Anterior Cruciate Ligament Reconstruction (ACLR), Anterior Cruciate Ligament Reconstruction Rehabilitation, Anterior Cruciate Ligament/Surgery, Anterior Cruciate Ligament (ACL) Reconstruction Surgery, ACL Surgery, ACL Reconstruction
Conditions
Keywords
isokinetic training, plyometric training, muscular strength, functional performance, peak torque, hop tests
Brief summary
The primary goal of this RCT is to evaluate the effects of isokinetic training compared to plyometric training in patients aged 18-40 years who have undergone ACLR surgery. The primary question to answer is which of the two interventions (isokinetic or plyometrics) has superior effect in the improvement of muscular strength, functional performance and patient-reported outcomes in ACLR patients. Participants will be divided into two groups. Both groups received standard rehabilitation for 16 weeks, followed by adding for 8 weeks: Group 1: receives isokinetic training, Group 2: receives plyometric training (total=24 weeks).
Detailed description
Isokinetic and plyometric training represent two distinct approaches used in ACLR rehabilitation. Based on evidence, both showed significant improvements when performed postoperatively. However, there is no randomized controlled trial that has directly compared their effects on the comprehensive outcomes required for RTS clearance. This study hypothesizes that both interventions will improve muscular strength, functional performance and patient related outcomes, with no significance of one over the other.
Interventions
OTHERIsokinetic Training
Participants will receive standard therapy for 16 weeks, followed by an additional 8 weeks of isokinetic training alongside with standard therapy.
OTHERPlyometrics Training
Participants will receive standard therapy for 16 weeks, followed by an additional 8 weeks of plyometric training alongside with standard therapy.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
1. Age 18-40 years 2. Primary unilateral ACL reconstruction 3. Reconstruction using bone-patellar tendon-bone (BPTB) or hamstring tendon (HT) autograft 4. Cleared by operating surgeon for progressive resistance and functional training 5. Able to perform full weight-bearing ambulation without assistive devices
Exclusion criteria
1. Revision ACL reconstruction 2. Associated grade III ligament injury 3. Meniscal repair (meniscectomy is not an exclusion) 4. Concomitant chondral defect requiring surgical intervention or cartilage repair 5. Contralateral lower limb injury within the preceding 12 months 6. Body mass index (BMI) \> 35 kg/m²
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Isokinetic Quadriceps & Hamstring Peak Torques Normalized to Body Weight | Baseline (week 16), post-intervention (week 24) and follow up (week 32). | The peak torques of quadriceps and hamstring are considered as the highest peak torque along the 5 repetitions at velocity 60°/s. Each is then normalized to body mass by the following equation: PTrelative = Peak Torque (Nm) / Body Mass (kg). |
| Isokinetic Limb Symmetry Index (ISOK-LSI) of Quadriceps & Hamstring | Baseline (week 16), post-intervention (week 24) and follow up (week 32). | ISOK-LSI is calculated by the following equation: ISOK-LSI = (involved limb PT / uninvolved limb PT) × 100. An LSI \>90% is commonly used as a criterion for adequate interlimb symmetry following ACL reconstruction. |
| Hamstring - Quadriceps Ratio (H/Q) | Baseline (week 16), post-intervention (week 24) and follow up (week 32). | H/Q is calculated by the following equation: H/Q = (hamstring PT/quadriceps PT) × 100. The hamstring-to-quadriceps (H/Q) ratio was calculated as the ratio of hamstring peak torque to quadriceps peak torque, expressed as a percentage. H/Q ratio of approximately 66.7% at 60°/s has been suggested as a reference value. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Functional Performance test | Baseline (week 16), post-intervention (week 24) and follow up (week 32). | For the distance tests (single-leg, triple ho, crossover hop), the longest distance (cm) is the best and is measured in centimeters using calibrated floor markings. For the time related test (6-meter timed hop), the shortest time (s) is considered and is measured using a digital stopwatch. For all four hop tests, 3 trials will be performed. The best trial will be taken to statistical analysis. |
| Visual Analog Scale (VAS) | Baseline (week 16), post-intervention (week 24) and follow up (week 32). | VAS is a subjective tool designed to assess the intensity of pain by providing quantitative measures of self-reported severity of symptoms. Ranges are: 0-3 indicates mild pain, 4-6 moderate pain, and 7-10 severe pain. |
| Knee Injury and Osteoarthritis Outcome Score (KOOS) | Baseline (week 16), post-intervention (week 24) and follow up (week 32). | KOOS is a subjective tool designed to measure the patients' opinion about their knee function and problems related to injuries that may lead to osteoarthritis including ACL, meniscal or chondral injuries. It is composed of 5 domains: 1) Symptoms, 2) Stiffness, 3) Pain, 4) Function - daily living, and 5) Function - sports and recreational activities, of total 42 items. The sum of all 5 dimensions represents the total score that is then transformed to a 0-100 score (%), where 0 indicates "extreme knee problem" and 100 indicates "no knee problems". |
Countries
Egypt
Contacts
CONTACTAhmed El Melhat, PhD
CONTACTMarwa J. Awkal, DPT
STUDY_DIRECTORAhmed El Melhat, PhD
South Valley University
Outcome results
None listed