Conditioning Brain Responses to Improve Thigh Muscle Function After Anterior Cruciate Ligament Reconstruction

N/ACompletedNCT03209531

University of Michigan11 enrolled

Overview

The purpose of this study is to examine if thigh muscle weakness and the lack of muscle activation that accompanies ACL injury can be improved through a form of mental coaching and encouragement, known as operant conditioning.

Thigh muscle weakness is a common result after anterior cruciate ligament (ACL) injury and reconstruction surgery. Therefore, reducing thigh muscle weakness after ACL injury and reconstructive surgery is important as the quadriceps muscles act as shock absorbers that protect the knee joint. If significant weakness is present in the quadriceps, the knee is exposed to increased forces and often results in degeneration of the structures in the joint leading to osteoarthritis. Thus, it is important to investigate activation and strength rehabilitation methods for the quadriceps muscles. This research study is being done to learn if thigh muscle weakness and the lack of muscle activation that accompanies ACL injury can be improved by conditioning brain responses (elicited by non-invasive transcranial magnetic stimulation) using a form of training called as operant conditioning.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Anterior Cruciate Ligament Injury

Interventions

Operant ConditioningBEHAVIORAL

Active encouragement and feedback to increase motor evoked response when stimulated.

ControlBEHAVIORAL

Absence of active encouragement and feedback to increase motor evoked response when stimulated.

Single Pulse Transcranial Magnetic StimulationDEVICE

Transcranial magnetic stimulation to elicit a motor evoked response from the quadriceps muscles.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 45 Years

Medical Language ↔ Plain English

Inclusion Criteria: * aged 18-45 years * suffered an acute, complete ACL rupture * have undergone ACL reconstructive surgery * willingness to participate in testing and follow-up as outlined in the protocol Exclusion Criteria: * have suffered a previous ACL injury; * have undergone previous major surgery to either knee; * have a history of recent significant knee injury (other than ACL) or lower-extremity fracture; * have a history of uncontrolled diabetes or hypertension; * be pregnant or plan to become pregnant; * have metal implants in the head; * have electronic devices in their ear or heart (e.g., cochlear implants or cardiac pacemakers); * have unexplained recurrent headaches; * have a recent history of seizures; * be taking drugs that reduce seizure threshold; * have a history of repeated fainting spells;

Locations (1)

University of Michigan

Ann Arbor, Michigan, United States

Outcomes

Primary Outcomes

Changes in Quadriceps muscle strength

Quadriceps strength will be measured using an isokinetic dynamometer. Improvements in quadriceps strength from baseline to the end of intervention will be assessed and compared between groups.

Time frame: Approximately 8 weeks after the start of intervention

Secondary Outcomes

Changes in voluntary activation

Voluntary activation will be measured using an electrical superimposition technique. Improvements in voluntary activation from baseline to the end of intervention will be assessed and compared between groups.

Time frame: Approximately 8 weeks after the start of intervention

Data from ClinicalTrials.gov

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