Comparative Effects of Neuromuscular Training Vs Close Chain Exercises in Athletes With Post Operative ACL Injury

NCT ID: NCT06797102

Last Updated: 2025-02-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-04-01

Study Completion Date

2024-09-30

Brief Summary

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The aim of this study is to determine the effects of close chain exercises and neuromuscular training on pain, range of motion, strength and endurance in athletes with post operative ACL injury The study will be randomized control trial with the sample size of 36. Subjects will be enrolled according to inclusion and exclusion criteria. Patients will be divided into two groups, each with 18 patients. Group A will receive Neuromuscular training while Group B will receive Close chain exercises. The participants will receive treatment sessions over 6-week period. The treatment session will be of 60 minutes with a warm up and cool down period of 10 minutes. Outcome measures in both groups will be assessed by International Knee Documentation Committee Evaluation Form. Score for function, Numeric Pain Rating Scale (NPRS) for pain, Goniometer to measure range of motion, single leg hop, squats, triple jump test, push ups for strength and endurance respectively.

Detailed Description

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Objective of my study is to compare the effects of Neuromuscular Training vs Close Chain Exercises on pain, range of motion, strength and endurance in athletes with post operative ACL injury

Conditions

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Sports Physical Therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Group A neuromuscular training

Patients in this group received a neuromuscular training protocol along with general treatment for 10 minutes

Group Type EXPERIMENTAL

Neuromuscular Exercises

Intervention Type OTHER

Patients in this group received a neuromuscular training protocol along with general treatment for 10 minutes. This included hot packs, lumbar stretches, and ergonomic posture correction divided over 6 weeks The exercises performed included squatting, single leg stance, and balance reach leg and arm exercises with 10 repetitions each. They also did lunge exercises with five repetitions bilaterally, step up and down exercises with 10 repetitions, single leg standing on a balance mat with 10 repetitions and a 10-second hold, single board exercises, and single leg stance with weights and eyes closed for five minutes with a 10-second hold. Additionally, they stood on a wobble board with eyes closed five times with a 10-second hold. The protocol included running on a treadmill and trampoline for five minutes per day, running figure-of-eight patterns, and agility drills at a slow speed for five minutes each.

Group B Close chain exercises

Patients in this group will receive close chain exercises for core strengthening along with general treatment for 10 min

Group Type EXPERIMENTAL

Close Chain Exercises

Intervention Type OTHER

Patients in this group received closed chain exercises for core strengthening along with general treatment for 10 minutes, including hot packs, lumbar stretches, and ergonomic posture correction, divided over 6 weeks. The exercises included sets of squats, lunges, leg presses, wall squats, standing heel raises on a single leg, and single leg dead lifts. Each treatment session lasted 60 minutes, incorporating a warm-up and cool-down period of 10 minutes.

Interventions

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Neuromuscular Exercises

Patients in this group received a neuromuscular training protocol along with general treatment for 10 minutes. This included hot packs, lumbar stretches, and ergonomic posture correction divided over 6 weeks The exercises performed included squatting, single leg stance, and balance reach leg and arm exercises with 10 repetitions each. They also did lunge exercises with five repetitions bilaterally, step up and down exercises with 10 repetitions, single leg standing on a balance mat with 10 repetitions and a 10-second hold, single board exercises, and single leg stance with weights and eyes closed for five minutes with a 10-second hold. Additionally, they stood on a wobble board with eyes closed five times with a 10-second hold. The protocol included running on a treadmill and trampoline for five minutes per day, running figure-of-eight patterns, and agility drills at a slow speed for five minutes each.

Intervention Type OTHER

Close Chain Exercises

Patients in this group received closed chain exercises for core strengthening along with general treatment for 10 minutes, including hot packs, lumbar stretches, and ergonomic posture correction, divided over 6 weeks. The exercises included sets of squats, lunges, leg presses, wall squats, standing heel raises on a single leg, and single leg dead lifts. Each treatment session lasted 60 minutes, incorporating a warm-up and cool-down period of 10 minutes.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Athletes aged 18 to 35 years
* 6-9 months after ACL reconstruction
* Athletes who sustained unilateral ACL injury treated surgically
* Athletes returning to sports
* minimal to no knee effusion
* normal knee range of motion
* Willing to take post-operative exercise program

Exclusion Criteria

* History of lower extremity fractures surgery or traumatic injuries
* Neuromuscular disease
* Systemic disease
* Patients who had history of prior knee surgery were excluded
Minimum Eligible Age

18 Years

Maximum Eligible Age

35 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Riphah International University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Aamir Gul Memon, MS

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

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Bahawal Victoria Hospital

Bahawalpur, Punjab Province, Pakistan

Site Status

Countries

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Pakistan

References

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Joreitz R, Lynch A, Rabuck S, Lynch B, Davin S, Irrgang J. PATIENT-SPECIFIC AND SURGERY-SPECIFIC FACTORS THAT AFFECT RETURN TO SPORT AFTER ACL RECONSTRUCTION. Int J Sports Phys Ther. 2016 Apr;11(2):264-78.

