Effects of Progressive Resistance Exercises Among Athletes With Hamstring Deficit After ACL Reconstruction

NCT06846164 | Active Not Recruiting

• 1 other identifier: REC/RCR&AHS/24/0409
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of the study is to find out how mild home exercises (similar to usual care) and progressive strength training, which include neuromuscular exercise, affected knee joint function and HS muscle strength in individuals who has persistent HS muscle strength deficits 12-24 months after ACLR.

Conditions

Sports Physical Therapy

Keywords

Anterior Cruciate Ligament; resistance training; Athletes

Outcome Measures

Primary Outcomes (1)

• Limb Symmetry Index

  It is used for knee extensors and flexors strength. It is the strength ratio between the injured and uninjured knees. It is a common method of assessing strength and functional performance after ACLR.

  12 weeks

Secondary Outcomes (1)

• H/Q ratio

  12 weeks

Other Outcomes (1)

• KOOS questionnaire

  12 weeks

Study Arms (2)

Supervised progressive strength training with elements like (SNG)

EXPERIMENTAL

Participants will be randomized to SNG and perform training sessions (60-70 minutes) twice weekly, over 12 weeks, commencing 8 exercises for the lower extremities in 3 sets of 10 repetitions with an intensity of 12 repetitions maximum. Individual progression, quality of exercise, number of sets, repetitions, and additional training weights will be monitored and adjusted throughout the intervention period by experienced physiotherapists

Other: Supervised progressive strength training including elements of neuromuscular exercise intervention (SNG)

home based low-intensity weight-bearing exercise protocol

EXPERIMENTAL

Participants allocated to CON will receive written and verbal instructions regarding 4 home-based (low-intensity), weight-bearing exercises for the lower extremities, to be performed twice weekly. This intervention is designed to resemble usual care in cases where persistent knee muscle strength deficits would be discovered and considered a clinical issue.

Other: home based low-intensity weight-bearing exercise protocol.

Interventions

Supervised progressive strength training including elements of neuromuscular exercise intervention (SNG) OTHER

Participants will be randomized to SNG and will perform training sessions (60-70 minutes) twice weekly, over a duration of 12 weeks, commencing 8 exercises for the lower extremities in 3 sets of 10 repetitions with an intensity of 12 repetitions maximum. Individual progression, quality of exercise, number of sets, repetitions, and additional training weights will be monitored

Supervised progressive strength training with elements like (SNG)

home based low-intensity weight-bearing exercise protocol. OTHER

Participants allocated to CON will receive written and verbal instructions regarding 4 home-based (low intensity), weight-bearing exercises for the lower extremities, to be performed twice weekly. This intervention is designed to resemble usual care in cases where persistent knee muscle strength deficits would be discovered and considered a clinical issue.

home based low-intensity weight-bearing exercise protocol

Eligibility Criteria

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

You may qualify if:

• Age between 18 - 30 years
• months post-surgery (ACL reconstruction)
• Persistent maximal isometric knee flexor strength asymmetry (\>10% leg-to-leg the difference, in the isometric testing angle of 90° knee flexion)

You may not qualify if:

• Body mass index \[BMI\] more than 35
• known lower limb pathology (including previous and/or concomitant knee injuries requiring surgical intervention to either knee)

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Innovative Health Concept

Lahore, 54770, Pakistan

Location

Related Publications (12)

• Chechik O, Amar E, Khashan M, Lador R, Eyal G, Gold A. An international survey on anterior cruciate ligament reconstruction practices. Int Orthop. 2013 Feb;37(2):201-6. doi: 10.1007/s00264-012-1611-9. Epub 2012 Jul 11.

  PMID: 22782378 BACKGROUND

• Mall NA, Chalmers PN, Moric M, Tanaka MJ, Cole BJ, Bach BR Jr, Paletta GA Jr. Incidence and trends of anterior cruciate ligament reconstruction in the United States. Am J Sports Med. 2014 Oct;42(10):2363-70. doi: 10.1177/0363546514542796. Epub 2014 Aug 1.

