Visual Utilization During Postural Control in Anterior Cruciate Ligament– Deficient and –Reconstructed Patients: Systematic Reviews and Meta-Analyses



      To determine whether anterior cruciate ligament–deficient (ACL-D) individuals and individuals with a reconstructed anterior cruciate ligament (ACL-R) rely more heavily on visual information to maintain postural control.

      Data Sources

      PubMed, CINAHL, and SPORTDiscus databases were searched from their earliest available date to May 24, 2016, using a combination of keywords.

      Study Selection

      Articles were included if they reported any instrumented static single-leg balance outcome in both a patient and control sample. The means and SDs of these outcomes must have been reported with both eyes open and eyes closed.

      Data Extraction

      Sample sizes, means, and SDs of single-leg balance measures for each group's eyes open and eyes closed testing conditions were extracted. The methodological quality of included studies was independently evaluated by multiple authors using an adapted version of the Quality Index.

      Data Synthesis

      Effect sizes were calculated by dividing the differences in change between eyes closed and eyes open in the ACL-D and control group and the ACL-R and control group by the pooled SD from the eyes closed trials for each analysis. Significant differences between the ACL-D and control group (effect size, −1.66; 95% confidence interval [CI], −2.90 to −.41) were noted. The ACL-R and control group were not different (effect size, −.61; 95% CI, −2.17 to .95).


      ACL-D individuals but not individuals with ACL-R demonstrate a greater reliance on visual information during single-leg stance compared with healthy individuals.


      List of abbreviations:

      ACL (anterior cruciate ligament), ACL-D (anterior cruciate ligament–deficient), ACL-R (anterior cruciate ligament–reconstructed), CI (confidence interval), QI (Quality Index)
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