Study on the rehabilitation effect of SAQ training on anterior cruciate ligament injury

Study on the rehabilitation effect of SAQ training on anterior cruciate ligament injury | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Study on the rehabilitation effect of SAQ training on anterior cruciate ligament injury Huan Wang, Hanming Wang, Xiaoming Xi, Zhijiao Fan, Shuyan Qie, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8664084/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Objective: To observe the rehabilitation effect of SAQ training on knee flexion Angle, knee extension Angle, balance function and overall knee function in patients with anterior cruciate ligament injury. Methods: A total of 36 patients with anterior cruciate ligament injury who were hospitalized or treated in the outpatient department of Beijing Rehabilitation Hospital Affiliated to Capital Medical University from September 2021 to September 2024 were selected, and all patients were randomly divided into control group (n=30) and experimental group (n=30) by using digital table method. The control group received routine rehabilitation training, including joint motion training, strength training, core stability and balance/proprioceptive training; The experimental group was given SAQ training on the basis of the control group for a total of 4 weeks. The knee flexion Angle, knee extension Angle, ellipse area of pressure center movement, length of movement track and lysholm score of the two groups were compared before intervention and 4 weeks after intervention. Results: Before treatment, there were no significant differences in knee flexion Angle, knee extension Angle, balance instrument pressure center motion track length, elliptic area and lysholm score between the two groups (P > 0.05). After 4 weeks of treatment, the knee extension Angle in control group had no significant improvement compared with before treatment (P > 0.05), and no significant difference compared with experimental group (P > 0.05). Knee flexion Angle, balance instrument pressure center motion track length, elliptic area and lysholm score were significantly improved after treatment (P < 0.05), and the experimental group were significantly better than the control group (P < 0.05). Conclusion: SAQ training can effectively improve knee flexion Angle, balance function and overall knee function in patients with anterior cruciate ligament injury, and the rehabilitation effect is better than conventional rehabilitation training. However, for the improvement of the knee extension Angle, the rehabilitation effect is still controversial, which may be related to the small change of the knee extension Angle itself and the small sample size, resulting in experimental errors. The research protocol has been registered in the Chinese Clinical Trial Registry (Registration Number: ChiCTR2400085068).The registration date of the trial is May 30, 2024, and the registration institution is Beijing Rehabilitation Hospital Affiliated to Capital Medical University.“Retrospectively registered” SAQ training anterior cruciate ligament sports injuries rehabilitation Introduction Anterior cruciate ligament (ACL) injury is a common problem in the fields of sports medicine and rehabilitation medicine [ 1 ], especially in sports such as football, basketball, and track and field that require frequent knee joint movements. As a key structure that maintains the stability of the knee joint, ACL injury not only affects the patient's movement function but also may lead to long-term chronic knee instability [ 2 ], increase the risk of re-injury, and cause secondary meniscus and cartilage injuries, increasing the risk of osteoarthritis by 10 times [ 3 ]. Although surgical treatment can effectively repair the injured ACL, rehabilitation training is also very important. It can accelerate tissue repair, improve muscle strength and joint range of motion, and improve balance function [ 4 ], ultimately helping patients recover to the best functional state. However, traditional rehabilitation training programs often have problems such as long treatment duration, slow recovery, low interest, and poor effect, which cannot meet the needs of patients for a comprehensive recovery. Therefore, exploring effective rehabilitation treatment methods, stimulating patients' training enthusiasm, promoting the rapid recovery of ACL injury, reducing complications, improving the quality of life of patients, and restoring daily movement are important topics in current rehabilitation medicine research. In recent years, with the continuous advancement of rehabilitation medicine technology, SAQ (Speed, Agility, Quickness) training, as an emerging training method, has gradually gained attention. SAQ training originated in the United States in the 1980s and is mainly used in sports such as volleyball, basketball, and badminton. Its main feature is its flexibility and variability, which increases the fun of rehabilitation training [ 5 ]. The name of the SAQ training method is derived from the first letters of the three English words, namely Speed, Agility, and Quickness, whose meanings are speed, agility, and quick start ability [ 5 ]. It emphasizes that in dynamic and unstable environments, through rapid, precise, and agile movement responses, the control ability of the neuromuscular system and joint stability can be improved, thereby enhancing motor coordination, balance function, and athletic performance, and reducing the risk of sports injuries. Studies have shown that SAQ training can effectively prevent ACL injuries [ 6 ]. However, there is currently a lack of research on the rehabilitation effect of SAQ training after ACL injuries. Research indicates that SAQ training can effectively improve the neuromuscular system, thereby enhancing motor function and physical function [ 7 ]. Given that the recovery of neuromuscular control ability during the recovery process after ACL injury is crucial for improving athletic ability and preventing re-injury, this study intends to conduct a scientific and rigorous experimental design to systematically evaluate the rehabilitation effect of SAQ training on patients with ACL injuries, with the aim of providing new theoretical basis and practical methods for clinical rehabilitation practice. Materials and Methods 1.1 General Information Sixty patients with ACL injuries who were treated at Beijing Rehabilitation Hospital of Capital Medical University from September 2021 to September 2024 were selected. These patients met the clinical evidence-based guidelines for the diagnosis and treatment of anterior cruciate ligament injury (2022 edition) [8]. This study was approved by the Ethics Committee of Beijing Rehabilitation Hospital of Capital Medical University (2021bkky-037) [The ethical approval document will be uploaded as an attachment when submitted]. Our research is in line with the Helsinki Declaration.All patients signed the informed consent form.For detailed data, you can contact Wang Huan from Beijing Rehabilitation Hospital affiliated to Capital Medical University. You can contact her via email at [email protected] trial received the informed consent of the patients as well as the publication consent. Inclusion criteria: ①Age: 18-65 years old, gender not limited; ②Diagnosed with anterior cruciate ligament injury through imaging examination (MRI), and have undergone surgical repair or conservative treatment; ③Able to independently perform daily activities; ④Fully understood the research content and voluntarily signed the informed consent form. Exclusion criteria: ①Accompanied by other serious diseases, such as cardiovascular diseases, respiratory system diseases, diabetes, etc.; ②Accompanied by other serious sports injuries, such as fractures, dislocations, nerve injuries, etc.; ③Have severe psychological disorders and cannot cooperate with the study; ④Pregnant women; ⑤Undergoing other rehabilitation treatments, such as physical therapy, drug therapy, etc. Drop-out criteria: ①Patient voluntarily withdraws from the study; ②Patient is unable to complete the training plan due to personal reasons; ③Patient experiences severe adverse reactions and cannot continue the training; ④Patient has serious diseases or other accidents during the study period. Exclusion criteria: ①Patient was found not to meet the inclusion criteria before or during the study; ②Patient violated the study protocol during the study period. The patient does not consent to the public release of their personal name and specific physical indicators, so the data cannot be shared. Table 1 Comparison of Baseline Data between the Two Groups of Patients Group n Gender / n Age (years, ±s) Disease duration (months, ±s) Grade classification BMI （kg⋅m -2 ， ±s） Male/Female Control group 30 22/8 37.56±12.761 2.50±0.707 2.06±0.802 23.96±2.202 Experimental group 30 20/10 40.44±7.641 2.67±0.840 2.00±0.767 24.65±1.585 t/X² value 0.733 0.824 0.644 -0.212 -1.086 P value 0.367 0.078 0.689 0.655 0.285 The patients were divided into the control group (n = 30) and the experimental group (n = 30) using the random number table method. There were no statistically significant differences in gender, age, disease duration, BMI and Grade classification between the two groups (P > 0.05). 