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
plyometrics training, plyometrics, muscular strength, peak torque, functional performance, dynamic balance, proprioception
Brief summary
The primary goal of this RCT is to evaluate the effect of adding plyometric training on standard program intervention in patients aged 18-40 years who have undergone ACLR surgery. The primary question to answer is does adding plyometrics training to the standard rehabilitation program has superior effect in the improvement of muscular strength, dynamic balance and functional performance in ACLR patients. Participants will be divided into two groups. Group 1 (control) receives standard program for 24 weeks, and Group 2 (interventional) receives the same standard program for 16 weeks, followed by adding plyometrics for additional 8 weeks alongside with the standard program (total of 24 weeks).
Detailed description
Achieving full recovery after ACLR is still challenging as persistent deficits of muscular strength have still reported. Plyometrics consists of rapid muscle stretch (eccentric action) followed immediately by a shortening (concentric action) of the same muscle and connective tissue. This study hypothesizes that adding plyometric training to standard physiotherapy will improve muscular strength, proprioception, dynamic balance and functional performance
Interventions
OTHERStandard program
Participants will receive only standard therapy for 24 weeks.
OTHERPlyometrics Training
Participants will receive standard therapy for 16 weeks, followed by an additional 8 weeks of plyometrics training alongside with standard therapy. (total=24 weeks).
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 |
|---|---|---|
| Joint Position Sense (JPS) | Baseline (week 16), post-intervention (week 24) and follow up (week 32). | JPS was assessed by the Biodex System 4Pro isokinetic dynamometer by the Active Angle Reproduction technique (AAR) with eyes closed. The measurements are taken along 30° and 60° for both involved and uninvolved legs. The mean reproduced angle value is calculated at each angle to then calculate the JPS error. The smaller the error, the better the participant's perception of joint position is. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Dynamic Stability | Baseline (week 16), post-intervention (week 24) and follow up (week 32). | Y-Balance Test is used to assess stability and balance in different directions. It is performed by leg reaches along 3 dimensions: anterior, posteromedial and posterolateral. The participant stands on one leg and reaches as far as possible with the second one along all three dimensions. |
| Isokinetic Quadriceps Peak Torques Normalized to Body Weight | Baseline (week 16), post-intervention (week 24) and follow up (week 32). | The peak torque of quadriceps at 60°/s and 180°/s is considered as the highest peak torque along the 5 repetitions, each. It is then normalized to body mass by the following equation: PTrelative = Peak Torque (Nm) / Body Mass (kg). |
| 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. |
Countries
Egypt
Contacts
CONTACTAhmed El Melhat, PhD
CONTACTMarwa J. Awkal, DPT
STUDY_DIRECTORAhmed El Melhat
South Valley University
Outcome results
None listed