Anterior Cruciate Ligament Injuries Clinical Trial
Official title:
The Use of Visuomotor Therapy to Modulate Corticospinal Excitability in Patients Following ACL-Reconstruction
The purpose of this study is to investigate the neurophysiological contributors to muscle
function following ACL Reconstruction and the influence of motor control biofeedback exercise
on measures of muscle function. The research team hypothesizes that the application of motor
biofeedback will increase cortical excitability of the quadriceps compared to the passive
movement of the knee.
This is a single session cross-over intervention study with a 1-week washout period between
treatment arms.
1. Pre-treatment neuromuscular assessment Cortical Active Motor Threshed We will measure
motor evoked potentials with the use of a Transcranial magnetic stimulator (MagStim
model 200, Magstim Co., Ltd., Wales, UK). The MagStim has FDA 510K Clearance for
stimulation of peripheral nerves.
- The participant will be asked to sit in the dynamometer (Biodex, System 3) in knee
extension at 90 degrees of knee flexion.
- EMG electrodes will be placed on the distal quadriceps
o Local shaving, debridement, and cleaning will be done prior if necessary
- A non-latex swim cap will be placed on the participants head for investigator's
measurements
- Briefly, a magnetic field with a maximum value of 2.2 Tesla will be introduced to
the scalp at a location in the pre-motor cortex that corresponds to the quadriceps.
Single pulse stimulations will be delivered with no less than 10 seconds between
stimulations (maximum = 0.1 Hz).
- When the magnetic field is received at the premotor cortex at the appropriate area,
a motor signal is sent to the quadriceps. We will record this signal with surface
EMG electrodes that are on the quadriceps.
- The participant will be asked to extend their leg to match a force equivalent to 5%
MVIC. Feedback will be provided to the participant to provide such force.
- Stimulation of the TMS will happen once every ten seconds until the Active Motor
Threshold was found by the investigator.
- The motor evoked potential measured by the quadriceps will be recorded at 80%,
90%, 100%, 110%, 120%, 130%, 140%, and 150% of the patients Active motor
threshold.
2. Patient randomization
- The patient is then randomized to 1 of 2 treatment arms. 1) Visuomotor Therapy or 2)
Passive Motion
3. Perform Randomized Treatment Visuomotor Therapy
- The participant will sit in the Biodex chair with the tested limb secured in the
dynamometer
- The participant will receive live real-time biofeedback of their knee force output
(no more than 30% of maximum force)
- The participant will aim to match their force output to a target threshold
presented on the screen.
- The participant will complete 10 60-second trials of this exercise with a 30 second
rest between each trial.
OR
Passive Motion
- The participant will sit in the Biodex chair with the tested limb secured in the
dynamometer
- The dynamometer will passively move the patients lower limb between 80 to 120
degrees of knee flexion
- The participant will be asked to relax for the duration of testing - The
participant will complete 10 60-second trials of this exercise with a 30 second
rest between each trial.
4. Reassess Neuromuscular outcome (Step 1)
5. 1-week washout period
6. Repeat Steps 1 through 4 but the patient receives the cross-over arm intervention
;
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT04062578 -
Effects Provided by a Physiotherapy Treatment Preventing Lower Extremity Injuries in Female Football Players
|
N/A | |
Recruiting |
NCT05461326 -
Quadriceps Tendon Versus Bone Patellar Tendon Bone Autograft ACL Reconstruction RCT
|
N/A | |
Completed |
NCT05109871 -
Reliability and Validity of Inline Dynamometry Study for Measuring Knee Extensor Torque
|
N/A | |
Completed |
NCT05504018 -
Clinical and Radiological Evaluation of ACL Reconstruction Results
|
N/A | |
Recruiting |
NCT06185231 -
Investigation of the Effects of Vibration Therapy on Pain, Functionality, and Proprioception After ACL Injury
|
N/A | |
Recruiting |
NCT03968913 -
Biologic Therapy to Prevent Osteoarthritis After ACL Injury
|
Early Phase 1 | |
Completed |
NCT04408690 -
Feasibility of a RCT That Compares Immediate Versus Optional Delayed Surgical Repair After ACL Injury
|
Phase 3 | |
Recruiting |
NCT06222814 -
Evaluation of the Results of Two Different Methods in Management of Antero-lateral Instability of the Knee
|
N/A | |
Recruiting |
NCT05614297 -
Agreement Between Rolimeter and Lachmeter in Patients With ACL Injury
|
||
Active, not recruiting |
NCT05184023 -
The Effect of PEMF for Patients With Quadriceps Muscle Weakness After ACLR
|
N/A | |
Completed |
NCT04906538 -
Objective Results of Anterior Cruciate Ligament Reconstruction With and Without Internal Suture Augmentation Technique
|
Phase 2/Phase 3 | |
Completed |
NCT05014009 -
The Influence of Neuromuscular Training on Whole-body Movement Strategies and Knee Mechanics During Change-of-direction Tasks in Sports Science Students
|
N/A | |
Not yet recruiting |
NCT06083818 -
Anterior Cruciate Ligament Injury Prevention Protocol in Female Football Players With Dynamic Knee Valgus
|
N/A | |
Recruiting |
NCT05584020 -
Arthroscopic Anterior Cruciate Ligament Repair Versus Reconstruction for Acute Anterior Cruciate Ligament Injury
|
N/A | |
Completed |
NCT04580290 -
Jewel ACL Post Market Clinical Follow Up Study
|
||
Recruiting |
NCT04888052 -
Prolonged Preoperative Rehabilitation in ACL Rupture.
|
N/A | |
Recruiting |
NCT06430775 -
Exploring Prolonged AMR in ACL Reconstructed Patients
|
||
Not yet recruiting |
NCT05580133 -
All-Inside Single-Bundle for Anterior Cruciate Ligament Reconstruction With Full Thickness of the Peroneus Longus Tendon Compared to the Six-strand-hamstring Autograft (ACL)
|
||
Recruiting |
NCT04162613 -
Can Sensorimotor Function Predict Graft Rupture After ACL Reconstruction
|
||
Not yet recruiting |
NCT05619393 -
Comparison of Kinematic Movements Between ACL Deficiency With ACL Reconstruction and Healthy People
|
N/A |