Anterior cruciate ligament (ACL) injuries are common in sports and often require a long and challenging rehabilitation process. Athletes who sustain these injuries typically engage in pivoting and cutting sports, where these motor tasks must be performed simultaneously with cognitive tasks such as decision-making and keeping an eye on the opponent. Directing attention to both cognitive and motor tasks leads to cognitive-motor interference, which is associated with movement patterns that increase the risk of ACL (re)injury. Therefore, it is crucial that before returning to such demanding sports after ACL reconstruction, athletes sufficiently develop and automate safe yet efficient motor skills to free up attentional capacity for decision-making, thereby reducing the risk of suboptimal movement patterns and reinjury. However, current rehabilitation programs often primarily focus on the motor component in a single-task manner, giving insufficient attention to the cognitive component that is inseparable from sports. This randomized controlled trial aims to investigate the effects of implementing motor-cognitive dual tasks in the end phase rehabilitation after ACL reconstruction on muscle function, functional outcomes, and patient-reported outcomes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
80
Simultaneously performing cognitive tasks and motor rehabilitative exercises.
The current best physical therapy treatment for patients with anterior cruciate ligament reconstruction based on existing scientific evidence.
AZ Delta Roeselare (Campus Brugsesteenweg)
Roeselare, West-Vlaanderen, Belgium
RECRUITINGPsychological readiness to return to sport
Questioned using the ACL-RSI. Scores range from 0 to 100. Higher scores indicate higher psychological readiness.
Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)
Quadriceps and hamstrings activity / cocontraction during hop tasks
Electromyographical measurement of quadriceps and hamstrings activation during hop tasks.
Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)
Patient reported knee function
Questioned using the Knee Injury and Osteoarthritis Outcome Score (KOOS) with its different subscores. Scores on the KOOS range from 0-100, with 0 representing the greatest possible problems in terms of knee function and 100 representing no problems.
Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)
Jumping height in hop tests
Performance in single hop tests and a single leg drop-jump expressed by jump height in centimeters.
Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)
Activity level
Questioned using the Tegner Score. The scores range from 0 to 10, with higher scores indicating higher activity levels.
Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)
Voluntary quadriceps activation
A force-based isometric biodex measurement using the interpolated twitch/superimposed burst technique.
Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)
Quadriceps and hamstrings strength
Measured on the biodex.
Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)
Kinesiophobia
Questioned using the Tampa Scale of Kinesiophobia (TSK). Scores on the TSK range from 17 to 68, with higher scores indicating more kinesiophobia.
Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)
Subjective knee stability
Questioned using the first question of the Lysholm questionnaire. Scores range from 0 to 25 with 25 indicating no symptoms of subjective instability.
Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)
The amount of pain that the subjects experience.
Questioned using a Numeric Rating Scale. The scores range between 0 and 10 with 10 0representing the highest level of pain.
Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)
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