1.2 Methods Both groups received conventional rehabilitation training, and the experimental group additionally underwent SAQ training. 1.2.1 Conventional Rehabilitation Training The content of conventional rehabilitation training was based on the rehabilitation protocol for anterior cruciate ligament (ACL) reconstruction after injury (Rehabilitation Protocol for Anterior Cruciate Ligament (ACL) Reconstruction) issued by the Massachusetts General Hospital in the United States. It mainly included the following aspects: ① Joint range of motion training: Supine wall sliding training: Lie on your back, with your buttocks close to the wall, and extend your legs along the wall. Then, slowly slide your affected leg down along the wall to increase the knee flexion angle. 20 repetitions per set, 3 sets per session, 1 time per day. ② Strength enhancement training: Standing hamstring flexion, 20 repetitions per set, 3 sets per session, 1 time per day; Mini squats, hold onto a stable support, slightly flex the knees at about 0-30°, keep the back straight, and the knees aligned with the toes, 1 minute per set, 3 sets per session, 1 time per day; Wall squat training, 1 minute per set, 3 sets per session, 1 time per day, with the angle increasing from small to large (starting from 30°). ③ Strengthening exercises for the lumbar-pelvic region: Bridge exercise, lift the buttocks upwards, with the shoulders, hips, and knees in a straight line. Raise to the highest point and consciously contract the gluteal muscles for 2 seconds, feeling the glutes being tightened; Side-lying hip external rotation clamping exercise, 20 repetitions per set, 3 sets per session, 1 time per day. ④ Balance training: Single-leg standing training, keep the knee joint of the supporting leg slightly flexed, do not lock it, each side for 30 seconds as 1 set, 3 sets per session, 1 time per day; ⑤ Proprioceptive training: Stand on a balance pad and maintain stability. Each training session lasted approximately 60 minutes, with an interval of 1 minute between each movement training, 1 time per day, 5 days per week, for 4 consecutive weeks. The rehabilitation therapists all received the same professional training before the trial and were able to master the training content proficiently. 1.2.2 SAQ Training The content of the SAQ training is based on the graduation thesis "Research on the Impact of SAQ Training on the Quick Directional Movement Ability of Male Students in Senior Two Football Option Class" by Wang Shun'an from Yangzhou University [9]. It mainly includes the following aspects: ① Triangle Movement Training: Set up a 4-6-meter equilateral triangle with a marker disc, with the three vertices being points A, B, and C, and the starting point set at the center O of the triangle. The movement preparation posture (feet slightly wider than the shoulders, knees slightly bent, center of gravity on the front foot sole). Actions: O→A: Sprint forward to point A; A→B: Sideways sliding (keep facing the same direction, do not cross-step and turn); B→C: Backward running (keep body control, do not fully turn) to point C; C→O: Sprint forward back to the center O. 5 laps per set, 3 sets per session, 1 session per day, with 30 seconds of rest between sets. Notes: Always remind to keep the buttocks lowered, like sitting on a chair when moving; Start adjusting the foot position and body orientation 1-2 steps before reaching the apex, integrating the directional change movement into the deceleration step. ② Directional Sprint Jump Training (Hexagonal Jump): Mark a square with a side length of 50 centimeters with tape, with the six vertices marked as points A, B, C, D, E, and F. Set point A as the starting point, perform rapid double-foot jumps along the six sides, in the order of A→B→C→D→E→F, aiming for a balance between speed and stability. 3 laps per set, 3 sets per session, 1 session per day, with 30 seconds of rest between sets. The SAQ training lasts approximately 15 minutes each time, 1 session per day, 5 days per week, for 4 consecutive weeks. Before the formal training, professional guidance and explanations are provided by professionals. The professionals are all members of the SAQ training group, have received the same professional training, are proficient in the theoretical knowledge and clinical practice of SAQ training, and are aware of the training precautions. 1.3 Efficacy Evaluation A score of 85 or above indicates that the knee joint function can be restored to normal; a score of 70 to 84 indicates that the knee joint function is good, but there are still certain limitations and discomfort; a score of 56 to 69 indicates that the knee joint function is poor, and further treatment and rehabilitation are needed; a score of 55 or below indicates that the knee joint function is very poor, and active treatment is required. 1.4 Statistical Analysis Data processing was conducted using SPSS 21.0 statistical software. All measurement data followed a normal distribution and were expressed as (x̄ ± s). Within-group comparisons and between-group comparisons were performed using paired t-test and independent sample t-test, respectively. The significance level was α= 0.05. 2 Results Before treatment, there were no significant differences in the knee joint flexion and extension angles, the movement trajectory length of the pressure center on the balance instrument, the elliptical area, and the Lysholm score between the two groups (P > 0.05). In terms of knee joint extension angle, there was no significant improvement before and after treatment in the control group (P > 0.05), and there was no significant difference between the two groups after treatment (P > 0.05); all other outcome indicators showed significant improvements after treatment (P < 0.05), and the experimental group was significantly better than the control group (P < 0.05). See Tables 2-4. Table 2 Knee flexion and extension angles before and after treatment in both groups Group n Knee joint flexion angle Knee joint extension angle Before treatment After treatment t P Before treatment After treatment t P Experimental group 30 85.56±15.136 123.33±12.005 9.950 ＜0.001 -4.72±6.524 -0.56±1.617 3.220 0.0050 Control group 30 90.56±13.921 112.50±10.467 8.464 ＜0.001 -1.11±6.077 -0.83±3.536 0.3249 0.7492 t 1.032 2.886 1.718 0.3031 P 0.3096 0.0067 0.0948 0.7636 Table 3 Changes in elliptical area and trajectory length before and after treatment in both groups Group n The area of an elliptical shape Length of the movement trajectory Before treatment After treatment t P Before treatment After treatment t P Experimental group 30 348.61±156.977 149.67±100.214 6.053 ＜0.001 362.72±148.282 201.39±68.233 4.186 ＜0.001 Control group 30 472.83±230.041 322.83±147.346 5.398 ＜0.001 400.50±122.183 308.72±83.933 4.055 ＜0.001 t 1.892 4.123 0.8342 4.210 P 0.0670 ＜0.001 0.4100 ＜0.001 Table 4 Lysholm Scores Before and After Treatment in Both Groups Group n Lysholm Score Before treatment After treatment t P Experimental group 130 37.17±13.426 79.06±13.554 14.55 ＜0.001 Control group 30 36.72±13.851 66.06±9.471 14.19 ＜0.001 t 0.0978 3.336 P 0.9227 0.0021 Discussion Recent studies [ 10 ] have shown that SAQ training can significantly enhance the anaerobic performance of football players, which is closely related to the strengthening