The Impact of Neuromuscular Rehabilitation on Knee Function and Brain Plasticity in Patients With Anterior Cruciate Ligament Rupture and Reconstruction
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- isokinetic muscle strength
研究概览
简要总结
This study focuses on patients with anterior cruciate ligament (ACL) rupture and reconstruction, aiming to systematically investigate the clinical efficacy and underlying mechanisms of neuromuscular training in restoring knee joint function.Beyond examining improvements in local knee biomechanics, the research delves into brain plasticity changes during rehabilitation to reveal the central regulatory mechanisms of neuromuscular control.The findings are expected to provide a solid theoretical and empirical foundation for optimizing post-ACL rehabilitation strategies, fostering interdisciplinary integration from peripheral interventions to neural central regulation.
详细描述
In the field of sports medicine, anterior cruciate ligament (ACL) injury is a common yet severe sports-related condition with significant consequences. Patients exhibit considerable variation in knee functional recovery following anterior cruciate ligament reconstruction (ACLR). Although neuromuscular training serves as an effective rehabilitation intervention, its mechanistic underpinnings remain incompletely elucidated, and the relationship between brain plasticity and functional recovery of the knee joint has not been sufficiently explored. Therefore, this study focuses on patients with ACL rupture and reconstruction, aiming to elucidate the specific mechanisms through which neuromuscular training contributes to the restoration of neuromuscular function in patients following ACL rupture and reconstruction, with particular emphasis on its effects on brain plasticity and neuromuscular control. It will systematically investigate the dynamic changes in brain functional plasticity and their underlying mechanisms throughout the rehabilitation process post-ACL injury and reconstruction. By uncovering the operational mechanisms of neuromuscular training in injury prevention and rehabilitation, this research will provide new empirical evidence to advance the theoretical framework of sports rehabilitation.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 45 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Body Mass Index (BMI) ≥18.5 kg/m² and <35 kg/m²;
- •Diagnosed with first-time, unilateral, isolated anterior cruciate ligament (ACL) rupture ;
- •No or only mild concomitant injuries to the posterior cruciate ligament, medial collateral ligament, or lateral collateral ligament;
- •Voluntarily participated in the study and provided written informed consent .
排除标准
- •Patients with ACL rupture for more than 6 months;
- •Combined severe injuries (Grade II or higher) to the posterior cruciate ligament, medial collateral ligament, or lateral collateral ligament(Grading Note: Grade II indicates partial tear with ligament thickening, tortuosity, and fiber disruption; Grade III indicates complete rupture);OR combined severe meniscal tears ;
- •History of prior knee surgery (e.g., meniscal repair, ligament reconstruction, arthroplasty, arthroscopic debridement);
- •Presence of other knee pathologies: knee osteoarthritis, tumors, rheumatoid arthritis, tuberculosis, infectious or inflammatory diseases, fractures, dislocations, or other skeletal injuries;
- •Severe cardiac, pulmonary, cerebral, hepatic, or renal dysfunction; OR visual/cognitive impairments.
研究组 & 干预措施
Neuromuscular Training
干预措施: Neuromuscular Training (Behavioral)
Conventional Rehabilitation
干预措施: Conventional Rehabilitation (Behavioral)
结局指标
主要结局
isokinetic muscle strength
时间窗: Pre-intervention and preoperative intervention, at 12 weeks and 12 months postoperatively
The isokinetic muscle strength test selected angular velocities of 60°/s (slow) and 180°/s (medium). Observe the peak torque of the quadriceps femoris and hamstring muscles, the relative peak torque, the limb symmetry index, the ratio of peak torque between the hamstring and quadriceps muscles, and the total work.
sEMG
时间窗: Pre-intervention and preoperative intervention, at 12 weeks and 12 months postoperatively
The American-made Delsys wireless surface EMG system was used to measure EMG signals from the lower limb muscles during walking, running, and single-leg standing. A total of five muscles on the affected lower limb were recorded, including the rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), and semitendinosus (ST).The parameters collected and analyzed using the Delsys surface electromyography (sEMG) system include: raw EMG values during walking, running, and single-leg standing，root mean square (RMS) amplitude.
Three-Dimensional Gait Analysis using the Vicon System
时间窗: Pre-intervention and preoperative intervention, at 12 weeks and 12 months postoperatively
During the running process, the joint angles and torques of the hip joint, knee joint and ankle joint in the sagittal plane, coronal plane and horizontal plane, as well as the peak vertical ground reaction force, vertical instantaneous loading rate and rate of internal knee extension moment
Electroencephalography Assessment
时间窗: Pre-intervention and preoperative intervention, at 12 weeks and 12 months postoperatively
Electroencephalogram (EEG) analysis involves extracting raw EEG data during motor tasks and performing domain-specific feature analyses. This includes power spectral density and relative power as frequency-domain metrics, as well as functional and effective connectivity measures such as coherence and Granger causality.
次要结局
- IKDC 2000(Pre-intervention and preoperative intervention, at 12 weeks and 12 months postoperatively)
- Lysholm Knee Score(Pre-intervention and preoperative intervention, at 12 weeks and 12 months postoperatively)