Entrenamiento unipodal para el dolor lumbar y la rehabilitación del ligamento cruzado anterior: mecanismos y aplicación

Resumen

Esta revisión narrativa con búsqueda estructurada tuvo como objetivo analizar críticamente los mecanismos neuromusculares asociados al entrenamiento unilateral/unipodal y discutir la posible aplicación de estos ejercicios en el dolor lumbar crónico inespecífico y en la rehabilitación del ligamento cruzado anterior (LCA). La literatura consultada aborda resultados diferentes, como actividad electromiográfica, asimetrías intermiembro, control motor, fuerza y función. Sin embargo, parte de la evidencia es indirecta: los estudios sobre estabilización del tronco, ejercicio general para el dolor lumbar o rehabilitación del LCA no demuestran por sí solos la eficacia específica del entrenamiento unipodal. Del mismo modo, los cambios electromiográficos o de simetría no prueban reducción del dolor, prevención de lesiones ni retorno seguro al deporte. La aplicación clínica debe considerar la población, la fase de rehabilitación, los resultados evaluados y las limitaciones metodológicas de los estudios. Se concluye que el entrenamiento unipodal puede ser una opción dentro de programas individualizados, pero la evidencia específica sobre sus efectos clínicos en el dolor lumbar y después de una lesión del LCA sigue siendo insuficiente para recomendar su superioridad.

Palabras clave: Entrenamiento unipodal, Dor lombar, LCA, Estabilidad lumbopélvica, Rehabilitación deportiva

Referencias

Afonso, J., Peña, J., Sá, M., Virgile, A., García-de-Alcaraz, A., e Bishop, C. (2022). Why sports should embrace bilateral asymmetry: A narrative review. Symmetry, 14(10), 1993. https://doi.org/10.3390/sym14101993

Behm, D.G., Anderson, K., e Curnew, R.S. (2002). Muscle force and activation under stable and unstable conditions. Journal of Strength and Conditioning Research, 16(3), 416-422. https://doi.org/10.1519/00124278-200208000-00012

Bettariga, F., Turner, A., Maloney, S., Maestroni, L., Jarvis, P., e Bishop, C. (2022). The Effects of Training Interventions on Interlimb Asymmetries: A Systematic Review with Meta-analysis. Strength & Conditioning Journal, 44(5), 69-86. https://doi.org/10.1519/SSC.0000000000000701

Bishop, C., Turner, A., e Read, P. (2018). Effects of inter-limb asymmetries on physical and sports performance: A systematic review. Sports Medicine, 48(5), 1139-1156. https://doi.org/10.1007/s40279-018-0944-4

Buckthorpe, M. (2020). Optimising the late-stage rehabilitation and return-to-sport training after ACL reconstruction. Sports Medicine, 50(4), 657-678. https://doi.org/10.1007/s40279-019-01218-3

Buckthorpe, M., Danelon, F., La Rosa, G., Nanni, G., Stride, M., e Della Villa, F. (2021). Recommendations for hamstring function recovery after ACL reconstruction. Sports Medicine, 51(4), 607-624. https://doi.org/10.1007/s40279-020-01400-x

Buckthorpe, M., e Della Villa, F. (2020). Optimising the “mid-stage” training and testing process after ACL reconstruction. Sports Medicine, 50(4), 657-678. https://doi.org/10.1007/s40279-019-01222-6

Buckthorpe, M., e Della Villa, F. (2021). Recommendations for plyometric training after ACL reconstruction: A clinical commentary. International Journal of Sports Physical Therapy, 16(3), 879-895. https://doi.org/10.26603/001c.23549

Buckthorpe, M., Tamisari, A., e Della Villa, F. (2020). A ten task-based progression in rehabilitation after ACL reconstruction: From post-surgery to return to play. International Journal of Sports Physical Therapy, 15(4), 611-623. https://doi.org/10.26603/ijspt20200611

Fox, K.T., Pearson, L.T., e Hicks, K.M. (2023). The effect of lower inter-limb asymmetries on athletic performance: A systematic review and meta-analysis. PLoS ONE, 18(6), e0286942. https://doi.org/10.1371/journal.pone.0286942

Grindem, H., Snyder-Mackler, L., Moksnes, H., Engebretsen, L., e Risberg, M.A. (2016). Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: The Delaware-Oslo ACL cohort study. British Journal of Sports Medicine, 50(13), 804-808. https://doi.org/10.1136/bjsports-2015-095908

Grooten, W.J.A., Boström, C., e Dedering, Å. (2022). Summarizing the effects of different exercise types in chronic low back pain: A systematic review of systematic reviews. BMC Musculoskeletal Disorders, 23, 801. https://doi.org/10.1186/s12891-022-05722-x

Guerrero-Tapia, H., Martín-Baeza, R., e Cuesta-Barriuso, R. (2021). Effectiveness of abdominal and gluteus medius training in lumbo-pelvic stability and adductor strength in female soccer players: A randomized controlled study. International Journal of Environmental Research and Public Health, 18(4), Article 1528. https://doi.org/10.3390/ijerph18041528