of the phosphagen system and glycolytic system. This study also emphasizes that SAQ training can make up for the deficiencies in key athletic qualities such as explosive power, agility, and speed endurance in traditional training, thereby providing effective support for the improvement of football players' competitive performance. Although SAQ training has begun to be used to enhance the anaerobic capacity of athletes, it is currently more commonly applied to improving the agility, coordination, and rapid movement abilities of athletes [ 11 – 19 ]. After ACL injury, patients' agility, coordination, and rapid movement abilities decline, resulting in restricted movement function [ 20 , 21 ], often failing to achieve the goal of restoring daily exercise and fitness, which will not effectively improve the patient's quality of life. Deceleration cutting, side-step rotation, and landing with jumping are the main causes of ACL injury [ 22 ]. At this vulnerable knee joint position, ACL will become overly tense due to its inability to effectively stabilize the knee joint. From the characteristics of SAQ training, the mechanism of ACL injury, and the characteristics of the decline in movement function after ACL injury, SAQ training may effectively improve the movement function after ACL injury. Previous studies [ 6 ] have shown that SAQ training can effectively prevent ACL injury in women, believing that it is related to enhancing the activity of the hamstring muscles, improving neuromuscular control ability, and knee joint stability. The results of this study show that SAQ training can effectively expand the knee joint flexion range of motion after ACL injury, improve balance function and overall knee joint function, thereby enhancing the movement ability of patients with ACL injury, and the effect is superior to that of the control group.The results of this study show that SAQ training can effectively expand the knee joint flexion range of motion after ACL injury, improve balance function and overall knee joint function, thereby enhancing the movement ability of patients with ACL injury, and the effect is superior to that of the control group. The agility training in SAQ has been recommended to improve the activation of the hamstring muscles, enabling the muscles to respond more quickly to the joint disturbance caused by anterior displacement of the tibia, thereby enhancing neuromuscular control and dynamic stability of the knee joint [ 23 ]. This may be an important mechanism by which SAQ training improves the functional level after ACL injury. In this study, the improvement of balance function in the experimental group was significantly better than that in the control group. The mechanism may be related to the improvement of muscle function, nerve function, vestibular and proprioceptive functions. After ACL injury, local mechanoreceptors are damaged, and the resulting inflammatory cascade changes originate from the neural input activities in the tissues around the joint [ 24 ]. The interruption of reflexive (i.e., joint-originated muscle inhibition) and sensory (i.e., proprioceptive impairment) input, theoretically, can inhibit the neural plasticity of ACL injury patients [ 25 ]. Importantly, sensory-motor plasticity is conducive to changes in pre-motor and motor brain regions, motor control, and knee joint muscle function, which may increase the rate of ACL re-injury and induce knee joint diseases [ 26 ]. The study found [ 9 ] that the action patterns of SAQ training can enhance the plasticity and flexibility of the cerebral cortex. This is related to the enhancement of the signal transmission rate of neurons, spatial sense of movement, movement response, and motor skills, thereby promoting correct body posture and balance maintenance [ 27 ], and helping to prevent ACL re-injury and secondary knee joint diseases. Core control ability is important in movement as it provides a stable foundation for distal segment movement. These core muscles, including trunk and pelvic muscles, are known to be activated before the initial movement of the limbs and can provide proximal stability for distal activities [ 28 ]. Moreover, core stability may help to reduce the risk of ACL injury [ 29 ]. A 3-year prospective study [ 31 ] showed that athletes with poor core stability were more likely to suffer from ACL tears. Additionally, participants with lower core strength had poorer ability to resist the internal rotation torque of the hip joint, which led to excessive external rotation of the knee joint during weight-bearing movements. The above literature indicates that by changing the biomechanical risk factors associated with non-contact ACL injury, strengthening the core muscle group can help reduce the risk of ACL injury in athletes. SAQ training requires the stable participation of core muscles, thereby strengthening the strength and coordination of core muscles such as abdominal and back muscles, improving the stability of the trunk, providing support for the balance of the limbs [ 32 – 34 ], and effectively preventing the occurrence of secondary injuries. Another study [ 35 ] found that SAQ training can also strengthen the input stimulation of sensory centers such as vision, enhance vestibular function, and achieve better dynamic balance. The rapid movements such as jumping and changing direction in SAQ training can stimulate proprioceptors, thus improving the perception of joint position, movement, and force, thereby enhancing neuromuscular control [ 36 , 37 ]. Moreover, SAQ training can promote the correct activation pattern of lower limb muscles and also play a role in maintaining balance [ 38 ]. It can effectively activate the quadriceps femoris, especially the medial rectus muscle, and the enhancement of its strength helps stabilize the patella, reduces activity limitation caused by abnormal patellar movement, and thereby improves joint range of motion and flexibility. Additionally, the neuromuscular control and proprioceptive function mentioned above have a good promoting effect on the improvement of joint range of motion. However, in this study, the impact of SAQ training on the knee extension angle of ACL injury patients is still controversial. This may be related to the relatively small change in knee extension angle itself and the small sample size, resulting in experimental errors. In conclusion, SAQ training can effectively improve the knee flexion range of motion, balance function, and motor ability of patients with ACL injury. However, the impact on knee extension angle still requires further large-sample studies. Moreover, future research can adopt techniques such as surface electromyography, three-dimensional gait analysis, and interference running platforms to evaluate the rehabilitation effect of SAQ training on ACL injury, further revealing its potential mechanism. The research protocol has been registered in the Chinese Clinical Trial Registry (Registration Number: ChiCTR2400085068). Abbreviations ACL (anterior cruciate ligament); SA (Speed, Agility, Quickness) Declarations This study was approved by the Ethics Committee of Beijing Rehabilitation Hospital Affiliated to Capital Medical University (2021bkky-037) This study received informed consent from all participants. If this research is accepted by your journal, we will agree to have the paper published. Conflict of Interest Declaration: All authors declare no conflict of interest. This study was funded by the Special Research Fund of Beijing Rehabilitation Hospital Affiliated to Capital Medical University (2021-003). Author Contributions: Wang Huan is responsible for the writing of the manuscript, data collection and processing; Wang Hanming reviews the manuscript; Xi Xiaoming, Fan Zhijiao, Qi Shuyan and Li Nan are responsible for the evaluation, collection and processing of data. 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Identification of anterior cruciate ligament fibroblasts and their contribution to knee osteoarthritis progression using single-cell analyses [J]. Int Immunopharmacol, 2023, 125(Pt A): 111109. MANCINO F, GABR A, PLASTOW R, et al. Anterior cruciate ligament injuries in female athletes [J]. Bone Joint J, 2023, 105-b(10): 1033-7. DIERMEIER T, ROTHRAUFF B B, ENGEBRETSEN L, et al. Treatment after anterior cruciate ligament injury: Panther Symposium ACL Treatment Consensus Group [J]. Knee Surg Sports Traumatol Arthrosc, 2020, 28(8): 2390-402. STONE A V, MARX S, CONLEY C W. Management of Partial Tears of the Anterior Cruciate Ligament: A Review of the Anatomy, Diagnosis, and Treatment [J]. J Am Acad Orthop Surg, 2021, 29(2): 60-70. