Anterior Cruciate Ligament Injury
Conditions
Keywords
Anterior Cruciate Ligament, ACL Reconstruction, Prehabilitation, Digital Health, Exercise Therapy, Telerehabilitation, Quadriceps Strength, Knee Function
Brief summary
Background Prehabilitation prior to anterior cruciate ligament reconstruction (ACLR) has been shown to improve preoperative knee function, enhance quadriceps strength, and optimize postoperative recovery. However, access to supervised prehabilitation programmes remains limited. Digital health interventions may improve accessibility, adherence, and continuity of care. Objective To determine whether a structured digital prehabilitation programme is more effective than usual care in improving quadriceps strength and functional outcomes after ACL reconstruction. Methods/design This study is a single-centre, parallel-group, assessor-blinded randomised controlled trial. Adult participants scheduled for primary ACL reconstruction will be randomly allocated to either a usual care group or a digital prehabilitation group. The intervention group will complete a 4-week structured digital prehabilitation programme prior to surgery. Outcomes will be assessed preoperatively and up to 12 weeks postoperatively. Expected Results The digital prehabilitation programme is expected to improve preoperative knee status and enhance postoperative quadriceps strength and functional recovery compared to usual care.
Interventions
OTHERDigital Prehabilitation Programme
Participants in the intervention group will undergo a structured 4-week digital prehabilitation programme prior to anterior cruciate ligament reconstruction.The programme includes:- Range of motion exercises targeting knee extension and flexion- Strength training focusing on quadriceps, hamstrings, and hip musculature- Neuromuscular and balance training- Patient education on surgical procedure, postoperative expectations, and recovery process- Lifestyle optimisation advice including pain management, nutrition, and emotional supportThe intervention will be delivered through a digital platform with guided exercise sessions and remote supervision.Frequency: 3 sessions per weekDuration: approximately 10-20 minutes per sessionThe programme aims to optimise preoperative knee function, improve quadriceps strength, and enhance postoperative recovery outcomes.
OTHERUsual Care
Participants in the control group will receive standard preoperative care, which may include general advice and routine clinical follow-up, but no structured prehabilitation programme.Participants will not receive a supervised or digital exercise intervention prior to surgery.
Sponsors
Alejandro Caña Pino
University of Extremadura
University of Évora
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* Adults 18-55 years * Diagnosed ACL rupture * Scheduled for primary ACL reconstruction * Waiting ≥4 weeks before surgery
Exclusion criteria
* Multiligament injury * Severe comorbidities * Previous ACL surgery same knee
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Quadriceps Isometric Strength | 12 weeks postoperative | Maximum isometric quadriceps strength measured in seated position at 90° knee flexion. Three repetitions will be recorded, and the highest value will be used |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Knee Extension Range of Motion | Baseline and preoperative (prior to surgery) | Passive knee extension will be measured in degrees using a standard goniometer. Full extension (0°) will be considered optimal preoperative status |
| Knee Pain Intensity | Up to 12 weeks postoperative | Pain intensity will be assessed using a Visual Analogue Scale (VAS), ranging from 0 (no pain) to 100 (worst imaginable pain) |
| Knee Injury and Osteoarthritis Outcome Score (KOOS) | Up to 12 weeks postoperative | Knee-related symptoms, pain, function in daily living, sport and recreation function, and knee-related quality of life will be assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Each subscale is scored from 0 to 100, where 0 represents extreme problems and 100 represents no problems (best outcome). |
| Single Leg Hop Distance | Up to 12 weeks postoperative | Patients will perform a single-leg hop for maximum distance. The distance will be measured in centimetres |
| Pain Catastrophizing | Up to 12 weeks postoperative | Pain-related catastrophic thinking will be assessed using the Pain Catastrophizing Scale (PCS). The total score ranges from 0 to 52, where higher scores indicate greater levels of pain catastrophizing (worse outcome). |
| DASS-21. Depression, Anxiety and Stress | Up to 12 weeks postoperative | Psychological status will be assessed using the Depression Anxiety Stress Scales (DASS-21). The scale consists of three subscales (depression, anxiety, and stress), each ranging from 0 to 42 after score multiplication. Higher scores indicate greater emotional distress (worse outcome). |
Contacts
CONTACTAlejandro Caña Pino, PhD
CONTACTJoão Paulo Sousa, PhD
Outcome results
None listed