Harput, G., Tunay, V.B., e Ithurburn, M.P. (2021). Quadriceps and hamstring strength symmetry after anterior cruciate ligament reconstruction: A prospective study. Journal of Sport Rehabilitation, 30(1), 1-8. https://doi.org/10.1123/jsr.2019-0271

Hewett, T.E., Di Stasi, S.L., e Myer, G.D. (2013). Current concepts for injury prevention in athletes after ACL reconstruction. American Journal of Sports Medicine, 41(1), 216-224. https://doi.org/10.1177/0363546512459638

Jiang, Y., Xu, Y., Kong, X., Zhao, E., Ma, C., Lv, Y., Xu, H., Sun, H., e Gao, X. (2024). How to tackle non-specific low back pain among adult patients? A systematic review with a meta-analysis to compare four interventions. Journal of Orthopaedic Surgery and Research, 19, Article 1. https://doi.org/10.1186/s13018-023-04392-2

Lecce, E., Amoruso, P., Vecchio, A. D., Casolo, A., Felici, F., Farina, D., e Bazzucchi, I. (2025). Neural determinants of the increase in muscle strength and force steadiness of the untrained limb following a 4 week unilateral training. The Journal of Physiology, 603, 3605-3630. https://doi.org/10.1113/JP288954

Lee, M., e Carroll, T.J. (2007). Cross education: Possible mechanisms for the contralateral effects of unilateral resistance training. Sports Medicine, 37(1), 1-14. https://doi.org/10.2165/00007256-200737010-00001

Li, Z., Lei, S., Zhang, H., Wang, X., Sun, Y., Fan, J., e Xie, B. (2025). Effects of unilateral and bilateral plyometrics training on basketball players' leg power and change of direction ability. Sport Sciences for Health, 21(3), 1711. https://doi.org/10.1007/s11332-025-01390-1

Manca, A., Hortobágyi, T., Carroll, TJ, Enoka, RM, Farthing, JP, Gandevia, SC, Kidgell, DJ, Taylor, JL, e Deriu, F. (2021). Contralateral effects of unilateral strength and skill training: Modified Delphi consensus to establish key aspects of cross-education. Sports Medicine, 51(1), 11-20. https://doi.org/10.1007/s40279-020-01377-7

McBurnie, A.J., Harper, D.J., Jones, P.A., e Dos'Santos, T. (2022). Deceleration training in team sports: Another potential "vaccine" for sports-related injury? Sports Medicine, 52(1), 1-12. https://doi.org/10.1007/s40279-021-01583-x

McGill, S.M. (2010). Core training: Evidence translating to better performance and injury prevention. Journal of Electromyography and Kinesiology, 20(3), 430-439. https://doi.org/10.1016/j.jelekin.2009.08.004

Muyor, J.M., Martín-Fuentes, I., Rodríguez-Ridao, D., e Antequera-Vique, J.A. (2020). Electromyographic activity in the gluteus medius, gluteus maximus, biceps femoris, vastus lateralis, vastus medialis and rectus femoris during the monopodal squat, forward lunge and lateral step-up exercises. Plos ONE, 15(4), e0230841. https://doi.org/10.1371/journal.pone.0230841

Nagelli, CV, Di Stasi, SL, Tatarski, R., Chen, A., Wordeman, SC, Hoffman, J., e Hewett, TE (2020). Neuromuscular training improves self-reported function and single-leg landing hip biomechanics in athletes after anterior cruciate ligament reconstruction. Orthopaedic Journal of Sports Medicine, 8(10). https://doi.org/10.1177/2325967120959347

Niederer, D., e Mueller, J. (2020). Sustainability effects of motor control stabilisation exercises on pain and function in chronic nonspecific low back pain patients: A systematic review with meta-analysis and meta-regression. PLoS ONE, 15(1), e0227423. https://doi.org/10.1371/journal.pone.0227423

Page, MJ, McKenzie, JE, Bossuyt, PM, Boutron, I., Hoffmann, TC, Mulrow, CD, Shamseer, L., Tetzlaff, JM, Akl, EA, Brennan, SE, Chou, R., Glanville, J., Grimshaw, JM, Hróbjartsson, A., Lalu, MM, Li, T., Loder, EW, Mayo-Wilson, E., McDonald, S., ... Moher, D. (2021). PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Journal of Clinical Epidemiology, 134, 178-189. https://doi.org/10.1016/j.jclinepi.2021.03.001

Pamboris, G.M., Pavlou, K., e Paraskevopoulos, E. (2024). Effect of open vs. closed kinetic chain exercises in ACL rehabilitation on knee joint pain, laxity, extensor muscle strength, and function: A systematic review with meta-analysis. Frontiers in Sports and Active Living, 6. https://doi.org/10.3389/fspor.2024.1416690

