Anterior Cruciate Ligament Injuries
Conditions
Keywords
Knee, Disability, Range of motion, Balance
Brief summary
Anterior cruciate ligament (ACL) injuries are among the most common and functionally disabling knee injuries, particularly in physically active individuals. Despite advancements in surgical techniques, optimal post-operative rehabilitation remains critical for successful functional recovery, minimizing re-injury risk, and restoring pre-injury performance levels
Detailed description
This randomized controlled trial aims to compare the effectiveness of perturbation training and task-oriented functional activities in patients following ACL reconstruction surgery. Perturbation training is a neuromuscular re-education strategy that involves controlled, unexpected movements to enhance joint stability and proprioceptive feedback. In contrast, task-oriented functional training focuses on restoring movement through activities that mimic daily or sports-related functional tasks. This study will be a Randomized Control Trail and will be conducted in physiogic physiotherapy clinic and Ghurki Trust and Teaching Hospital. Non-Probability Convenient Sampling will be used to collect data. Total of 54 Participants of the age 18-45 years with post 12 weeks to 1 year ACL reconstruction will be included in the study. An informed consent will be taken prior study from all the subjects. Outcomes measure will be included Numerical Pain Rating Scale (NPRS) for pain, Universal Goniometer (UG) for Range of Motion, Y balance test for Knee Stability, International Knee Documentation Committee scores, (IKDC) for Knee function
Interventions
OTHERPerturbation Training Group
Two-leg rocker board One-leg rocker board Roller board / stable (weight scale) surface Roller board / BOSU ball TheraBand feedback / perturbation training Simple sport-specific technique on rocker board Moderate demand sport-specific technique on rocker board Advanced sport-specific technique on rocker board This sequence reflects a progressive challenge to knee stability, beginning with bilateral balance tasks, advancing to unilateral control, and culminating in sport-specific perturbation drills.
OTHERTask-Oriented Functional Activities Group
Functional Recovery Tasks After ACLR Normal walking gait Bilateral squat Unilateral foundation exercises - Single leg squat Bilateral landing Running - Run on treadmill Bilateral plyometric - Bilateral drop jump Unilateral landing / deceleration - Single leg deceleration Unilateral plyometric - Single leg drop jump Change of direction ability / coordination - 90º cut maneuver Sport-specific movements - Movement control under sport-specific change of direction This sequence reflects a progressive load and skill development pathway, starting from basic gait and bilateral tasks, moving toward unilateral control, plyometrics, and finally sport-specific agility.
OTHERControl Group (Standard Rehabilitation Protocol)
Heating pad (5-10 minutes) TENS (short bursts, 10-15 minutes, frequency 100 Hz) Stationary cycling Gentle range of motion exercises Passive and active-assisted ROM Isometric quadriceps contractions Straight leg raises Quadriceps setting with a towel under the knee Closed-chain exercises (e.g., wall sits, mini-squats) Hamstring curls Double-leg stance on foam pad This set emphasizes pain relief, mobility restoration, and foundational strength before progressing to advanced neuromuscular or sport-specific tasks.
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Age range: 18-45 years Male participants only History of Anterior Cruciate Ligament Reconstruction (ACLR) of 3 to 12 months No prior ACL surgery on the affected knee ACL reconstruction with autograft of hamstrings tendon Knee flexion range of motion less than 120° Extension lag less than or equal to 10° Pain during functional activities
Exclusion criteria
* Any type of fracture Concurrent ligamentous injury or repairable meniscus Osteochondral defect Any systemic and/or neurological illness Rheumatoid arthritis Osteomyelitis or any neurological disorders Spinal disorders Inflammatory conditions such as ankylosing spondylitis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| NPRS for Pain | 6 weeks | Numeric Pain Rating Scale (NPRS) it is a unidimensional scale to measure pain intensity, particularly in adults. It is a 10-rating scale and an 11-point numeric scale in the form of a horizontal bar or line |
| Universal Goniometer for Range of motion | 6 weeks | A universal goniometer (UG) will be used to determine the range of motion of the target joint. |
| The Y-Balance test (YBT) | 6 weeks | The Y-Balance test (YBT) is used to assess dynamic balance impairments associated with lower extremity injuries such as ACL injury, patellofemoral pain syndrome, and ankle instability. |
| International Knee Documentation Committee scores (IKDC) | 6 weeks | Patients' knee function is evaluated using the International Knee Documentation Committee's (IKDC) Subjective Knee Form. Through 18 questions, it assesses symptoms, athletic activity, and general knee function; higher scores indicate better knee function. |
Countries
Pakistan
Contacts
CONTACTImran Amjad, PhD
CONTACTHira Butt
PRINCIPAL_INVESTIGATORHira Shaukat, Mphill
Riphah International University
Outcome results
None listed