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 06 Apr, 2026 Reviewers agreed at journal 03 Apr, 2026 Reviewers invited by journal 01 Apr, 2026 Editor invited by journal 05 Mar, 2026 Editor assigned by journal 09 Feb, 2026 Submission checks completed at journal 09 Feb, 2026 First submitted to journal 09 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8664084","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":617413204,"identity":"faaa7ab4-c339-4619-be42-ea7ac123ac75","order_by":0,"name":"Huan Wang","email":"","orcid":"","institution":"Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Huan","middleName":"","lastName":"Wang","suffix":""},{"id":617413205,"identity":"99309341-3c9f-466d-a37f-af3ab21242cc","order_by":1,"name":"Hanming Wang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/UlEQVRIiWNgGAWjYJACZhDBxsDA+OBDhQ0PP38D8VqYDWecSZORnHGASC0gXcKcLYdtDBoS8Cs3OH728OuCmjvRfNLt15gZG87zGDAcYPzwMQePljN5adYzjj3LbZM5U/a4cMdtHnPmBmbJmdtwazE7kGNmzMN2OLdNIifdeOaZ2zyWDQfYmHnxaTn/BqjlH1hLmjRv2zkegwMJBLTcyDF+zNsG0pJ+DKjlAGEt9jfemDHz9oFtAQVyMo/kjIPNeP0i2Z9j/Jnn2+Hc+TPSHwKj0s6en7/54IePeLQAAZsEhAYGLwQwNuBVDwTMHyA0+wNCKkfBKBgFo2CEAgCFdVhmG2jJUQAAAABJRU5ErkJggg==","orcid":"","institution":"Capital Medical University","correspondingAuthor":true,"prefix":"","firstName":"Hanming","middleName":"","lastName":"Wang","suffix":""},{"id":617413206,"identity":"13fea941-1bd4-4518-977c-3a27f8ea9c05","order_by":2,"name":"Xiaoming Xi","email":"","orcid":"","institution":"Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Xiaoming","middleName":"","lastName":"Xi","suffix":""},{"id":617413207,"identity":"77882fad-b094-4f3b-99b7-f81ad6005f6c","order_by":3,"name":"Zhijiao Fan","email":"","orcid":"","institution":"Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Zhijiao","middleName":"","lastName":"Fan","suffix":""},{"id":617413208,"identity":"e9f2620b-f94e-463e-90cf-4d095a332a56","order_by":4,"name":"Shuyan Qie","email":"","orcid":"","institution":"Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Shuyan","middleName":"","lastName":"Qie","suffix":""},{"id":617413209,"identity":"855a7227-3883-4af0-8431-39d2698d4dbd","order_by":5,"name":"Nan Li","email":"","orcid":"","institution":"Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Nan","middleName":"","lastName":"Li","suffix":""}],"badges":[],"createdAt":"2026-01-22 01:08:43","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8664084/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8664084/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106415086,"identity":"076caea7-905e-43fb-9240-d128293add15","added_by":"auto","created_at":"2026-04-08 10:32:48","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":387162,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8664084/v1/7e9411f1-1d18-4832-aa08-de23bf71f0fc.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Study on the rehabilitation effect of SAQ training on anterior cruciate ligament injury","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAnterior cruciate ligament (ACL) injury is a common problem in the fields of sports medicine and rehabilitation medicine [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], especially in sports such as football, basketball, and track and field that require frequent knee joint movements. As a key structure that maintains the stability of the knee joint, ACL injury not only affects the patient's movement function but also may lead to long-term chronic knee instability [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], increase the risk of re-injury, and cause secondary meniscus and cartilage injuries, increasing the risk of osteoarthritis by 10 times [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Although surgical treatment can effectively repair the injured ACL, rehabilitation training is also very important. It can accelerate tissue repair, improve muscle strength and joint range of motion, and improve balance function [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], ultimately helping patients recover to the best functional state. However, traditional rehabilitation training programs often have problems such as long treatment duration, slow recovery, low interest, and poor effect, which cannot meet the needs of patients for a comprehensive recovery. Therefore, exploring effective rehabilitation treatment methods, stimulating patients' training enthusiasm, promoting the rapid recovery of ACL injury, reducing complications, improving the quality of life of patients, and restoring daily movement are important topics in current rehabilitation medicine research.\u003c/p\u003e \u003cp\u003eIn recent years, with the continuous advancement of rehabilitation medicine technology, SAQ (Speed, Agility, Quickness) training, as an emerging training method, has gradually gained attention. SAQ training originated in the United States in the 1980s and is mainly used in sports such as volleyball, basketball, and badminton. Its main feature is its flexibility and variability, which increases the fun of rehabilitation training [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The name of the SAQ training method is derived from the first letters of the three English words, namely Speed, Agility, and Quickness, whose meanings are speed, agility, and quick start ability [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. It emphasizes that in dynamic and unstable environments, through rapid, precise, and agile movement responses, the control ability of the neuromuscular system and joint stability can be improved, thereby enhancing motor coordination, balance function, and athletic performance, and reducing the risk of sports injuries.\u003c/p\u003e \u003cp\u003eStudies have shown that SAQ training can effectively prevent ACL injuries [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. However, there is currently a lack of research on the rehabilitation effect of SAQ training after ACL injuries. Research indicates that SAQ training can effectively improve the neuromuscular system, thereby enhancing motor function and physical function [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Given that the recovery of neuromuscular control ability during the recovery process after ACL injury is crucial for improving athletic ability and preventing re-injury, this study intends to conduct a scientific and rigorous experimental design to systematically evaluate the rehabilitation effect of SAQ training on patients with ACL injuries, with the aim of providing new theoretical basis and practical methods for clinical rehabilitation practice.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e1.1 General Information\u003c/p\u003e\n\u003cp\u003eSixty patients with ACL injuries who were treated at Beijing Rehabilitation Hospital of Capital Medical University from September 2021 to September 2024 were selected. These patients met the clinical evidence-based guidelines for the diagnosis and treatment of anterior cruciate ligament injury (2022 edition) [8]. This study was approved by the Ethics Committee of Beijing Rehabilitation Hospital of Capital Medical University (2021bkky-037) [The ethical approval document will be uploaded as an attachment when submitted]. Our research is in line with the Helsinki Declaration.All patients signed the informed consent form.For detailed data, you can contact Wang Huan from Beijing Rehabilitation Hospital affiliated to Capital Medical University. You can contact her via email at [email protected] trial received the informed consent of the patients as well as the publication consent.\u003c/p\u003e\n\u003cp\u003eInclusion criteria: ①Age: 18-65 years old, gender not limited; ②Diagnosed with anterior cruciate ligament injury through imaging examination (MRI), and have undergone surgical repair or conservative treatment; ③Able to independently perform daily activities; ④Fully understood the research content and voluntarily signed the informed consent form.