None listed
Conditions
Brief summary
This study examines the effects of combining upper limb isometric training (ULIT) with standard care in an anterior cruciate ligament reconstruction (ACLR) rehabilitation program on hamstring strength and physical function during the early postoperative period. Hamstring strength deficits can lead to functional limitations and an increased risk of secondary injuries. We hypothesise that participants receiving ULIT in addition to standard care will demonstrate better hamstring strength at 12 weeks post-operatively compared to those receiving standard care rehabilitation alone. The study will randomly assign 32 patients to either an intervention group (receiving ULIT plus standard care) or a control group (receiving standard postoperative rehabilitation only). The primary outcome will be the change in hamstring strength in the operated limb at 12 weeks post-ACLR, while secondary outcomes will include hamstring flexibility and patient-reported outcomes on symptoms, physical function, and adherence. The findings will contribute to understanding the global functional muscle concept, suggest safe, effective, and cost-efficient interventions, and encourage further exploration of interlimb muscle activation and flexibility in heterologous muscle groups following ACLR.
Interventions
The intervention group will participate in the Upper Limb Isometric Training (ULIT) alongside the standard care rehabilitation program. Participants will follow the standard care rehabilitation as outpatients from week 1 post-ACLR and the prescribed home exercise program. Starting in week 4 and continuing through week 12 post-ACLR, participants will integrate the ULIT into their warm-up and home exercise program in addition to standard ACLR rehabilitation, approximately lasting an hour per sessi
The intervention group will participate in the Upper Limb Isometric Training (ULIT) alongside the standard care rehabilitation program. Participants will follow the standard care rehabilitation as outpatients from week 1 post-ACLR and the prescribed home exercise program. Starting in week 4 and continuing through week 12 post-ACLR, participants will integrate the ULIT into their warm-up and home exercise program in addition to standard ACLR rehabilitation, approximately lasting an hour per session. A physiotherapist with more than five years of clinical experience will administer the ULIT program to participants following anterior cruciate ligament reconstruction (ACLR) surgery at an outpatient physiotherapy clinic. This will involve verbal instructions, demonstrations, and written materials. The program includes three standing exercises—an isometric wall push-up, isometric shoulder extension, and isometric shoulder external rotation. General Exercise Instructions: Finding Suitable Walls and Floors: Use a sturdy wall, ideally made of concrete, brick, or drywall supported by a stud frame, and avoid any walls with sharp edges. This ensures stability under applied force. Floors should have excellent traction, such as rubber mats or non-slip tiles, to prevent slipping. Standing Position: Stand upright with feet shoulder-width apart. Maintain a neutral alignment of the lower back and hip, with knees fully extended and weight distributed evenly across both feet. Effort Level: Begin each exercise with 100% effort for the first repetition. Perform the remaining 5 repetitions at 50% of maximum effort. Repetition Structure: Hold each position for 5 seconds, followed by a 5-second rest. Complete a total of 5 repetitions per exercise. Perform 1 set of each exercise, 1–2 times daily. Rest: Allow the upper limb muscles to relax and step back slightly from the wall to rest for 1 minute before starting the next exercise. Additional adherence measures: Materials provided: Patients will receive an exercise pamphlet and an online exercise diary to facilitate adherence to the program. Self-reporting and monitoring: Participants are advised to follow the home exercise program guidelines included in their informational flyers. They will ask to complete a weekly exercise diary using an online Google Form. The physiotherapist will communicate with the participants weekly via phone or WhatsApp to reinforce adherence to the exercise program.
Sponsors
Hospital Canselor Tuanku Muhriz UKM
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
The inclusion criteria are as follows: individuals who plan for ACLR using a ipsilateral hamstring tendon autograft, with or without a meniscal injury, capable of understanding English and giving informed consent, and are aged between 18 to 45 years.
Exclusion criteria
Individuals with a revision ACL surgery, a multi-ligament injury (such as instability in the collateral, posterolateral, medial, or posterior cruciate ligaments), the use of allografts, an upper limb and contralateral lower limb injury after ACL surgery.
Outcome results
None listed