## 3 Results
### Results of Individual Studies
(2022) [45]} \\  & post-ACLR (EXP = 44, 59 & & 2 times/week, & & \\  & CON = 44; 59 & & 3 \(\times\) 12 reps (press, & HQ, HOP (\(p<0.001\)), & & \\  & males/29 females), symmetry post-ACLR & & & & & \\  & 28–29 years, active & & & & & \\  & \(>\)3s/week & & & & & \\  & & & & & & \\  & & & & & & \\  & & & & & & \\  & & & & & & \\  & & & & & & \\ \hline \multirow{4}{*}{RCT} & 8 weeks, 30 male & Evaluate contralateral & \multirow{2}{*}{times/week,} & EXP: unilateral & \multirow{2}{*}{[PERSON] et al. (2022) [45]} \\  & athletes post-ACLR & & & & & \\  & (EXP = 15, CON = 15), & & & & \\  & 27.5 [44] years: no & & & & & \\  & strength training data & & & & & \\  & & & & & \\  & & & & & & \\  & & & & & \\  & & & & & & \\  & & & & & \\  & & & & & & \\ \hline \multirow{4}{*}{Case Study} & 8 weeks, 5 post-ACLR (3 males/2 females), & \multirow{2}{*}{Describe eccentric CE} & 24 sessions & fMRI (brain & \multirow{2}{*}{\(\uparrow\) signal (HAM ratio \(<\)57\%\)} \\  & 16–21 years & & & 4 \(\times\) 10 eccentric & & \\  & & & & & \\  & & & & & \\  & & & & & \\  & & & & & \\  & & & & & \\  & & & & & \\ \hline \multirow{4}{*}{RCT} & 8 weeks, 42 soldiers & \multirow{4}{*}{Compare 3 vs. 5 days/week CEE} & 24 sessions & fMRI (brain & \multirow{2}{*}{\(\uparrow\) signal (HAM ratio \(<\)57\%\)} \\  & 14 each; males only), & & & & \\  & & & & & \\  & 20–25 years; no & & & & \\  & strength training data & & & & \\ \hline \multirow{4}{*}{RCT} & 8 weeks, 42 soldiers & \multirow{4}{*}{Compare 3 vs. 5 days/week CEE} & 24 sessions & fMRI (brain & \multirow{2}{*}{\(\uparrow\) signal (HAM ratio \(<\)57\%\)} \\  & &  
\begin{table}
\begin{tabular}{c c c c c c c} \hline \hline
**Type of Study** & **Design** & **Objectives** & **Intervention** & **Outcomes** & **Key Findings/Conclusions** & **References** \\ \hline \multirow{4}{*}{RCT} & 8 weeks, 42 soldiers & \multirow{4}{*}{Assess CEE effects on \(\mathrm{post}\)-ACLR (CE \(\mathrm{s}\)) isometric QF at \(\mathrm{s  
Twelve randomized controlled clinical trials (RCTs), one case study, and one systematic review with meta-analysis were included, totaling 721 participants, reduced to 637 after removing duplicates of participant samples across different studies by the same author. The sample primarily consisted of young adults, aged between 17 and 45, with a BMI of 21 to 25. The interventions lasted between 6 and 12 weeks, with 2 to 5 sessions per week, focusing on unilateral training of the contralateral non-injured leg. The protocols included isometric and dynamic exercises with progressive loads [24; 46; 47; 50], and some studies used electromyography (EMG) to monitor neuromuscular activation and physiological adaptations [43; 51]. A low-to-moderate risk of bias was detected across the articles. The studies employed various assessment tools, such as isokinetic dynamometry, stability and balance tests, and pain perception scales. Muscle strength, range of motion (ROM), and knee function were also evaluated. The results showed significant improvements in strength and function of the untrained contralateral limb, particularly in quadriceps strength and functional symmetry. Additionally, a gradual recovery of strength was observed in the operated leg, along with improvements in functionality and dynamic balance. However, the variability in results highlights the need to standardize protocols and measurement tools to optimize the clinical application of CE in ACL rehabilitation. Regarding neuroplasticity, only one study [44] directly evaluated central adaptations using neurophysiological tools such as fMRI, TMS, and H-reflexes, reporting significant increases in cortical and spinal excitability following eccentric CE. Additionally, other studies indirectly addressed neuroplasticity through changes in EMG activity, postural control, and motor coordination [43; 51], suggesting functional improvements potentially mediated by central nervous system adaptations.