\u003c/p\u003e\n\u003cp\u003eExclusion criteria: ①Accompanied by other serious diseases, such as cardiovascular diseases, respiratory system diseases, diabetes, etc.; ②Accompanied by other serious sports injuries, such as fractures, dislocations, nerve injuries, etc.; ③Have severe psychological disorders and cannot cooperate with the study; ④Pregnant women; ⑤Undergoing other rehabilitation treatments, such as physical therapy, drug therapy, etc.\u003c/p\u003e\n\u003cp\u003eDrop-out criteria: ①Patient voluntarily withdraws from the study; ②Patient is unable to complete the training plan due to personal reasons; ③Patient experiences severe adverse reactions and cannot continue the training; ④Patient has serious diseases or other accidents during the study period.\u003c/p\u003e\n\u003cp\u003eExclusion criteria: ①Patient was found not to meet the inclusion criteria before or during the study; ②Patient violated the study protocol during the study period.\u003c/p\u003e\n\u003cp\u003eThe patient does not consent to the public release of their personal name and specific physical indicators, so the data cannot be shared.\u003c/p\u003e\n\u003cp\u003eTable 1 Comparison of Baseline Data between the Two Groups of Patients\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"642\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;Gender / \u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 117px;\"\u003e\n \u003cp\u003eAge (years, \u0026plusmn;s)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 112px;\"\u003e\n \u003cp\u003eDisease duration (months, \u0026plusmn;s)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 112px;\"\u003e\n \u003cp\u003eGrade classification\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 112px;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003cp\u003e（kg\u0026sdot;m\u003csup\u003e-2\u003c/sup\u003e，\u003cimg width=\"13\" height=\"23\" src=\"data:image/wmf;base64,R0lGODlhFAAiAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAQABgANABYAhQAAAAAAAB0dAB0AAAAdHQAAHQAAMwAdMgAcSB0zWgAzWh1GbDMAADIdADMzWzNGbjNbgEgcAFozHVozAFszM1tINV1GXUhZf1tuSF1/f0huf1luf2xGHW5GRn9uSH9uWX9/XW5uWWaIiIBbM4BuboiIZgECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwECAwY9wIBwSAwAjsikcslsOp/QqHRKpVYEC6QkkEAOhIZjRKhYGiXPAAHKkBagjUD2OXB6kOHkRMkJPJRGSXVJQQA7\" v:shapes=\"_x0000_i1025\" alt=\"image\"\u003e\u0026plusmn;s）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003eMale/Female\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003eControl group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e22/8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e37.56\u0026plusmn;12.761\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e2.50\u0026plusmn;0.707\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e2.06\u0026plusmn;0.802\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e23.96\u0026plusmn;2.202\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003eExperimental group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e20/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e40.44\u0026plusmn;7.641\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e2.67\u0026plusmn;0.840\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.767\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e24.65\u0026plusmn;1.585\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cem\u003et/X\u0026sup2;\u003c/em\u003e value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.733\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e0.824\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e0.644\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e-0.212\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e-1.086\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.367\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e0.078\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e0.689\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e0.655\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e0.285\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;The patients were divided into the control group (n = 30) and the experimental group (n = 30) using the random number table method. There were no statistically significant differences in gender, age, disease duration, BMI and Grade classification between the two groups (P \u0026gt; 0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1.2 Methods\u003c/p\u003e\n\u003cp\u003eBoth groups received conventional rehabilitation training, and the experimental group additionally underwent SAQ training.\u003c/p\u003e\n\u003cp\u003e1.2.1 Conventional Rehabilitation Training\u003c/p\u003e\n\u003cp\u003eThe content of conventional rehabilitation training was based on the rehabilitation protocol for anterior cruciate ligament (ACL) reconstruction after injury (Rehabilitation Protocol for Anterior Cruciate Ligament (ACL) Reconstruction) issued by the Massachusetts General Hospital in the United States. It mainly included the following aspects: ① Joint range of motion training: Supine wall sliding training: Lie on your back, with your buttocks close to the wall, and extend your legs along the wall. Then, slowly slide your affected leg down along the wall to increase the knee flexion angle. 20 repetitions per set, 3 sets per session, 1 time per day. ② Strength enhancement training: Standing hamstring flexion, 20 repetitions per set, 3 sets per session, 1 time per day; Mini squats, hold onto a stable support, slightly flex the knees at about 0-30\u0026deg;, keep the back straight, and the knees aligned with the toes, 1 minute per set, 3 sets per session, 1 time per day; Wall squat training, 1 minute per set, 3 sets per session, 1 time per day, with the angle increasing from small to large (starting from 30\u0026deg;). ③ Strengthening exercises for the lumbar-pelvic region: Bridge exercise, lift the buttocks upwards, with the shoulders, hips, and knees in a straight line. Raise to the highest point and consciously contract the gluteal muscles for 2 seconds, feeling the glutes being tightened; Side-lying hip external rotation clamping exercise, 20 repetitions per set, 3 sets per session, 1 time per day. ④ Balance training: Single-leg standing training, keep the knee joint of the supporting leg slightly flexed, do not lock it, each side for 30 seconds as 1 set, 3 sets per session, 1 time per day; ⑤ Proprioceptive training: Stand on a balance pad and maintain stability. Each training session lasted approximately 60 minutes, with an interval of 1 minute between each movement training, 1 time per day, 5 days per week, for 4 consecutive weeks. The rehabilitation therapists all received the same professional training before the trial and were able to master the training content proficiently.\u003c/p\u003e\n\u003cp\u003e1.2.2 SAQ Training\u003c/p\u003e\n\u003cp\u003eThe content of the SAQ training is based on the graduation thesis \u0026quot;Research on the Impact of SAQ Training on the Quick Directional Movement Ability of Male Students in Senior Two Football Option Class\u0026quot; by Wang Shun\u0026apos;an from Yangzhou University [9]. It mainly includes the following aspects: ① Triangle Movement Training: Set up a 4-6-meter equilateral triangle with a marker disc, with the three vertices being points A, B, and C, and the starting point set at the center O of the triangle. The movement preparation posture (feet slightly wider than the shoulders, knees slightly bent, center of gravity on the front foot sole). Actions: O\u0026rarr;A: Sprint forward to point A; A\u0026rarr;B: Sideways sliding (keep facing the same direction, do not cross-step and turn); B\u0026rarr;C: Backward running (keep body control, do not fully turn) to point C; C\u0026rarr;O: Sprint forward back to the center O. 5 laps per set, 3 sets per session, 1 session per day, with 30 seconds of rest between sets. Notes: Always remind to keep the buttocks lowered, like sitting on a chair when moving; Start adjusting the foot position and body orientation 1-2 steps before reaching the apex, integrating the directional change movement into the deceleration step. ② Directional Sprint Jump Training (Hexagonal Jump): Mark a square with a side length of 50 centimeters with tape, with the six vertices marked as points A, B, C, D, E, and F. Set point A as the starting point, perform rapid double-foot jumps along the six sides, in the order of A\u0026rarr;B\u0026rarr;C\u0026rarr;D\u0026rarr;E\u0026rarr;F, aiming for a balance between speed and stability. 