Clinical Trials Logo

Clinical Trial Summary

To examine the long-term effects of anterior cruciate ligament injuries and reconstructions (after successful rehabilitation) on cortical processes of motor planning during complex jump landing tasks and the relevance of cognitive performance measures for landing stability, respectively knee injury risk.


Clinical Trial Description

Particularly, in the context of ball sports ruptures of the anterior cruciate ligament (ACL) are among the most frequent injuries. However, the ACL tear does not only result in a loss of mechanical stability in the knee joint: the tear of the ligament and the subsequent reconstructive surgery lead to a massive damage of so-called mechanoreceptors (proprioceptors). These small sensors provide the brain with precise information on the tension of the cruciate ligament and the position of the knee joint. Due to this feedback, it is possible for humans to adjust the activity of the stabilizing muscles to various situations in sports and daily life and to protect the knee from injuries. Thus, coordination deficits are common consequences after ACL-rupture and reconstruction due to the poorer sensory feedback.

New findings provide evidence that the injury-induced damage of the mechanoreceptors also causes persistent, neuronal reorganisations in the brain (injury induced neuroplasticity). These relate in particular to the motor cortex by which voluntary movements are controlled. According to the results of imaging (eg. functional magnetic resonance tomography; MRI) and electrophysiological studies (eg. Electroencephalography; EEG), these neurologic adaptation appear to persist far beyond the resumption of daily, sporting or competitive activities. Researchers suggest that these adaptations of the central nervous system might be the underlying cause of the frequently observed, persistent motor control and functional deficits (eg. muscle strength and muscle activation deficits), the relatively high re-injury, low return to sports rates and small proportions returning to their initial performance level after ACL tears and reconstruction. A pure restoration of the neuromuscular function without the elimination of the neuroplastic changes in the brain does therefore not appear sufficient.

In recent studies the effects of ACL trauma on brain activity have been investigated exclusively during unspecific, sport- and injury-unrelated tests (eg. simple flexion and extension movements and angular reproduction tasks of the knee). Often, injuries to the ACL occur under unpredictable conditions, especially in complex, dynamic movements such as changes of direction, jumps and landings. Here, the brain has to process information from the receptors of the ACL as quickly as possible to initiate an adequate motor response to protect the knee.

Against the background of the above described findings, this cross-sectional case-control study will firstly investigate the effects of completely healed ACL tears and reconstruction (side symmetry of neuromuscular performance measures above 85%) on movement planning related cortical activity (via Electroencephalography) measures during complex jump-landing tasks: The study participants perform counter-movement jumps (n=80; CMJ, flight time approximately 500 ms) followed by single leg landings. While under an anticipated condition (n=40), the individuals receive the visual information (presented on a screen) on which leg/ foot (left, right) they are required to land before self-initiated CMJs, the individuals will receive this information under the non-anticipated condition (n=40) only after take-off (approximately 400 ms before ground contact). The measurement of the landing stability is standardized by means of selected biomechanical parameters (capacitive force platform). Injury-relevant, cognitive characteristics (e.g., reaction, information processing speed and working memory) are detected by computer and paper-based clinical cognition tests.

The investigators hypothesize that the injury-related neurological adjustments in the motor cortex lead to a more intensive motor action planning before movement initiation (compensation of sensory deficits). The increased use of neuronal capacities for movement planning could subsequently lead to a slower or to unprecise motor responses to unforeseen/ non-anticipated events and subsequently cause greater landing instability, or increase the knee injury risk, respectively. It is also assumed that a lower cognitive information processing is associated with a more instable landing, or a higher risk of injury or higher injury incidence rate, respectively. ;


Study Design


Related Conditions & MeSH terms

  • Anterior Cruciate Ligament Reconstruction

NCT number NCT03336060
Study type Observational
Source Goethe University
Contact Winfried Banzer, Prof
Phone 06979824482
Email Banzer@sport.uni-frankfurt.de
Status Recruiting
Phase N/A
Start date October 1, 2017
Completion date June 30, 2018

See also
  Status Clinical Trial Phase
Completed NCT06280456 - Tranexamic Acid Injection With Different Drainage Clamping Time After Anterior Cruciate Ligament Reconstruction N/A
Active, not recruiting NCT02772770 - Pediatric ACL: Understanding Treatment Options
Terminated NCT00300300 - Anterior Cruciate Ligament (ACL) Reconstruction Using Different Grafts and Surgical Techniques Phase 4
Completed NCT00775892 - SeriACLâ„¢ Device (Gen IB) Trial for Anterior Cruciate Ligament (ACL) Repair Phase 1/Phase 2
Completed NCT04504344 - Non-invasive Brain Stimulation to Improve Quadriceps Muscle Function After Anterior Cruciate Ligament Reconstruction Phase 1
Recruiting NCT06327555 - Study on the Effect of Telerehabilitation Using Wearable Devices After ACL Reconstruction N/A
Recruiting NCT05968729 - Assessment of Gait Adaptation Due to an Asymmetric Walking Protocol N/A
Not yet recruiting NCT05972876 - Graft Maturity After Blood Flow Restriction Training in ACL Reconstruction N/A
Withdrawn NCT03688477 - Iovera° to Treat Pain Associated With ACL Reconstruction and Rehabilitation N/A
Completed NCT02945553 - Prevention of Skeletal Muscle Adaptations to Traumatic Knee Injury and Surgery Phase 1/Phase 2
Recruiting NCT01279759 - Follow up of Patients Operated With Anterior Cruciate Ligament Reconstruction N/A
Completed NCT00245271 - Safety of OMS103HP in Patients Undergoing Anterior Cruciate Ligament (ACL) Reconstruction Phase 3
Recruiting NCT06131047 - High Intensity Resistance Training With and Without Blood Flow Restriction in ACL Reconstruction N/A
Recruiting NCT06430775 - Exploring Prolonged AMR in ACL Reconstructed Patients
Recruiting NCT06206200 - The Effect of Cognitive Dual-task Rehabilitation on Arthrogenic Muscle Responses After ACL Reconstruction N/A
Not yet recruiting NCT06318039 - Operation ACL: Rehabilitation After Anterior Cruciate Ligament Reconstruction N/A
Completed NCT03304561 - The Effect of Contralateral Limb Training on Functional Outcomes in Patients With ACL Reconstruction N/A
Not yet recruiting NCT05619393 - Comparison of Kinematic Movements Between ACL Deficiency With ACL Reconstruction and Healthy People N/A
Completed NCT02604550 - Anterior Cruciate Ligament Pain Study Phase 4
Completed NCT02257164 - Anesthesic Techniques for Surgery of the Anterior Cruciate Ligament of the Knee in Ambulatory Surgery. Randomized Pilot Monocentric Trial Phase 4