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

NCT05342415 | Completed

• 1 other identifier: FTREK24/31
• Study Type: interventional
• Target: 24
• Locations: 1 country
• Sites: 1

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.

Conditions

Anterior Cruciate Ligament Reconstruction

Keywords

external focus; internal focus; knee rehabilitation; electromyography

Outcome Measures

Primary Outcomes (1)

• Determine if different focus techniques change thigh muscle activation

  Vastus medialis, vastus lateralis, and rectus femoris muscle activation will be measured by superficial electromyography

  Baseline and 1 month after surgery

Secondary Outcomes (2)

• Knee edema

  Baseline and 1 month after surgery

• Knee range of motion

  Baseline and 1 month after surgery

Study Arms (2)

Internally Focused

ACTIVE COMPARATOR

Focusing on the muscles that reveal the movement.

Other: Internally Focused Exercise

Externally Focused

EXPERIMENTAL

Focusing on the result of the movement.

Other: Externally Focused Exercise

Interventions

Internally Focused Exercise OTHER

While performing the exercises participants will be instructed to focus on the muscle itself.

Internally Focused

Externally Focused Exercise OTHER

While performing the exercises participants will be instructed to focus on the external target (towel, target line, etc.)

Externally Focused

Eligibility Criteria

• Age: 18 Years - 30 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

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

You may not qualify if:

• 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

Sponsors & Collaborators

• Hacettepe University: lead

Study Sites (1)

Hacettepe University

Ankara, Turkey (Türkiye)

Location

Related Publications (12)

• Saka T. Principles of postoperative anterior cruciate ligament rehabilitation. World J Orthop. 2014 Sep 18;5(4):450-9. doi: 10.5312/wjo.v5.i4.450. eCollection 2014 Sep 18.

  PMID: 25232521 BACKGROUND

• Kim DK, Hwang JH, Park WH. Effects of 4 weeks preoperative exercise on knee extensor strength after anterior cruciate ligament reconstruction. J Phys Ther Sci. 2015 Sep;27(9):2693-6. doi: 10.1589/jpts.27.2693. Epub 2015 Sep 30.

  PMID: 26504270 BACKGROUND

• Cavanaugh JT, Powers M. ACL Rehabilitation Progression: Where Are We Now? Curr Rev Musculoskelet Med. 2017 Sep;10(3):289-296. doi: 10.1007/s12178-017-9426-3.

  PMID: 28791612 BACKGROUND

• Sonnery-Cottet B, Saithna A, Quelard B, Daggett M, Borade A, Ouanezar H, Thaunat M, Blakeney WG. Arthrogenic muscle inhibition after ACL reconstruction: a scoping review of the efficacy of interventions. Br J Sports Med. 2019 Mar;53(5):289-298. doi: 10.1136/bjsports-2017-098401. Epub 2018 Sep 7.

  PMID: 30194224 BACKGROUND

• Halperin I, Williams KJ, Martin DT, Chapman DW. The Effects of Attentional Focusing Instructions on Force Production During the Isometric Midthigh Pull. J Strength Cond Res. 2016 Apr;30(4):919-23. doi: 10.1519/JSC.0000000000001194.

  PMID: 27003451 BACKGROUND

• Porter JM, Anton PM, Wikoff NM, Ostrowski JB. Instructing skilled athletes to focus their attention externally at greater distances enhances jumping performance. J Strength Cond Res. 2013 Aug;27(8):2073-8. doi: 10.1519/JSC.0b013e31827e1521.

  PMID: 23222082 BACKGROUND

• Ille A, Selin I, Do MC, Thon B. Attentional focus effects on sprint start performance as a function of skill level. J Sports Sci. 2013;31(15):1705-12. doi: 10.1080/02640414.2013.797097. Epub 2013 May 28.

  PMID: 23710928 BACKGROUND

• Marchant DC, Greig M, Scott C. Attentional focusing instructions influence force production and muscular activity during isokinetic elbow flexions. J Strength Cond Res. 2009 Nov;23(8):2358-66. doi: 10.1519/JSC.0b013e3181b8d1e5.

  PMID: 19826287 BACKGROUND

• Schoenfeld BJ, Vigotsky A, Contreras B, Golden S, Alto A, Larson R, Winkelman N, Paoli A. Differential effects of attentional focus strategies during long-term resistance training. Eur J Sport Sci. 2018 Jun;18(5):705-712. doi: 10.1080/17461391.2018.1447020. Epub 2018 Mar 13.

  PMID: 29533715 BACKGROUND

• Wulf G, Dufek JS, Lozano L, Pettigrew C. Increased jump height and reduced EMG activity with an external focus. Hum Mov Sci. 2010 Jun;29(3):440-8. doi: 10.1016/j.humov.2009.11.008. Epub 2010 Apr 21.

  PMID: 20409600 BACKGROUND

• Kal EC, van der Kamp J, Houdijk H. External attentional focus enhances movement automatization: a comprehensive test of the constrained action hypothesis. Hum Mov Sci. 2013 Aug;32(4):527-39. doi: 10.1016/j.humov.2013.04.001. Epub 2013 Jun 30.

  PMID: 24054892 BACKGROUND

• Ogrodzka-Ciechanowicz K, Glab G, Slusarski J, Gadek A. Quadriceps muscle strength recovery with the use of high tone power therapy after anterior cruciate ligament reconstruction: a randomized controlled trial. BMC Musculoskelet Disord. 2021 Nov 23;22(1):975. doi: 10.1186/s12891-021-04862-w.

  PMID: 34814896 BACKGROUND

Study Officials

• Volga Bayrakcı Tunay, PhD, Prof.

  Hacettepe University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The pre-and-post measurements will be performed by researchers who do not know the group allocation.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: April 3, 2022
• First Posted: April 22, 2022
• Study Start: September 1, 2024
• Primary Completion: September 1, 2025
• Study Completion: January 1, 2026
• Last Updated: January 8, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)