ACL Injury is a severe injury for athletes, which frequently results in functional limits and a higher likelihood of re-injury. Although bracing regimens are frequently used in rehabilitation, their ability to restore functional movements after an ACL Injury is still uncertain. Dynamic neuromuscular stabilization (DNS) training, which targets the core and proprioception, has emerged as a viable method for enhancing motor control and decreasing knee instability. The objective of this study is to examine the synergistic impact of cross bracing and DNS training on the functional movements of athletes who have recently experienced an ACL Injury . A randomized controlled trial will be conducted to study the effects of different interventions on athletes with acute ACL Injury. The participants will be divided into two groups: (A= control group) Cross bracing with conservative treatment, (B= Treatment group) Cross bracing + DNS training with conservative treatment. Both groups will engage in targeted exercises that aim to activate the core, improve proprioception, and enhance movement patterns. The participants' functional movements will be assessed at the beginning of the study and 6 weeks later using established questionnaire such as International Knee Documentation Committee (IKDC) score - assesses knee function and symptoms, Landing error scoring system (LESS), Y Balance (YB), Functional movement screening (FMS) Statistical analysis will be performed to compare the functional performance and neuromuscular parameters between the groups in order to determine the most effective intervention for restoring movement quality after ACL Injury .
The study's emphasis on cross bracing protocol and DNS training is warranted due to the necessity of investigating non-invasive and conservative therapy methods that have the ability to improve functional movements in athletes with ACL Injury . Cross bracing is frequently employed to offer external reinforcement and enhance stability to the knee joint subsequent to an ACL damage, whereas DNS training concentrates on reconditioning the neuromuscular system to enhance movement patterns and motor control. The study seeks to provide significant insights into the most effective rehabilitation regimens for athletes with acute ACL Injury by evaluating the effects of two therapies. The ultimate goal is to enhance their functional results and long-term sports performance.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
26
Week Exercise Training Frequency (sets x reps) Week 1-2 1. Cross Bracing (Isometric Holds) 2. Quad Sets 3. Straight Leg Raise 4. Ankle Pumps 5. Heel and Toe Raises 6. Glute Bridge 2 sets x 10 reps Week 3-4 1. Cross Bracing (Isometric Holds) 2. Hamstring Curls 3. Step-ups 4. Mini Squats (with support) 5. Leg Press 6. Lateral Leg Raises 3 sets x 12 reps Week 5-6 1. Cross Bracing (Isometric Holds) 2. Single-leg Balance (with support) 3. Lunges (with proper technique) 4. Squats (bodyweight) 5. Box Jumps 6. Lateral Step-ups 3 sets x 15 reps
Week Exercise Training Frequency (sets x reps) Week 1-2 1. Cross Bracing (Isometric Holds) 2. DNS Core Activation (supine, prone positions) 3. Quad Sets 4. Straight Leg Raise 5. Ankle Pumps 6. Heel and Toe Raises 7. Glute Bridge 2 sets x 10 reps Week 3-4 1\. Cross Bracing (Isometric Holds) 2. DNS Core Stabilization (advanced activation) 3. Hamstring Curls 4. Step-ups 5. Mini Squats 6. Leg Press 7. Lateral Leg Raises 8. Pelvic Tilts 3 sets x 12 reps Week 5-6 1. Cross Bracing (Isometric Holds) 2. DNS Dynamic Stabilization (with resistance) 3. Single-leg Balance (with and without support) 4. Lunges (with added resistance) 5. Squats (bodyweight or weighted) 6. Box Jumps 7. Lateral Step-ups 8. Running Drills (if tolerated) 3 sets x 15 reps
PSRD
Lahore, Punjab Province, Pakistan
International Knee Documentation Committee score
The International Knee Documentation Committee (IKDC) Subjective Knee Form is a patient-oriented questionnaire that assesses symptoms and function in daily living activities. The purpose of this study was to validate the IKDC Subjective Knee Form in a large patient population with various knee disorders. It contains sections on knee symptoms (7 items), function (2 items), and sports activities (2 items). Scores range from 0 points (lowest level of function or highest level of symptoms) to 100 points (highest level of function and lowest level of symptoms). The overall IKDC score showed acceptable test-retest reliability with an interclass correlation of 0.95.
Time frame: 6 week
Landing Error Scoring System
The Landing Error Scoring System (LESS) is a clinical tool often used in research and practice to identify athletes presenting high injury-risk biomechanical patterns during a jump-landing task. It is used to identify the risk of non-contact injuries during jumping and landing movements. It assesses 9 landing concepts and has 17 questions which are scored out of 19 points. Interrater reliability (ICC2, 1) for the LESS-RT ranged from .72 to .81 with standard error of measurements ranging from .69 to .79.
Time frame: 6 week
Y- Balance Test
The Y Balance Test was developed as a test of dynamic postural control and has been shown to be predictive of lower-extremity injury. It can be used for both the upper quarter and lower quarter. The YBT for the lower quarter (LQYBT) has been thoroughly researched as its protocol is based on research done on the Star Excursion Balance Test. The Star Excursion Balance Test demonstrated reliable results on its ability to predict LE injury in high school basketball players. The YBT has proven to have very good levels of interrater test-retest reliability (ICC = 0.80 - 0.85)
Time frame: 6 week
Functional Movement Screening
The Functional Movement Screen (FMS) is utilized by professional and collegiate sports teams and the military for the prevention of musculoskeletal injuries. The FMS is a tool used to identify asymmetries which result in functional movement deficiencies. The FMS aims to identify imbalances in mobility and stability during seven fundamental movement patterns. ICC values of 0.90-0.99 indicated excellent reliability, 0.80-0.89 indicated good reliability, 0.70-0.79 indicated fair reliability, and 0-0.69 indicated poor reliability.
Time frame: 6 week
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