  PMID: 25086064 BACKGROUND

• Shaerf DA, Pastides PS, Sarraf KM, Willis-Owen CA. Anterior cruciate ligament reconstruction best practice: A review of graft choice. World J Orthop. 2014 Jan 18;5(1):23-9. doi: 10.5312/wjo.v5.i1.23. eCollection 2014 Jan 18.

  PMID: 24649411 BACKGROUND

• Ardern CL, Webster KE, Taylor NF, Feller JA. Return to the preinjury level of competitive sport after anterior cruciate ligament reconstruction surgery: two-thirds of patients have not returned by 12 months after surgery. Am J Sports Med. 2011 Mar;39(3):538-43. doi: 10.1177/0363546510384798. Epub 2010 Nov 23.

  PMID: 21098818 BACKGROUND

• Filbay SR, Grindem H. Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture. Best Pract Res Clin Rheumatol. 2019 Feb;33(1):33-47. doi: 10.1016/j.berh.2019.01.018. Epub 2019 Feb 21.

  PMID: 31431274 BACKGROUND

• Gobbi A, Francisco R. Factors affecting return to sports after anterior cruciate ligament reconstruction with patellar tendon and hamstring graft: a prospective clinical investigation. Knee Surg Sports Traumatol Arthrosc. 2006 Oct;14(10):1021-8. doi: 10.1007/s00167-006-0050-9. Epub 2006 Feb 22.

  PMID: 16496124 BACKGROUND

• Bram JT, Magee LC, Mehta NN, Patel NM, Ganley TJ. Anterior Cruciate Ligament Injury Incidence in Adolescent Athletes: A Systematic Review and Meta-analysis. Am J Sports Med. 2021 Jun;49(7):1962-1972. doi: 10.1177/0363546520959619. Epub 2020 Oct 22.

  PMID: 33090889 BACKGROUND

• Bencke J, Aagaard P, Zebis MK. Muscle Activation During ACL Injury Risk Movements in Young Female Athletes: A Narrative Review. Front Physiol. 2018 May 15;9:445. doi: 10.3389/fphys.2018.00445. eCollection 2018.

  PMID: 29867521 BACKGROUND

• More RC, Karras BT, Neiman R, Fritschy D, Woo SL, Daniel DM. Hamstrings--an anterior cruciate ligament protagonist. An in vitro study. Am J Sports Med. 1993 Mar-Apr;21(2):231-7. doi: 10.1177/036354659302100212.

  PMID: 8465918 BACKGROUND

• Zebis MK, Andersen LL, Bencke J, Kjaer M, Aagaard P. Identification of athletes at future risk of anterior cruciate ligament ruptures by neuromuscular screening. Am J Sports Med. 2009 Oct;37(10):1967-73. doi: 10.1177/0363546509335000. Epub 2009 Jul 2.

  PMID: 19574475 BACKGROUND

• Bieler T, Sobol NA, Andersen LL, Kiel P, Lofholm P, Aagaard P, Magnusson SP, Krogsgaard MR, Beyer N. The effects of high-intensity versus low-intensity resistance training on leg extensor power and recovery of knee function after ACL-reconstruction. Biomed Res Int. 2014;2014:278512. doi: 10.1155/2014/278512. Epub 2014 Apr 27.

  PMID: 24877078 BACKGROUND

• Hanada M, Yoshikura T, Matsuyama Y. Muscle recovery at 1 year after the anterior cruciate ligament reconstruction surgery is associated with preoperative and early postoperative muscular strength of the knee extension. Eur J Orthop Surg Traumatol. 2019 Dec;29(8):1759-1764. doi: 10.1007/s00590-019-02479-3. Epub 2019 Jun 25.

  PMID: 31240385 BACKGROUND

Study Officials

• Hafiz Attiq ur Rehman

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 20, 2025
• First Posted: February 25, 2025
• Study Start: April 24, 2024
• Primary Completion: November 10, 2024
• Study Completion: February 25, 2025
• Last Updated: February 25, 2025

Record last verified: 2025-02

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)