Effect of Different Focused Techniques on Thigh Muscle Activation After Anterior Cruciate Ligament Reconstruction

Not Applicable

• Conditions: Anterior Cruciate Ligament Reconstruction
• Interventions: Other: Internally Focused Exercise; Other: Externally Focused Exercise

• Registration Number: NCT05342415
• Lead Sponsor: Hacettepe University

Brief Summary

In recent years, it has been shown that different focuses (externally vs. internally focused) used when explaining exercises to patients after knee surgeries affect exercise performance and rehabilitation outcomes. Quadriceps muscle inhibition after anterior cruciate ligament reconstruction is one of the primary symptoms that should be treated. This study aimed to investigate the effects of different focusing techniques during the rehabilitation exercises after anterior cruciate ligament rehabilitation.

Detailed Description

Exercises are given for the symptoms of knee edema, knee range of motion, and quadriceps reflex inhibition in the acute period after anterior cruciate ligament surgery. In recent years it has been shown that the different focuses when explaining exercises to patients affect exercise performance and rehabilitation outcomes. It has been shown that the increase in performance of some exercises that require strength and power, such as long jump and sprint, especially with the applied external focus (the method of focusing on the result of the movement). However, it has been shown that there is an increase in muscle activation with internal focus (focusing on the muscles that reveal the movement). There is no study examining the effects of focusing differences on the exercise program given after anterior cruciate ligament reconstruction, especially on muscle activation after knee reflex inhibition.

30 individuals between the ages of 18-and 30 who had undergone anterior cruciate ligament reconstruction for the first time will be included in the study. The first evaluation will be performed and rehabilitation will begin in the first week after surgery. Patients who were taken into rehabilitation after anterior cruciate ligament surgery will be distributed into two different groups by the block randomization method. The same structured exercise program will be applied to the patients in both groups. Only the commands given during the exercise will be different.

Group 1: Internal Focused Exercise: E.g; While describing the knee pressing exercise (quadriceps isometric) in the long sitting position, the command "press your knee towards the bed by squeezing your thigh muscle" will be given by showing the muscle.

Group 2: External Focused Exercise: E.g; While describing the knee pressing (quadriceps isometric) exercise in the long sitting position, the command "press the towel/cloth that we put under your knee and compress your knee" will be given by showing the towel.

Patients will be followed under the supervision of a physiotherapist in the clinic 2 days a week and exercise progression will be provided. On the other days, the exercises will be continued as a home program. In order for the patients to comply with the exercises more easily and to be reminded easily, an exercise brochure will be given to the patients with the commands written and the exercises explained with pictures.

The last measurements will be performed at the end of one month after surgery.

Basic Information
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Recruitment & Eligibility
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Study & Design

Study Timeline

• Status Verified: 2022-04
• Study First Submitted: 2022-04-03
• Study First Submitted QC: 2022-04-18
• Last Update Submitted: 2022-04-18
• Study First Posted: 2022-04-22
• Last Update Posted: 2022-04-22
• Study Start: 2022-05-23
• Primary Completion: 2022-12-23
• Study Completion: 2023-02-23

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 30

Inclusion Criteria

• who underwent anterior cruciate ligament reconstruction with hamstring tendon autograft for the first time
• no systemic inflammation
• agreed to participate in the study

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Exclusion Criteria

• having a chronic disease/injury in the ankle, hip and knee
• contralateral knee symptoms and/or surgery history
• other surgeries in addition to the anterior cruciate ligament reconstruction (meniscus repair, chondral surgery, etc.)
• post-operative referral of the patient more than a week later

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Internally Focused	Internally Focused Exercise	Focusing on the muscles that reveal the movement.
Externally Focused	Externally Focused Exercise	Focusing on the result of the movement.

Primary Outcome Measures

Name	Time	Method
Determine if different focus techniques change thigh muscle activation	Baseline and 1 month after surgery	Vastus medialis, vastus lateralis, and rectus femoris muscle activation will be measured by superficial electromyography

Secondary Outcome Measures

Name	Time	Method
Knee range of motion	Baseline and 1 month after surgery	The changes in knee flexion and extension degree will be measured with a goniometer.
Knee edema	Baseline and 1 month after surgery	The changes in the limb circumference will be measured with a tape measure (cm).