NCT03626857

Brief Summary

This clinical trial evaluates interventions to maximize muscle function and improve cartilage health following anterior cruciate ligament reconstruction. Improving muscle function may improve patient outcomes, improve joint mechanics, and potentially serve as a prevention approach for post-traumatic knee osteoarthritis. Knee osteoarthritis (OA) is a disabling disease that carries a substantial burden to society and to the individual affected.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
135

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Feb 2019

Longer than P75 for not_applicable

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 8, 2018

Completed
5 days until next milestone

First Posted

Study publicly available on registry

August 13, 2018

Completed
6 months until next milestone

Study Start

First participant enrolled

February 22, 2019

Completed
5.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 9, 2025

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

January 9, 2025

Completed
12 months until next milestone

Results Posted

Study results publicly available

January 2, 2026

Completed
Last Updated

January 2, 2026

Status Verified

December 1, 2025

Enrollment Period

5.9 years

First QC Date

August 8, 2018

Results QC Date

November 18, 2025

Last Update Submit

December 11, 2025

Conditions

Keywords

KneeACLReconstructionRehabilitationEccentric ExerciseElectrical Stimulation

Outcome Measures

Primary Outcomes (2)

  • Immediately Post NMES+ECC Intervention Isokinetic Quadriceps Strength Index

    Bilateral concentric isokinetic muscle strength at 60 degrees per second. Limb symmetry index is calculated as (ACL strength/Non-ACL strength)\*100

    Post-NMES+ECC intervention (approximately 16 weeks post-ACL reconstruction)

  • 9 Months Isokinetic Quadriceps Strength Limb Symmetry Index

    Bilateral concentric isokinetic muscle strength at 60 degrees per second. Limb symmetry index is calculated as (ACL strength/Non-ACL strength)\*100

    9 months (9 months post-ACL reconstruction)

Secondary Outcomes (6)

  • Knee Flexion Angle at 9 Months

    9 months post-ACL reconstruction

  • Knee Flexion Moment at 9 Months

    9 months post-ACL reconstruction

  • Knee Flexion Angle at 18 Months

    18 months post-ACL reconstruction

  • Knee Flexion Moment at 18 Months

    18 months post-ACL reconstruction

  • T1 Rho Relaxation Time Symmetry Score for Femoral Knee Joint Cartilage

    18 months post-ACL reconstruction

  • +1 more secondary outcomes

Study Arms (2)

NMES+ECC

EXPERIMENTAL

Neuromuscular electrical stimulation (NMES) and Eccentric Exercise (ECC). Patients randomized to the NMES+ECC group will first receive NMES for 2x/week for 8 weeks, beginning at the first post-operative visit. Beginning at 9 weeks after anterior cruciate ligament reconstruction (ACLR) patients will begin to receive eccentric exercise 2x/week for an additional 8 weeks. For NMES, patients will have electrical stimulation delivered to their quadriceps. Fifteen isometric actions lasting 10 seconds each will be elicited during each session. For eccentric exercise, patients will train for 4 sets of 10 repetitions. This group will also receive standard of care ACL rehabilitation alongside the study interventions.

Device: Neuromuscular Electrical Stimulation (NMES)Other: Eccentric Exercise (ECC)

NMES placebo + ECC placebo

PLACEBO COMPARATOR

Neuromuscular electrical stimulation (NMES) low intensity/placebo + Eccentric Exercise (ECC) low intensity/placebo arm. Patients randomized to the NMES low intesntiy/placebo + ECC low intensity/placebo group will first receive NMES placebo/low-intensity treatment for 2x/week for 8 weeks, beginning at the first post-operative physical therapy visit. Beginning at 9 weeks after anterior cruciate ligament reconstruction (ACLR) patients will begin to receive an eccentric exercise low-intensity/placebo 2x/week for 8 weeks. For the NMES low intensity/placebo, patients will have it delivered to their quadriceps 2x/week for 8 weeks beginning at the first post-operative visit. Fifteen isometric actions lasting 10 seconds each will be elicited during each session. For the eccentric exercise low-intensity/placebo, patients will begin to receive eccentric exercise two times per week for 8 weeks. Patients will train for 4 sets of 10 repetitions.

Device: Neuromuscular Electrical Stimulation (NMES) placeboOther: Eccentric Exercise (ECC) placebo

Interventions

The electrical stimulator will deliver a 2500 Hz alternating current, modulated at 75 bursts/s, with a ramp-up time of 2-seconds, followed by a 50-second rest period. Stimulus intensity set to generate a maximum voluntary isometric contraction (MVIC) of at least 40\& of the contralateral MVIC.

Also known as: Electrical Stimulation, Estim
NMES+ECC

4 sets of 10 repetitions of an eccentric leg press exercise performed at 70-90% of the 1 repetition maximum

NMES+ECC

The electrical stimulator will deliver a 2500 Hz alternating current, modulated at 75 bursts/s, with a ramp-up time of 2-seconds, followed by a 50-second rest period. Stimulus intensity set to generate a maximum voluntary isometric contraction (MVIC) of 10-20% of the contralateral MVIC.

NMES placebo + ECC placebo

4 sets of 10 repetitions of an eccentric leg press exercise performed at 10-20% of the 1 repetition maximum

NMES placebo + ECC placebo

Eligibility Criteria

Age14 Years - 45 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • Acute, complete ACL rupture
  • ACL reconstruction with autograft
  • Scheduled to undergo ACLR at U of Michigan
  • Willingness to participate in testing and follow-up as outlined

You may not qualify if:

  • Previous surgery to either knee
  • Bony fracture accompanying ACL injury
  • Patients who experienced a knee dislocation
  • Female participants who are pregnant or planning pregnancy

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

MedSport

Ann Arbor, Michigan, 48109, United States

Location

University of Michigan

Ann Arbor, Michigan, 48109, United States

Location

Related Publications (1)

  • Rodriguez K, Garcia SA, Spino C, Lepley LK, Pang Y, Wojtys E, Bedi A, Angelini M, Ruffino B, Bolley T, Block C, Kellum J, Swartout A, Palmieri-Smith RM. Michigan Initiative for Anterior Cruciate Ligament Rehabilitation (MiACLR): A Protocol for a Randomized Clinical Trial. Phys Ther. 2020 Dec 7;100(12):2154-2164. doi: 10.1093/ptj/pzaa169.

MeSH Terms

Conditions

Anterior Cruciate Ligament Injuries

Interventions

Electric Stimulation

Condition Hierarchy (Ancestors)

Knee InjuriesLeg InjuriesWounds and Injuries

Intervention Hierarchy (Ancestors)

Physical StimulationInvestigative Techniques

Results Point of Contact

Title
Riann Palmieri-Smith, PhD, ATC
Organization
University of Michigan

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor

Study Record Dates

First Submitted

August 8, 2018

First Posted

August 13, 2018

Study Start

February 22, 2019

Primary Completion

January 9, 2025

Study Completion

January 9, 2025

Last Updated

January 2, 2026

Results First Posted

January 2, 2026

Record last verified: 2025-12

Data Sharing

IPD Sharing
Will not share

Locations