The Effect of Cognitive-Based Neuromuscular Exercises on Reaction Time, Joint Position Sense, Proprioceptive Force Sense and Balance in Individuals Who Had Anterior Cruciate Ligament Surgery

NCT06755398 | Enrolling By Invitation

• 1 other identifier: AnkaraYBU-OA
• Study Type: interventional
• Target: 28
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to investigate the effects of cognitive-based neuromuscular exercises on increased reaction time, decreased joint position sense, reduced proprioceptive force sense, and balance problems in individuals who have undergone surgery following anterior cruciate ligament (ACL) injuries. With the results obtained from the study, the investigators aim to provide a different perspective on rehabilitation methods applied after ACL reconstruction and contribute to the literature with objective and evidence-based information regarding the effects of cognitive-based neuromuscular exercises on sensorimotor, neuromuscular, and proprioceptive senses.

Conditions

ACL - Anterior Cruciate Ligament Rupture

Keywords

ACL rupture; Cocnitive task; Proprioception; Dual Task

Outcome Measures

Primary Outcomes (1)

• The Effect of an 8-Week Cognitive-Based Neuromuscular Exercise Program on Lower Extremity Reaction Time

  This study evaluates lower extremity reaction time in individuals with anterior cruciate ligament (ACL) injuries using the FITLIGHT Corp system. Participants will deactivate randomly illuminated lights with their lower extremities. The system's wireless sensor discs will be placed according to each participant's leg length to minimize balance-related factors. Five lights will be arranged in a semicircular pattern at 45-degree intervals. Reaction time will be measured under three conditions: baseline, cognitive task, and motor task. In the baseline condition, participants will complete a 30-second practice trial followed by a 1-minute test trial. During the cognitive task, participants will count backward from 600 by fives while deactivating the lights. In the motor task, they will toss and catch a ball with their dominant hand while performing the light-deactivation task. The average reaction time in seconds will be recorded for both the injured and uninjured limbs.

  8 week

Study Arms (2)

Standard treatment group

SHAM COMPARATOR

The protocol developed by the Royal Dutch Society for Physical Therapy (KNGF) will be applied following anterior cruciate ligament (ACL) surgery.

Other: Exercise

experimental group

EXPERIMENTAL

During the exercises based on the protocol developed by the Royal Dutch Society for Physical Therapy (KNGF) following anterior cruciate ligament (ACL) surgery, additional cognitive tasks will be assigned to the patients.

Other: Exercise

Interventions

Exercise OTHER

During the exercises based on the protocol developed by the Royal Dutch Society for Physical Therapy (KNGF) following anterior cruciate ligament (ACL) surgery, additional cognitive tasks will be assigned to the patients.

Also known as: dual task exercises, cognitive exercises

Standard treatment group

Eligibility Criteria

• Age: 20 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Having sustained a unilateral isolated anterior cruciate ligament injury,
• Having undergone anterior cruciate ligament reconstruction using a hamstring graft by a surgeon at least 8 weeks ago,
• Having completed the early phase of the postoperative criterion-based rehabilitation protocol and met the criteria for progression to the intermediate phase of the rehabilitation program (1- pain between 0-2 on the numeric pain scale, 2- no effusion in the knee, 3- no limitation in passive knee extension, 4- passive knee flexion of at least 120°, 5- full quadriceps activation (patient able to perform 10 repetitions of a single-leg raise exercise), and 6- normalized gait pattern without assistance).

You may not qualify if:

• Having a partial ACL tear,
• Having sustained bilateral ACL injuries,
• Having additional injuries accompanying the ACL injury,
• Having undergone ACL revision surgery,
• Having a history of complex knee surgery,
• Having any neurological, orthopedic, or systemic disease that may contraindicate exercise.

Sponsors & Collaborators

• Ertuğrul Demirdel: lead
• Antalya Bilim University: collaborator

Study Sites (1)

Antalya Bilim University

Antalya, 07100, Turkey (Türkiye)

Location

Related Publications (7)

• Elabd OM, Elabd AM. Functional outcomes of a criterion-based rehabilitation protocol for anterior cruciate ligament reconstruction in amateur athletes: A randomised clinical trial. J Bodyw Mov Ther. 2023 Jul;35:7-13. doi: 10.1016/j.jbmt.2023.04.037. Epub 2023 Apr 17.

  PMID: 37330806 BACKGROUND

• Buckthorpe M, Della Villa F. Optimising the 'Mid-Stage' Training and Testing Process After ACL Reconstruction. Sports Med. 2020 Apr;50(4):657-678. doi: 10.1007/s40279-019-01222-6.

  PMID: 31782065 BACKGROUND

• Elabd OM, Alghadir AH, Ibrahim AR, Hasan S, Rizvi MR, Sharma A, Iqbal A, Elabd AM. Functional outcomes of accelerated rehabilitation protocol for anterior cruciate ligament reconstruction in amateur athletes: a randomized clinical trial. J Rehabil Med. 2024 Feb 22;56:jrm12296. doi: 10.2340/jrm.v56.12296.

  PMID: 38385715 BACKGROUND

• Li D, Zhang Q, Liu X, Chen C, Lu J, Ye D, Li Y, Wang W, Shen M. Effect of water-based walking exercise on rehabilitation of patients following ACL reconstruction: a prospective, randomised, single-blind clinical trial. Physiotherapy. 2022 Jun;115:18-26. doi: 10.1016/j.physio.2021.11.003. Epub 2021 Dec 1.

  PMID: 35101723 BACKGROUND

• Kiele D, Solianik R. Four-Week Application of Kinesiotaping Improves Proprioception, Strength, and Balance in Individuals With Complete Anterior Cruciate Ligament Rupture. J Strength Cond Res. 2023 Jan 1;37(1):213-219. doi: 10.1519/JSC.0000000000004245. Epub 2022 Apr 13.

  PMID: 35438677 BACKGROUND

• Buckthorpe M, Gokeler A, Herrington L, Hughes M, Grassi A, Wadey R, Patterson S, Compagnin A, La Rosa G, Della Villa F. Optimising the Early-Stage Rehabilitation Process Post-ACL Reconstruction. Sports Med. 2024 Jan;54(1):49-72. doi: 10.1007/s40279-023-01934-w. Epub 2023 Oct 3.

  PMID: 37787846 BACKGROUND

• Leal J, Mirza B, Davies L, Fletcher H, Stokes J, Cook JA, Price A, Beard DJ. Cost-effectiveness analysis of a pragmatic randomized trial evaluating surgical reconstruction versus rehabilitation in patients with long-standing anterior cruciate ligament injury. Bone Joint J. 2024 Jan 1;106-B(1):38-45. doi: 10.1302/0301-620X.106B1.BJJ-2023-0175.R1.

  PMID: 38160685 BACKGROUND

MeSH Terms

Conditions

Anterior Cruciate Ligament Injuries

Interventions

Exercise

Condition Hierarchy (Ancestors)

Knee Injuries; Leg Injuries; Wounds and Injuries

Intervention Hierarchy (Ancestors)

Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Ertugrul Demirdel, Associate professor

  Ankara Yildirim Beyazıt University

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Associate professor

Study Record Dates

• First Submitted: December 18, 2024
• First Posted: January 1, 2025
• Study Start: June 20, 2024
• Primary Completion: December 31, 2025
• Study Completion: December 31, 2025
• Last Updated: January 1, 2025

Record last verified: 2024-06

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)