ACL Injury, Anterior Cruciate Ligament Reconstruction, Athrogenic Muscle Responses
Conditions
Brief summary
Anterior cruciate ligament (ACL) injuries are common in sports and often require a long and challenging rehabilitation process. Athletes who sustain these injuries typically engage in pivoting and cutting sports, where these motor tasks must be performed simultaneously with cognitive tasks such as decision-making and keeping an eye on the opponent. Directing attention to both cognitive and motor tasks leads to cognitive-motor interference, which is associated with movement patterns that increase the risk of ACL (re)injury. Therefore, it is crucial that before returning to such demanding sports after ACL reconstruction, athletes sufficiently develop and automate safe yet efficient motor skills to free up attentional capacity for decision-making, thereby reducing the risk of suboptimal movement patterns and reinjury. However, current rehabilitation programs often primarily focus on the motor component in a single-task manner, giving insufficient attention to the cognitive component that is inseparable from sports. This randomized controlled trial aims to investigate the effects of implementing motor-cognitive dual tasks in the end phase rehabilitation after ACL reconstruction on muscle function, functional outcomes, and patient-reported outcomes.
Interventions
OTHERCognitive dual task training (intervention group)
Simultaneously performing cognitive tasks and motor rehabilitative exercises.
OTHERStandard of care physiotherapy (control group)
The current best physical therapy treatment for patients with anterior cruciate ligament reconstruction based on existing scientific evidence.
Sponsors
Research Foundation Flanders
University Ghent
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* 18-40 years old. * Having suffered an ACL rupture. * Undergoing a surgical ACL reconstruction in the AZ Delta hospital in Roeselare (Campus Brugsesteenweg).
Exclusion criteria
* Revision ACL reconstruction. * Other severe injuries to the lower limbs within the past year. * Muscle or neurological disorders affecting lower limb functioning. * Fibromyalgia or chronic fatigue syndrome.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Jumping height in hop tests | 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period) | Performance in single hop tests and a single leg drop-jump expressed by jump height in centimeters. |
| Patient reported knee function | 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period) | Questioned using the Knee Injury and Osteoarthritis Outcome Score (KOOS) with its different subscores. Scores on the KOOS range from 0-100, with 0 representing the greatest possible problems in terms of knee function and 100 representing no problems. |
| Psychological readiness to return to sport | 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period) | Questioned using the ACL-RSI. Scores range from 0 to 100. Higher scores indicate higher psychological readiness. |
| Quadriceps and hamstrings activity / cocontraction during hop tasks | 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period) | Electromyographical measurement of quadriceps and hamstrings activation during hop tasks. |
| Voluntary quadriceps activation | 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period) | A force-based isometric biodex measurement using the interpolated twitch/superimposed burst technique. |
| Activity level | 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period) | Questioned using the Tegner Score. The scores range from 0 to 10, with higher scores indicating higher activity levels. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The amount of pain that the subjects experience. | 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period) | Questioned using a Numeric Rating Scale. The scores range between 0 and 10 with 10 0representing the highest level of pain. |
| Quadriceps and hamstrings strength | 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period) | Measured on the biodex. |
| Kinesiophobia | 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period) | Questioned using the Tampa Scale of Kinesiophobia (TSK). Scores on the TSK range from 17 to 68, with higher scores indicating more kinesiophobia. |
| Subjective knee stability | 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period) | Questioned using the first question of the Lysholm questionnaire. Scores range from 0 to 25 with 25 indicating no symptoms of subjective instability. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Duration of ground contact in hop tests | 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period) | Performance in single hop tests and a single leg drop-jump expressed by the duration of ground contact. |
| Expectations regarding return to sport | 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period) | Questioned using the Tegner Score: 'how active do you want to be at the end of your rehabilitation?'. The scores range from 0 to 10, with higher scores indicating higher activity levels. |
| Strength endurance during timed single leg step down and timed single leg squat | 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period) | The strength endurance of the subjects will be evaluated by the amount of repetitions they can perform in a time span of 30 seconds. |
| Performance in the T-agility test | 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period) | It will be measured how much time subjects require to complete a T-agility test. |
Countries
Belgium
Contacts
Primary ContactEvy Deschaumes, MSc
Backup ContactErik Witvrouw, prof. dr.
Outcome results
None listed