ],
      "name": "Ahmed Mohamed Fathi Elshiwi"
    },
    {
      "affs": [
        4
      ],
      "name": "Saleh M. Kardm"
    },
    {
      "affs": [
        2
      ],
      "name": "Amal Awad Saeed Alqahtani"
    },
    {
      "affs": [
        2
      ],
      "name": "Ravi Shankar Reddy",
      "orcid": "0000-0001-6638-0585"
    },
    {
      "affs": [
        2
      ],
      "name": "Ajay Prashad Gautam",
      "orcid": "0000-0002-5004-2909"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Zeinab A. Ali"
    },
    {
      "affs": [
        7
      ],
      "name": "Maram Y. Al Ahmari"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/501wtknynbgan.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15218699",
  "fulltext_url": null,
  "id": "501wtknynbgan",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/21/8699",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-07",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/501wtknynbgan.ris",
  "sources": [
    {
      "first_seen": "2026-11-10T00:21:41Z",
      "native_id": "10.3390/jcm15218699",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/21/8699"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Residual Postural-Control Differences After Anterior Cruciate Ligament Reconstruction: Dual-Task Postural Control and Associations with Time Since Return to Sport",
  "title_text": "Residual Postural-Control Differences After Anterior Cruciate Ligament Reconstruction: Dual-Task Postural Control and Associations with Time Since Return to Sport",
  "type": "peer-reviewed",
  "updated_at": "2026-11-10T00:21:41Z",
  "url": "https://research.draconitic.com/paper/501wtknynbgan",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}