3 laps per set, 3 sets per session, 1 session per day, with 30 seconds of rest between sets. The SAQ training lasts approximately 15 minutes each time, 1 session per day, 5 days per week, for 4 consecutive weeks. Before the formal training, professional guidance and explanations are provided by professionals. The professionals are all members of the SAQ training group, have received the same professional training, are proficient in the theoretical knowledge and clinical practice of SAQ training, and are aware of the training precautions.\u003c/p\u003e\n\u003cp\u003e1.3 Efficacy Evaluation A score of 85 or above indicates that the knee joint function can be restored to normal; a score of 70 to 84 indicates that the knee joint function is good, but there are still certain limitations and discomfort; a score of 56 to 69 indicates that the knee joint function is poor, and further treatment and rehabilitation are needed; a score of 55 or below indicates that the knee joint function is very poor, and active treatment is required.\u003c/p\u003e\n\u003cp\u003e1.4 Statistical Analysis\u003c/p\u003e\n\u003cp\u003eData processing was conducted using SPSS 21.0 statistical software. All measurement data followed a normal distribution and were expressed as (x̄ \u0026plusmn; s). Within-group comparisons and between-group comparisons were performed using paired t-test and independent sample t-test, respectively. The significance level was \u0026alpha;= 0.05.\u003c/p\u003e\n\u003cp\u003e2 Results\u003c/p\u003e\n\u003cp\u003eBefore treatment, there were no significant differences in the knee joint flexion and extension angles, the movement trajectory length of the pressure center on the balance instrument, the elliptical area, and the Lysholm score between the two groups (P \u0026gt; 0.05). In terms of knee joint extension angle, there was no significant improvement before and after treatment in the control group (P \u0026gt; 0.05), and there was no significant difference between the two groups after treatment (P \u0026gt; 0.05); all other outcome indicators showed significant improvements after treatment (P \u0026lt; 0.05), and the experimental group was significantly better than the control group (P \u0026lt; 0.05). See Tables 2-4.\u003c/p\u003e\n\u003cp\u003eTable 2 \u0026nbsp;Knee flexion and extension angles before and after treatment in both groups\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"557\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 67px;\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 43px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eKnee joint flexion angle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eKnee joint extension angle\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eBefore treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eAfter treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003eBefore treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003eAfter treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003eExperimental group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e85.56\u0026plusmn;15.136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e123.33\u0026plusmn;12.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e9.950\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e-4.72\u0026plusmn;6.524\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-0.56\u0026plusmn;1.617\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e3.220\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.0050\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003eControl group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e90.56\u0026plusmn;13.921\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e112.50\u0026plusmn;10.467\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e8.464\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e-1.11\u0026plusmn;6.077\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-0.83\u0026plusmn;3.536\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.3249\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.7492\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.032\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2.886\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e1.718\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.3031\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.3096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.0067\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.0948\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.7636\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;Table 3 \u0026nbsp;Changes in elliptical area and trajectory length before and after treatment in both groups\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"557\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 67px;\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 43px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 219px;\"\u003e\n \u003cp\u003eThe area of an elliptical shape\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eLength of the movement trajectory\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eBefore treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eAfter treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003eBefore treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003eAfter treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003eExperimental group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e348.61\u0026plusmn;156.977\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e149.67\u0026plusmn;100.214\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e6.053\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e362.72\u0026plusmn;148.282\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e201.39\u0026plusmn;68.233\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e4.186\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003eControl group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e472.83\u0026plusmn;230.041\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e322.83\u0026plusmn;147.346\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e5.398\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e400.50\u0026plusmn;122.183\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e308.72\u0026plusmn;83.933\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e4.055\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.892\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e4.123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.8342\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e4.210\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0670\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.4100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 4 \u0026nbsp;Lysholm Scores Before and After Treatment in Both Groups\u003c/p\u003e\n\u003cdiv align=\"Left\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"342\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 67px;\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 43px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 232px;\"\u003e\n \u003cp\u003eLysholm Score\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eBefore treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eAfter treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003eExperimental group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e37.17\u0026plusmn;13.426\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e79.06\u0026plusmn;13.554\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e14.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003eControl group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e36.72\u0026plusmn;13.851\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e66.06\u0026plusmn;9.471\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e14.