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Is visual reliance increased in athletes after ACL injury? A scoping review

Brief summary, from the abstract

This scoping review found that athletes who tear their ACL appear to lean more on vision to stay balanced, though the pattern differs by treatment: ACL-deficient patients show clear balance deficits when their eyes are closed, while in ACL-reconstructed patients the problem mostly surfaces when a thinking task is added on top of the visual challenge.

  • The review synthesized 23 studies: 7 (31%) in ACL-deficient patients, 15 (65%) in ACL-reconstructed patients, and 1 (4%) in both.
  • Most studies of ACL-deficient patients showed worse postural stability with eyes closed versus uninjured controls, suggesting greater reliance on vision; complete visual obstruction (eyes closed or blindfolded) was the most common assessment method (52%).
  • In ACL-reconstructed patients, adding a visual-cognitive challenge produced significantly worse postural stability than in controls, whereas plain eyes-closed testing was less revealing.
  • This is a qualitative scoping review, so it maps the evidence rather than pooling effect sizes; the authors note the evidence for visual reliance was weaker in reconstructed than in deficient knees.
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