Reyes-Ferrada, W., Chirosa-Rios, L., Martinez-Garcia, D., Rodríguez-Perea, A., e Jerez-Mayorga, D. (2023). Isokinetic trunk training on pain, disability, and strength in non-specific low back pain patients: A systematic review and meta-analysis. Journal of Back and Musculoskeletal Rehabilitation, 36(6). https://doi.org/10.3233/BMR-220301

Rizzato, A., Bozzato, M., Rotundo, L., Zullo, G., De Vito, G., Paoli, A., e Marcolin, G. (2024). Multimodal training protocols on unstable rather than stable surfaces better improve dynamic balance ability in older adults. European Review of Aging and Physical Activity, 21, Article 19. https://doi.org/10.1186/s11556-024-00353-8

Smrcina, Z., Woelfel, S., e Burcal, C. (2022). A systematic review of the effectiveness of core stability exercises in patients with non-specific low back pain. International Journal of Sports Physical Therapy, 17(5), 766-774. https://doi.org/10.26603/001c.37251

Thornton, JS, Caneiro, JP, Hartvigsen, J., Ardern, CL, Vinther, A., Wilkie, K., Trease, L., Ackerman, KE, Dane, K., McDonnell, SJ, Mockler, D., Gissane, C., e Wilson, F. (2021). Treating low back pain in athletes: A systematic review with meta-analysis. British Journal of Sports Medicine, 55(12), 656-662. https://doi.org/10.1136/bjsports-2020-102723

Trybulski, R., Michał, W., Małgorzata, S., Bogdański, B., Bichowska-Pawęska, M., Ryszkiel, I., e Clemente, FM (2025). Impact of isolated lumbar extension strength training on reducing nonspecific low back pain, disability, and improving function: A systematic review and meta-analysis. Scientific Reports, 15, 6426. https://doi.org/10.1038/s41598-025-90699-5

Verhagen, A. P., Nasser, A., Jenkins, L., Monk, A.P., Saragiotto, B.T., e Stubbs, P. (2025). Exercise-based rehabilitation for anterior cruciate ligament injuries: A systematic review. Musculoskeletal Science and Practice, 80, 103392. https://doi.org/10.1016/j.msksp.2025.103392

Walker, A., Hing, W., e Lorimer, A. (2020). The influence, barriers to and facilitators of anterior cruciate ligament rehabilitation adherence and participation: A scoping review. Sports Medicine - Open, 6(32). https://doi.org/10.1186/s40798-020-00258-7

Wang, D., Valtonen, A.M., Thiel, T., Stenroth, L., Gao, Y., e Kulmala, J.-P. (2025). Effects of exercise-based ACL injury prevention interventions on knee motion in athletes: A systematic review and Bayesian network meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 55(2), 123-136. https://doi.org/10.2519/jospt.2024.12720

Wang, P., Liu, Y., e Chen, C. (2024). Effects of neuromuscular training on dynamic balance ability in athletes: A systematic review and meta-analysis. Heliyon, 10(15), e35823. https://doi.org/10.1016/j.heliyon.2024.e35823

Wiriawan, O., Rusdiawan, A., Kusuma, DA, Firmansyah, A., García-Jiménez, JV, Zein, MI, Pavlovic, R., Nowak, AM, Susanto, N., e Pranoto, A. (2024). Los ejercicios unilaterales de fortalecimiento de los músculos isquiotibiales pueden mejorar la asimetría de los isquiotibiales y aumentar el rendimiento de salto en atletas de bádminton de sub-élite [Unilateral hamstring muscle strengthening exercises can improve hamstring asymmetry and increase jumping performance in sub-elite badminton athletes]. Retos, 54, 761-770. https://doi.org/10.47197/retos.v54.103783

Zhang, Y., Jin, C., Sun, M., e Zhang, L. (2025). Effects of non-dominant side training on athletic performance: A systematic review. Frontiers in Physiology, 16, Article 1602586. https://doi.org/10.3389/fphys.2025.1602586

Zhang, Z., Qu, W., Peng, W., Sun, J., Yue, J., Guan, L., Lu, M., e Li, D. (2025). Effect of unilateral and bilateral plyometric training on jumping, sprinting, and change of direction abilities: A meta-analysis. BMC Sports Science, Medicine and Rehabilitation, 17, Article 97. https://doi.org/10.1186/s13102-025-01113-6

Zhong, Z., Guo, W., Gu, Q., Pang, T., Li, L., e Hao, A. (2025). The impact of exercise therapy on rehabilitation outcomes following anterior cruciate ligament reconstruction: A network meta-analysis. BMC Musculoskeletal Disorders, 26, Article 632. https://doi.org/10.1186/s12891-025-08876-6

Biografía del autor/a

Douglas Tajes Junior,

http://lattes.cnpq.br/0356695866177117

Publicado
2026-11-01
Cómo citar
Tajes Junior, D. (2026). Entrenamiento unipodal para el dolor lumbar y la rehabilitación del ligamento cruzado anterior: mecanismos y aplicación. Lecturas: Educación Física Y Deportes, 31(342), 230-249. https://doi.org/10.46642/efd.v31i342.8768
Sección
Artículos de Revisión