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0978\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3.336\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.9227\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.0021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n"},{"header":"Discussion","content":"\u003cp\u003eRecent studies [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] have shown that SAQ training can significantly enhance the anaerobic performance of football players, which is closely related to the strengthening of the phosphagen system and glycolytic system. This study also emphasizes that SAQ training can make up for the deficiencies in key athletic qualities such as explosive power, agility, and speed endurance in traditional training, thereby providing effective support for the improvement of football players' competitive performance. Although SAQ training has begun to be used to enhance the anaerobic capacity of athletes, it is currently more commonly applied to improving the agility, coordination, and rapid movement abilities of athletes [\u003cspan additionalcitationids=\"CR12 CR13 CR14 CR15 CR16 CR17 CR18\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. After ACL injury, patients' agility, coordination, and rapid movement abilities decline, resulting in restricted movement function [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], often failing to achieve the goal of restoring daily exercise and fitness, which will not effectively improve the patient's quality of life. Deceleration cutting, side-step rotation, and landing with jumping are the main causes of ACL injury [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. At this vulnerable knee joint position, ACL will become overly tense due to its inability to effectively stabilize the knee joint. From the characteristics of SAQ training, the mechanism of ACL injury, and the characteristics of the decline in movement function after ACL injury, SAQ training may effectively improve the movement function after ACL injury. Previous studies [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] have shown that SAQ training can effectively prevent ACL injury in women, believing that it is related to enhancing the activity of the hamstring muscles, improving neuromuscular control ability, and knee joint stability.\u003c/p\u003e \u003cp\u003eThe results of this study show that SAQ training can effectively expand the knee joint flexion range of motion after ACL injury, improve balance function and overall knee joint function, thereby enhancing the movement ability of patients with ACL injury, and the effect is superior to that of the control group.The results of this study show that SAQ training can effectively expand the knee joint flexion range of motion after ACL injury, improve balance function and overall knee joint function, thereby enhancing the movement ability of patients with ACL injury, and the effect is superior to that of the control group. The agility training in SAQ has been recommended to improve the activation of the hamstring muscles, enabling the muscles to respond more quickly to the joint disturbance caused by anterior displacement of the tibia, thereby enhancing neuromuscular control and dynamic stability of the knee joint [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. This may be an important mechanism by which SAQ training improves the functional level after ACL injury.\u003c/p\u003e \u003cp\u003eIn this study, the improvement of balance function in the experimental group was significantly better than that in the control group. The mechanism may be related to the improvement of muscle function, nerve function, vestibular and proprioceptive functions. After ACL injury, local mechanoreceptors are damaged, and the resulting inflammatory cascade changes originate from the neural input activities in the tissues around the joint [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The interruption of reflexive (i.e., joint-originated muscle inhibition) and sensory (i.e., proprioceptive impairment) input, theoretically, can inhibit the neural plasticity of ACL injury patients [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Importantly, sensory-motor plasticity is conducive to changes in pre-motor and motor brain regions, motor control, and knee joint muscle function, which may increase the rate of ACL re-injury and induce knee joint diseases [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. The study found [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] that the action patterns of SAQ training can enhance the plasticity and flexibility of the cerebral cortex. This is related to the enhancement of the signal transmission rate of neurons, spatial sense of movement, movement response, and motor skills, thereby promoting correct body posture and balance maintenance [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], and helping to prevent ACL re-injury and secondary knee joint diseases. Core control ability is important in movement as it provides a stable foundation for distal segment movement. These core muscles, including trunk and pelvic muscles, are known to be activated before the initial movement of the limbs and can provide proximal stability for distal activities [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Moreover, core stability may help to reduce the risk of ACL injury [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. A 3-year prospective study [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] showed that athletes with poor core stability were more likely to suffer from ACL tears. Additionally, participants with lower core strength had poorer ability to resist the internal rotation torque of the hip joint, which led to excessive external rotation of the knee joint during weight-bearing movements. The above literature indicates that by changing the biomechanical risk factors associated with non-contact ACL injury, strengthening the core muscle group can help reduce the risk of ACL injury in athletes. SAQ training requires the stable participation of core muscles, thereby strengthening the strength and coordination of core muscles such as abdominal and back muscles, improving the stability of the trunk, providing support for the balance of the limbs [\u003cspan additionalcitationids=\"CR33\" citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e], and effectively preventing the occurrence of secondary injuries. Another study [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e] found that SAQ training can also strengthen the input stimulation of sensory centers such as vision, enhance vestibular function, and achieve better dynamic balance. The rapid movements such as jumping and changing direction in SAQ training can stimulate proprioceptors, thus improving the perception of joint position, movement, and force, thereby enhancing neuromuscular control [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. Moreover, SAQ training can promote the correct activation pattern of lower limb muscles and also play a role in maintaining balance [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIt can effectively activate the quadriceps femoris, especially the medial rectus muscle, and the enhancement of its strength helps stabilize the patella, reduces activity limitation caused by abnormal patellar movement, and thereby improves joint range of motion and flexibility. Additionally, the neuromuscular control and proprioceptive function mentioned above have a good promoting effect on the improvement of joint range of motion. However, in this study, the impact of SAQ training on the knee extension angle of ACL injury patients is still controversial. This may be related to the relatively small change in knee extension angle itself and the small sample size, resulting in experimental errors.\u003c/p\u003e \u003cp\u003eIn conclusion, SAQ training can effectively improve the knee flexion range of motion, balance function, and motor ability of patients with ACL injury. However, the impact on knee extension angle still requires further large-sample studies. Moreover, future research can adopt techniques such as surface electromyography, three-dimensional gait analysis, and interference running platforms to evaluate the rehabilitation effect of SAQ training on ACL injury, further revealing its potential mechanism.\u003c/p\u003e \u003cp\u003eThe research protocol has been registered in the Chinese Clinical Trial Registry (Registration Number: ChiCTR2400085068).