Condition 1: Anterior cruciate ligament (ACL) reconstruction with concomitant functional foot pronation. Condition 2: Men with unilateral anterior cruciate ligament (ACL) reconstruction and concomitant functional foot pronation. Sprain of cruciate ligament of knee Flat foot [pes planus] (acquired), unspecified foot
Conditions
Interventions
Intervention 1: Intervention group: participants in the intervention group will receive an 8-week combined exercise program consisting of intrinsic foot muscle strengthening exercises and neuromuscula
Sponsors
Islamic Azad University
Eligibility
Sex/Gender
Male
Age
18 Years to 40 Years
Inclusion criteria
Inclusion criteria: Male participants aged 18 to 40 years. History of unilateral anterior cruciate ligament reconstruction using hamstring autograft. Time elapsed since surgery between 12 and 24 months. Completion of at least 6 months of standard postoperative rehabilitation. Ability to run and jump without significant pain in the operated limb. Presence of functional foot pronation based on navicular drop test above the predefined threshold. No pain, swelling, or functional limitation that prevents participation in the exercise program. Willingness to participate and signing written informed consent.
Exclusion criteria
Exclusion criteria: History of previous major surgery or fracture in the lower extremities other than the index ACL reconstruction. History of other significant ligamentous injuries of the knee (e.g. PCL, MCL, LCL) requiring surgery. Presence of neurological, neuromuscular, or vestibular disorders affecting balance or gait. Presence of severe flatfoot or foot deformities requiring orthotic or surgical management. Current acute musculoskeletal injury or pain in the lower extremities that limits participation. Systemic diseases such as uncontrolled diabetes, rheumatoid arthritis, or other inflammatory joint diseases. Participation in other structured lower extremity or neuromuscular training programs during the study period. Use of assistive devices for ambulation. Inability to follow instructions or complete the testing protocol.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Knee flexion angle at initial contact during single-leg landing from a standardized height. Timepoint: Baseline (before starting the intervention) and after 8 weeks of the training program. Method of measurement: Three-dimensional motion analysis will be performed using an optical motion capture system with at least four high-speed cameras (sampling frequency 200 Hertz). Reflective markers will be placed on pelvic and lower extremity anatomical landmarks according to a standard biomechanical model. Knee flexion angle at initial contact during single-leg landing from a standardized height will be calculated using biomechanical modeling software.;Maximum vertical ground reaction force during single-leg landing from a standardized height. Timepoint: Baseline (before starting the intervention) and after 8 weeks of the training program. Method of measurement: Ground reaction forces will be recorded using a force platform installed flush with the laboratory floor (sampling frequency 1000 Hertz). Participants will perform single-leg landings from a standardized height onto the center of the force platform. Vertical ground reaction force signals will be filtered using an appropriate low-pass filter, and the maximum vertical ground reaction force during the landing phase will be extracted and normalized to body weight.;Peak knee abduction moment during single-leg landing from a standardized height. Timepoint: Baseline (before starting the intervention) and after 8 weeks of the training program. Method of measurement: Three-dimensional inverse dynamics analysis will be used to calculate knee joint moments. Kinematic data of the pelvis and lower extremity will be collected using an optical motion capture system with at least four high-speed cameras (sampling frequency 200 Hertz), and ground reaction forces will be recorded using a force platform (sampling frequency 1000 Hertz). Reflective markers will be placed on anatomical landmarks of the pelvis and lower extremity accordin | — |
Secondary
| Measure | Time frame |
|---|---|
| Performance on the Star Excursion Balance Test to assess dynamic balance and lower limb function. Timepoint: Baseline (before starting the intervention) and after 8 weeks of the training program. Method of measurement: Performance on the Star Excursion Balance Test will be measured by recording the maximum reach distance in eight directions while the participant maintains single-leg stance on the tested limb. The composite score will be calculated by summing the reach distances in all directions and normalizing the total reach distance to the limb length. The test will be performed by trained outcome assessors according to a standardized protocol.;Self-reported intensity of knee pain. Timepoint: Baseline (before starting the intervention) and after 8 weeks of the training program. Method of measurement: Knee pain intensity will be assessed using the Numeric Pain Rating Scale, which is an eleven point scale from zero to ten, where zero indicates no pain and ten indicates the worst pain imaginable. Participants will be asked to rate their average knee pain during functional activities over the previous week on this scale.;Subjective knee function score based on the International Knee Documentation Committee subjective knee form. Timepoint: Baseline (before starting the intervention) and after 8 weeks of the training program. Method of measurement: Subjective knee function will be assessed using the International Knee Documentation Committee subjective knee form, which is a standardized questionnaire evaluating symptoms, function, and sports activity related to the knee. The responses to all items will be converted to a total score ranging from zero to one hundred, where higher scores indicate better knee function and fewer symptoms. Participants will complete the questionnaire independently, and trained research staff will check the forms for missing responses. | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactAmirali Jafarnezhadgero
Islamic Azad University
Outcome results
None listed