Evaluation of the Application of BOth Sides Up Ball Training Combined With Resistance Training in Joint Stability Improvement Following Anterior Cruciate Ligament Reconstruction Surgery in Teenage Athletes

Adolescent athletes participating in sports involving sudden directional changes, pivoting, and jumping frequently sustain anterior cruciate ligament (ACL) ruptures. ACL reconstruction (ACLR) surgery is often required, followed by a lengthy rehabilitation period. This study aims to evaluate the effectiveness of combining BOth Sides Up (BOSU) ball exercises with conventional resistance training in the recovery of joint stability and function after ACLR in adolescent athletes. Thirty adolescent athletes (ages 14-18) who underwent ACLR were randomly allocated to either the control group receiving traditional postoperative rehabilitation (n = 15) or the intervention group combining BOSU ball training with resistance exercises (n = 15). Joint stability, proprioception, strength, and functional outcomes were assessed before the procedure, as well as 3, 6, and 12 months after the operation using the KT-1000 arthrometer, Y-balance test, isokinetic dynamometry, and the ACL-Return to Sport after Injury ACL-Return to Sport after Injury (ACL-RSI) scale. The intervention group demonstrated notably better anterior-posterior knee joint stability (P < .05) than the control group at the 6-month and 12-month follow-ups after the surgery, greater reach distances in the Star Excursion Balance Test (P < .05), higher quadriceps and hamstring strength ratios (P < .05), and superior ACL-RSI scores (P < .01). Incorporating BOSU ball training with resistance exercises appears to be more effective than traditional rehabilitation alone in enhancing joint stability and neuromuscular control after ACLR in adolescent athletes. These results provide evidence supporting the incorporation of unstable surfaces into a comprehensive rehabilitation program to optimize recovery and safe return to sports.