\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eACL (anterior cruciate ligament); SA (Speed, Agility, Quickness)\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eThis study was approved by the Ethics Committee of Beijing Rehabilitation Hospital Affiliated to Capital Medical University (2021bkky-037)\u003c/p\u003e\n\u003cp\u003eThis study received informed consent from all participants.\u003c/p\u003e\n\u003cp\u003eIf this research is accepted by your journal, we will agree to have the paper published.\u003c/p\u003e\n\u003cp\u003eConflict of Interest Declaration: All authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003eThis study was funded by the Special Research Fund of Beijing Rehabilitation Hospital Affiliated to Capital Medical University (2021-003).\u003c/p\u003e\n\u003cp\u003eAuthor Contributions: Wang Huan is responsible for the writing of the manuscript, data collection and processing; Wang Hanming reviews the manuscript; Xi Xiaoming, Fan Zhijiao, Qi Shuyan and Li Nan are responsible for the evaluation, collection and processing of data.\u003c/p\u003e\n\u003cp\u003eAcknowledgements: We are grateful to all authors for their outstanding contributions, as well as the cooperation of all patients and the professional assessment and treatment of clinical rehabilitation therapists, which enabled the successful completion of this study. We are grateful to your journal for giving us the valuable opportunity to publish our paper.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eBEARD D J, DAVIES L, COOK J A, et al. Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial [J]. Lancet, 2022, 400(10352): 605-15.\u003c/li\u003e\n \u003cli\u003eFROBELL R B, ROOS E M, ROOS H P, et al. A randomized trial of treatment for acute anterior cruciate ligament tears [J]. N Engl J Med, 2010, 363(4): 331-42.\u003c/li\u003e\n \u003cli\u003eREIJMAN M, EGGERDING V, VAN ES E, et al. Early surgical reconstruction versus rehabilitation with elective delayed reconstruction for patients with anterior cruciate ligament rupture: COMPARE randomised controlled trial [J]. Bmj, 2021, 372: n375.\u003c/li\u003e\n \u003cli\u003eFILBAY S R, ROEMER F W, LOHMANDER L S, et al. 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J Funct Morphol Kinesiol, 2024, 9(1).\u003c/li\u003e\n \u003cli\u003eKOSHINO Y, SAMUKAWA M, CHIDA S, et al. Postural Stability and Muscle Activation Onset during Double- to Single-Leg Stance Transition in Flat-Footed Individuals [J]. J Sports Sci Med, 2020, 19(4): 662-9.\u003c/li\u003e\n \u003cli\u003eLI Z, ZHANG S, MAO G, et al. Identification of anterior cruciate ligament fibroblasts and their contribution to knee osteoarthritis progression using single-cell analyses [J]. Int Immunopharmacol, 2023, 125(Pt A): 111109.\u003c/li\u003e\n \u003cli\u003eMANCINO F, GABR A, PLASTOW R, et al. Anterior cruciate ligament injuries in female athletes [J]. Bone Joint J, 2023, 105-b(10): 1033-7.\u003c/li\u003e\n \u003cli\u003eDIERMEIER T, ROTHRAUFF B B, ENGEBRETSEN L, et al. Treatment after anterior cruciate ligament injury: Panther Symposium ACL Treatment Consensus Group [J]. Knee Surg Sports Traumatol Arthrosc, 2020, 28(8): 2390-402.\u003c/li\u003e\n \u003cli\u003eSTONE A V, MARX S, CONLEY C W. Management of Partial Tears of the Anterior Cruciate Ligament: A Review of the Anatomy, Diagnosis, and Treatment [J]. J Am Acad Orthop Surg, 2021, 29(2): 60-70.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-musculoskeletal-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmsd","sideBox":"Learn more about [BMC Musculoskeletal Disorders](http://bmcmusculoskeletdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12891","title":"BMC Musculoskeletal Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"SAQ training, anterior cruciate ligament, sports injuries, rehabilitation","lastPublishedDoi":"10.21203/rs.3.rs-8664084/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8664084/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eObjective: To observe the rehabilitation effect of SAQ training on knee flexion Angle, knee extension Angle, balance function and overall knee function in patients with anterior cruciate ligament injury.\u003c/p\u003e\n\u003cp\u003eMethods: A total of 36 patients with anterior cruciate ligament injury who were hospitalized or treated in the outpatient department of Beijing Rehabilitation Hospital Affiliated to Capital Medical University from September 2021 to September 2024 were selected, and all patients were randomly divided into control group (n=30) and experimental group (n=30) by using digital table method. The control group received routine rehabilitation training, including joint motion training, strength training, core stability and balance/proprioceptive training; The experimental group was given SAQ training on the basis of the control group for a total of 4 weeks. The knee flexion Angle, knee extension Angle, ellipse area of pressure center movement, length of movement track and lysholm score of the two groups were compared before intervention and 4 weeks after intervention.\u003c/p\u003e\n\u003cp\u003eResults: Before treatment, there were no significant differences in knee flexion Angle, knee extension Angle, balance instrument pressure center motion track length, elliptic area and lysholm score between the two groups (P \u0026gt; 0.05). After 4 weeks of treatment, the knee extension Angle in control group had no significant improvement compared with before treatment (P \u0026gt; 0.05), and no significant difference compared with experimental group (P \u0026gt; 0.05). Knee flexion Angle, balance instrument pressure center motion track length, elliptic area and lysholm score were significantly improved after treatment (P \u0026lt; 0.05), and the experimental group were significantly better than the control group (P \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003eConclusion: SAQ training can effectively improve knee flexion Angle, balance function and overall knee function in patients with anterior cruciate ligament injury, and the rehabilitation effect is better than conventional rehabilitation training. However, for the improvement of the knee extension Angle, the rehabilitation effect is still controversial, which may be related to the small change of the knee extension Angle itself and the small sample size, resulting in experimental errors.\u003c/p\u003e\n\u003cp\u003eThe research protocol has been registered in the Chinese Clinical Trial Registry (Registration Number: ChiCTR2400085068).The registration date of the trial is May 30, 2024, and the registration institution is Beijing Rehabilitation Hospital Affiliated to Capital Medical University.“Retrospectively registered”\u003c/p\u003e","manuscriptTitle":"Study on the rehabilitation effect of SAQ training on anterior cruciate ligament injury","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-07 05:49:38","doi":"10.21203/rs.3.rs-8664084/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-07T01:21:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"120278061262930445999281676700494531311","date":"2026-04-03T09:56:39+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-01T19:30:59+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-05T12:05:39+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-09T15:01:55+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-09T10:49:07+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Musculoskeletal Disorders","date":"2026-02-09T10:19:10+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-musculoskeletal-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmsd","sideBox":"Learn more about [BMC Musculoskeletal Disorders](http://bmcmusculoskeletdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12891","title":"BMC Musculoskeletal Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"344bd77d-9847-4e5c-9abe-a524b2558bb2","owner":[],"postedDate":"April 7th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-07T05:49:39+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-07 05:49:38","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8664084","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8664084","identity":"rs-8664084","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}