The South African Journal of Physiotherapy is the official scholarly refereed journal of the South African Society of Physiotherapy. It aims to publish original research and facilitate continuing professional development for physiotherapists and other health professions both nationally and internationally.

Purpose: Anterior cruciate ligament reconstruction (ACLR) using the hamstring graft is commonly performed to restore knee stability; however, it induces significant neuromuscular and biomechanical changes, particularly in the hamstring. This study aimed to evaluate the changes in maximum effective angle, hamstring strength, and hamstring-to-quadriceps (H/Q) strength ratio at 3 and 6 months post-ACLR and compare these outcomes to a control group. Methods: This prospective controlled study included 20 ACLR patients and 20 age- and gender-matched controls. Hamstring peak torque, maximum effective angle (MEA), and the H/Q ratio were assessed using isokinetic dynamometry at 60°/s. The ACLR group was evaluated postoperatively at 3 and 6 months, while the control group underwent a single evaluation. Results: At 3 and 6 months, the ACLR group exhibited significantly lower MEA (26.3° ± 8.2 and 28.2° ± 9.4) compared to the control group (36.4° ± 12.0; p < 0.01). Hamstring peak torque and H/Q ratios were also lower in the ACLR group but showed slight improvements over time. The H/Q ratio increased significantly between 3 and 6 months (51% to 56%; p = 0.041). Conclusion: The use of hamstring graft in ACLR leads to persistent MEA and strength deficits despite rehabilitation. Advanced, targeted rehabilitation protocols are essential to address these deficits, optimize recovery, and reduce the risk of reinjury.

Background: Anterior cruciate ligament reconstruction (ACLr) often leads to asymmetries between limbs, with variable return-to-performance rates in athletes. The single-leg countermovement jump (SLCMJ) is commonly used to assess postoperative knee function. However, limited research has explored deficits specifically during the unweighting phase of the jump. Methods: This study assessed 53 recreational athletes (11 females, 42 males) between 6 and 9 months post-ACLr using a dual force plate system (1000 Hz). Each participant performed three maximal-effort SLCMJs per limb. Outcome measures included jump height, negative peak velocity, minimum force, and center of mass (COM) displacement. Paired t-tests and Wilcoxon tests were used to compare the ACLr limb with the contralateral limb. Results: Compared to the healthy limb, the ACLr limb showed significantly lower negative peak velocity (−0.80 ± 0.40 m/s vs. −0.94 ± 0.40 m/s, p < 0.001), higher minimum force (36.75 ± 17.88 kg vs. 32.05 ± 17.25 kg, p < 0.001), and reduced COM displacement (−17.62 ± 6.25 cm vs. −19.73 ± 5.34 cm, p = 0.014). Eccentric phase duration did not differ significantly. Conclusions: Athletes post-ACLr demonstrate altered neuromuscular control during the early SLCMJ phase. These findings highlight the importance of rehabilitation strategies targeting eccentric strength and symmetry restoration.

Previous studies have shown that physical activity (PA) can improve insulin sensitivity and reduce insulin resistance (IR), a key determinant of metabolic dysfunction. While the beneficial effects of PA are well-documented in adults, evidence regarding the relationship between PA intensity and insulin resistance in adolescents, particularly in North African populations, remains scarce. This study aimed to compare the effects of a 12-week school-based high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) intervention, versus usual physical education, on insulin resistance as assessed by the homeostasis model assessment of insulin resistance (HOMA-IR) in overweight and obese non-diabetic Moroccan adolescents. The study included 90 non-diabetic overweight and obese Moroccan adolescents aged 12 to 17 years. Participants were randomly assigned to three groups (HIIT, MICT, and control) within a 12-week school-based intervention. Insulin resistance was assessed using the HOMA-IR index. Linear regression models were used to examine the associations between exercise modality and HOMA-IR, adjusting for age, sex, baseline body mass index (BMI), and baseline HOMA-IR. Compared with the control group, both HIIT and MICT were associated with significant reductions in HOMA-IR. In the fully adjusted models, HIIT showed a greater decrease of −0.90 (95% CI: −1.07 to −0.72) (all p < 0.001) and MICT showed a decrease of −0.77 (95% CI: −0.94 to −0.61). Stratified analyses by BMI categories showed consistent improvements in insulin resistance for both overweight and obese adolescents. These findings suggest that school-based structured exercise interventions, particularly HIIT and MICT, independent of dietary modification, may contribute to improvements in insulin sensitivity and help reduce early metabolic risk in overweight and obese non-diabetic Moroccan adolescents. However, these results should be interpreted with caution given that dietary intake and other lifestyle factors were not strictly controlled.