Effectiveness of Rehabilitation After Arthroscopic ACL Reconstruction Using Inertial Exercises

Not Applicable

Completed

• Conditions: Anterior Cruciate Ligament Injury

• Registration Number: NCT06726044
• Lead Sponsor: University in Zielona Góra

Brief Summary

The primary aim of the study was to compare the effectiveness of two rehabilitation protocols for patients following ACL reconstruction. The first group (SR) underwent standard rehabilitation, which included the following treatments:

Manual therapy: manual mobilization of the patella and fibular head Anti-swelling therapy: manual lymphatic drainage techniques Compression and cryotherapy Reflex therapy: clavi-therapy Kinesiotherapy: strength exercises Kinesiotaping Osteopathic techniques Myofascial release Manual scar treatment Activation of gliding movement in the knee joint; soft tissue techniques in the popliteal region Flossing Knee flexion and extension exercises in a closed and next in open kinematic chain Isometric quadriceps exercises at full extension and 45-degree flexion

In addition to the above, the second group (SR+I) performed inertial exercises, which were introduced starting from the fifth week of rehabilitation. After 12 weeks of rehabilitation, its effectiveness was evaluated using standard tests.

The results indicate that the innovative rehabilitation protocol incorporating inertial exercises can be effectively applied in the rehabilitation of individuals following arthroscopic ACL reconstruction. None of the monitored rehabilitation effectiveness indicators in the SR+I group were inferior to those in the SR group. Moreover, certain parameters assessing rehabilitation effectiveness showed the SR+I protocol to have advantages over the SR protocol.

Detailed Description

The primary goal of the study was to compare the effectiveness of two rehabilitation protocols in patients following ACL reconstruction. The first group (SR), consisting of 12 participants, underwent a standard rehabilitation program twice a week for 12 weeks. Each session lasted approximately 60 minutes and was conducted by the same therapist. The standard rehabilitation program included the following treatments:

Manual therapy: manual mobilization of the patella and fibular head Anti-swelling therapy: manual lymphatic drainage techniques Compression and cryotherapy Reflex therapy: clavi-therapy Kinesiotherapy: strength exercises Kinesiotaping Osteopathic techniques Myofascial release Manual scar treatment Activation of gliding movement in the knee joint; soft tissue techniques in the popliteal region Flossing Knee flexion and extension exercises in closed kinematic chains The same in open kinematic chains Isometric quadriceps exercises at full extension and 45-degree flexion

The second group (SR+I) followed the same standard protocol but also performed inertial exercises from the fifth week of rehabilitation. These exercises were conducted on an InerKnee setup, adapted from the Cyklotren device, and began four weeks post-surgery, provided the patient achieved at least 90 degrees of knee flexion (including full extension). The inertial exercises protocol included:

knee extension exercises performed in a seated position for the operated leg 4 sets of exercises, each lasting 15 seconds individually adjusted resistance to maintain a 1-second extension cycle passive rest periods of 2 minutes between sets

After 12 weeks of rehabilitation, effectiveness was evaluated using standard tests. The results showed that the innovative rehabilitation protocol, incorporating inertial exercises, can be effectively applied to patients following arthroscopic ACL reconstruction. No monitored indicators in the SR+I group were worse than those in the SR group. In fact, several parameters indicated the SR+I protocol's superiority over the standard protocol.

Study Timeline

• Study Start: 2022-04-02
• Primary Completion: 2023-02-28
• Study Completion: 2023-02-28
• Status Verified: 2024-12
• Study First Submitted: 2024-12-05
• Study First Submitted QC: 2024-12-05
• Study First Posted: 2024-12-10
• Last Update Submitted: 2024-12-13
• Last Update Posted: 2024-12-18

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 24

Inclusion Criteria

• ACL reconstruction performed by the same doctor using similar technique, lack of other disases, minimum 90% attendance in rehabilitation sessions

Exclusion Criteria

• other chronic disases, rehabilitation was not completed, other injury during rehabilitation

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Knee extensors anf flexors strength under isokinetic and inertial conditions.	12 weeks of rehabilitation	After 12 weeks of rehabilitation, muscle strength was assessed in all patients under isokinetic and inertial conditions. Measurements were conducted following these guidelines: * Isokinetic measurements at two speeds: of 60˚/s, and 180˚/s, with five repetitions of flexion and extension for each limb and each speed in a seated position,; * the axis of rotation of the dynamometer was aligned with the axis of rotation of the knee joint.; * patients performed trial repetitions to familiarize themselves with the movement speed and range of motion.; the range of motion was consistently set at 60˚, starting from a knee flexion angle of 90˚ ± 30˚.; * patients were secured using crossed straps, a hip belt, and a limb-specific belt.; * only the patient and the examiner are allowed in the room during the measurement process; The patient's arms were crossed on the chest during the measurement. Testing began with the healthy limb and concluded with the operated limb. Patients

Secondary Outcome Measures

Name	Time	Method
Body balance, stability and mobility after rehabilitation	12 weeks of rehabilitation	Y-Balance Test - Examination Description; The Y-Balance Test is a dynamic balance assessment tool used to evaluate an individual's postural control and stability. Here's the procedure: * positioning: the participant stands on a designated mark with one foot (the tested limb), which serves as the base and starting point for all three arms of the Y-shape scale. The opposite foot (non-tested limb) is used to reach as far as possible along the measurement arms of the Y.; * testing directions: Anterior Posterolateral Posteromedial; * rules: the foot of the reaching limb must not bear weight or touch the floor forcefully. The arms must stay positioned on the hips during the entire test. Loss of balance, ground contact with the reaching foot, or incorrect arm positioning invalidates the trial; * execution: the participant performs three attempts for each direction. The farthest distance reached in each direction is recorded.

Trial Locations

Locations (1)

Department of Physical Education and Sport, Faculty in Gorzow Wielkopolski, Poznan University of Physical Education, Poznan, Poland; 🇵🇱 Gorzow Wielkopolski, Poland