A Female Specific Anterior Cruciate Ligament Menstrual Cycle Phased Rehab Programme

Name: Menstrual Cycle Phased Anterior Cruciate Ligament Reconstruction Rehabilitation Aim: The study is aiming to investigate if menstrual cycle phased Anterior Cruciate Ligament reconstruction rehabilitation results in superior outcomes as compared to usual care Anterior Cruciate Ligament Reconstruction rehabilitation. What: The intervention provider (physiotherapists) will receive a booklet, which will explain how to correctly measure the outcome measures, the specific exercises to complete, along with a guide to confirm menstrual cycle phase and periodise exercises to the participants' menstrual cycle phase. The participants will be sent a basal body thermometer and a urinary ovulation prediction kit. Once the patient reaches six weeks post operation, they will commence completing their rehab exercises in line with their menstrual cycle phases. Over the twelve weeks of the study the participants in the intervention group will have to confirm their menstrual cycles. Participants will track their cycle via a calendar every day ie. mark the days they have their menses, take their basal body temperature every morning, and once a month, confirm their ovulation by using a urinary prediction kit. They will enter these details into a password protected individual data collection Google Sheet. After the twelve week intervention outcome measures will be remeasured. Who provided: Physiotherapists will be providing the intervention. These will be physiotherapists who regularly see post-operative anterior cruciate ligament reconstruction patients. They will have been given the information booklet which has been designed specifically for this study, and attended a training session with the primary investigator. This training session will be given over Zoom for 2 hours in small groups (maximum number 6 physios) which will include interactive activities to consolidate learning given in the information sheet and short videos to demonstrate exercises and outcome measurement taking. How: This intervention will be provided to the participant individually, face to face. The participants will be given a physiotherapy clinic to attend. When and how much: On initial assessment, at six weeks post operation, the physiotherapist will measure the outcome measures. Participants in the intervention group will attend their physiotherapy appointments in a physiotherapy clinic (which must have access to gym equipment including leg press and leg extension machines) for a 30-minute-long session twice a week for twelve weeks (24 sessions). Tailoring: Throughout the twelve week intervention, the participants in the intervention group will complete their rehabilitation strength exercises (moderate to vigorous intensity, as measured by Borg Rate of Perceived exertion scale and guided by physiotherapist) in the follicular phase of their own personal menstrual cycle. They will then complete cardiovascular exercises (eg. walking, cycling) and neuromuscular exercises eg., Toe Stand/Toe Walk/Wobble Board Stand/Single Leg Stand exercises (moderate to vigorous intensity, as measured by Borg Rate of Perceived exertion scale and guided by the treating physiotherapist) in the luteal phase of their own personal menstrual cycle.