Augmenting rehabilitation of male volleyball players after anterior cruciate ligament reconstruction with Thera-band based neuromuscular training to improve balance and functional performance: a pilot randomized clinical trial

Introduction Persistent neuromuscular deficits following anterior cruciate ligament reconstruction (ACLR) impair dynamic stability and sport-specific performance in volleyball athletes who rely on repetitive jumping and single-leg control. Reactive neuromuscular training (RNT) using TheraBand-mediated perturbations may enhance sensorimotor integration, yet evidence in male volleyball players during late-stage rehabilitation (6–12 months post-ACLR) remains limited. This study evaluated the effects of an eight-week TheraBand-based RNT program on dynamic balance and functional performance. Methods A quasi-experimental pre-test/post-test design was used with 30 male volleyball players (18–30 years) allocated to an experimental group ( n = 15) or control group ( n = 15). The experimental group completed 16 supervised RNT sessions (two 40-minute sessions per week) incorporating progressive TheraBand perturbations during squats, lunges, and single-leg landings. The control group maintained routine activity. Outcomes, assessed on the reconstructed limb, included Y Balance Test composite score (%), triple hop distance (cm), single-leg hop time for 6 m (s), and countermovement vertical jump height (cm). Within-group changes were analyzed with paired-samples t -tests; between-group differences were examined using ANCOVA with baseline adjustment (α = 0.05). Results The experimental group demonstrated significant improvements in dynamic balance ( p < 0.001), triple hop distance ( p = 0.022), single-leg hop time ( p = 0.015), and vertical jump height ( p = 0.014), whereas no significant changes occurred in the control group (all p > 0.05). ANCOVA revealed significant group effects favoring RNT for all outcomes ( F (1,27) = 5.67–8.66, p = 0.007–0.024, ηp 2 = 0.174–0.243). Discussion An eight-week TheraBand-based RNT program produced clinically meaningful short-term gains in balance and functional performance. These findings support integration of perturbation-based training into late-stage ACLR rehabilitation in male volleyball players, although longer-term studies are required to confirm retention and return-to-sport benefits.