Early Treatment Based Neuroscience Education in Knee
- Conditions
- Anterior Cruciate Ligament InjuriesAnterior Cruciate Ligament Rupture
- Interventions
- Other: Best current rehabilitation protocolOther: Cross-training protocol
- Registration Number
- NCT05440890
- Lead Sponsor
- University of Malaga
- Brief Summary
Determine the effecttiveness of a cross-education strength training protocol in a group of subjects with an anterior cruciate ligament surgery.
- Detailed Description
The cross-education (CE) phenomenon has been studied in recent years as a form of gain muscle strength not only in healthy subjects but also in acute injuries such as musculoskeletal disorders and immovilitations. Unilateral training of the not injured limb has been suggested as an option to produce cross-edutation in terms of strength and skills. In addition, functional magnetic resonance imaging have been postulated as a promising tool to study the mechanisms of transfer.
In the context of our study, arthrogenic muscle inhibition (AMI) of knee extensors is a common consequence after ACL repair in which a CE strength training can lead to reduce quadriceps atrophy and its implications in long terms achievements. Thus, an unilateral strength protocol of the uninjuried limb, according to the last Delphi Consensus, will be run for 8 weeks to check the possible benefits of the transfer in a sample of ACL repair.
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 45
- People between 18 and 40 years whith MRI diagnosis of ACL rupture.
- Autograft, allograft or artificail graft of any source.
- With/without any meniscal resection/repair.
- Diagnosis of systematic disease, no injury or symptomatic in contralateral lower limb, pregnancy, current or prior neurologic condiction.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Control group Best current rehabilitation protocol Standard protocol rehabilitation programme for an anterior cruciate ligament repair based on VAN MELICK N, et al 2016. Cross-education group Best current rehabilitation protocol Standard protocol rehabilitation programme for an anterior cruciate ligament repair based on VAN MELICK N, et al 2016. Additionally a contralateral lower limb strength training. Cross-education group Cross-training protocol Standard protocol rehabilitation programme for an anterior cruciate ligament repair based on VAN MELICK N, et al 2016. Additionally a contralateral lower limb strength training.
- Primary Outcome Measures
Name Time Method Changes in quadriceps strength. Baseline and 12 weeks post-surgery Isometric Maximal voluntary contraction in 60º/90º of knee flexion. Both legs. Patients performed two familiarization trials at 50% of their estimated MVC. Then 3 test of maximal contraction will be done. Measured in newtons.
Changes in cortical adaptation. Baseline and 10 weeks post-surgery Functional magnetic resonance including tractography, blood oxygen level dependent (BOLD) and resting-state study to measure how and where the cortical activation is meanwhile the subjects perform a 50% of the MVIC of knee extension with the injuried leg. Special focus on primery motor cortex and supplementary motor area.
- Secondary Outcome Measures
Name Time Method Limb symmetry index (LSI). Pre- surgery, 12 weeks post-surgery Comparison of both quadriceps MVC. Measured in percentage.
Contact time with the ground during gait 12 weeks post-surgery Measured in seconds of each limb with Optogait system
Cadence of the gait 12 weeks post-surgery Measured in step per seconds with Optogait system
Muscle activation. Pre- surgery, 12 weeks post-surgery Surface eletromyography in the main muscles of lower limb (rectus femoris, vastus medialis, vasto lateralis, biceps femoris) during the MVC test and functional task such as active straigth leg raise, gait, bilateral/unilateral squat, bilateral/unilateral rumanian deadlift, lunges and single and normal countermovement jump.
Muscle thickness of quadriceps. Pre- surgery, 12 weeks post-surgery Measured in cm by ultrasonography in both quadriceps.
Peak rate of force development (RFD). Pre- surgery, 12 weeks post-surgery Explosive strength as the speed which the muscle (quadriceps) can develop force. Measured in newtons per second.
Cross-sectional area of quadriceps Pre- surgery, 12 weeks post-surgery Sonography of quadriceps to determine the cross-sectional area of rectus femoris, vastus medialis and vastus laterlis. Measured in cm2.
The Lysholm questionnaire. 12 weeks post-surgery Total score of 100 points including the following variables: crutch support, knee locking, knee instability, pain, swelling and knee function. Score range 0 to 100 with high scores indicating better and positive knee outcomes.
The Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire. 12 weeks post-surgery The KOOS is a self-administered questionnaire with variables related to symptons, pain, quality of life, daily tasks and function and sport activities. Score range 0 to 100 with high scores indicating better and positive knee outcomes.
The International Knee Documentation Committee (IKDC) questionnarie. 12 weeks post-surgery IKDC is a reliable and valid measure for ACLR. It consists on 10 items related to knee symptons, knee function and sports activities. Score range from 0 to 100 with higher scores determine less disfunction.
Step length during gait 12 weeks post-surgery Measured in cm of each limb with Optogait system.