Reference Type BACKGROUND
PMID: 27104060 (View on PubMed)

Cavanaugh JT, Saldivar A, Marx RG. Postoperative rehabilitation after posterior cruciate ligament reconstruction and combined posterior cruciate ligament reconstruction-posterior lateral corner surgery. Operative Techniques in Sports Medicine. 2015;23(4):372-84.

Reference Type BACKGROUND

Nelson C, Rajan L, Day J, Hinton R, Bodendorfer BM. Postoperative Rehabilitation of Anterior Cruciate Ligament Reconstruction: A Systematic Review. Sports Med Arthrosc Rev. 2021 Jun 1;29(2):63-80. doi: 10.1097/JSA.0000000000000314.

Reference Type BACKGROUND
PMID: 33972483 (View on PubMed)

Perriman A, Leahy E, Semciw AI. The Effect of Open- Versus Closed-Kinetic-Chain Exercises on Anterior Tibial Laxity, Strength, and Function Following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2018 Jul;48(7):552-566. doi: 10.2519/jospt.2018.7656. Epub 2018 Apr 23.

Reference Type BACKGROUND
PMID: 29685058 (View on PubMed)

Kronenberger JN. What is the effectiveness of neuromuscular training versus traditional strength training on restoration of knee function in the rehabilitation of non-operative or post-operative anterior cruciate ligament patients? A Systematic Review: Walsh University; 2018.

Reference Type BACKGROUND

Huang DD, Chen LH, Yu Z, Chen QJ, Lai JN, Li HH, Liu G. Effect of suspension training on neuromuscular function, postural control, and knee kinematics in anterior cruciate ligament reconstruction patients. World J Clin Cases. 2021 Apr 6;9(10):2247-2258. doi: 10.12998/wjcc.v9.i10.2247.

Reference Type BACKGROUND
PMID: 33869600 (View on PubMed)

Wang K, Cheng L, Wang B, He B. Effect of isokinetic muscle strength training on knee muscle strength, proprioception, and balance ability in athletes with anterior cruciate ligament reconstruction: a randomised control trial. Front Physiol. 2023 Sep 19;14:1237497. doi: 10.3389/fphys.2023.1237497. eCollection 2023.

Reference Type BACKGROUND
PMID: 37795267 (View on PubMed)

Moubarak EES, Yousef EF, Dawood RS, El Shamy ASAH, Abdelrahem MEA. Effect of Adding Preoperative Exercise to Postoperative Rehabilitation Program of Progressive Exercises on Anterior Cruciate Ligament Reconstruction. Egyptian Journal of Physical Therapy. 2023;15(1):18-26.

Reference Type BACKGROUND

Walters SL. EFFECTS OF ACL RECONSTRUCTION ON MUSCULAR STRENGTH, ENDURANCE AND MITOCHONDRIAL CAPACITY: University of Georgia.

Reference Type BACKGROUND

Sigit M, Doewes M, Liskustyawati H. The effect of open kinetic chain exercise and close kinetic chain exercise on strength quadriceps femoris muscle post anterior cruciate ligament surgery in terms of age. Advances in Health and Exercise. 2024;4(1):10-6.

Reference Type BACKGROUND

Pamboris GM, Pavlou K, Paraskevopoulos E, Mohagheghi AA. Effect of open vs. closed kinetic chain exercises in ACL rehabilitation on knee joint pain, laxity, extensor muscles strength, and function: a systematic review with meta-analysis. Front Sports Act Living. 2024 Jun 3;6:1416690. doi: 10.3389/fspor.2024.1416690. eCollection 2024.

Reference Type BACKGROUND
PMID: 38887689 (View on PubMed)

Qiu M. Comparison of Modalities and Strength and Motor Control Training Methods after Anterior Cruciate Ligament Reconstruction Surgery and Recommendations. MedScien. 2024;1(7).

Reference Type BACKGROUND

Gandhi KM, Ratnani G, Deodhe NP, Shende K. Enhancing Muscle Strength Post Anterior Cruciate Ligament Reconstruction: A Case Report Assessing the Effectiveness of Russian Current. Cureus. 2024 Feb 21;16(2):e54593. doi: 10.7759/cureus.54593. eCollection 2024 Feb.

Reference Type BACKGROUND
PMID: 38524050 (View on PubMed)

Buckthorpe M. Optimising the Late-Stage Rehabilitation and Return-to-Sport Training and Testing Process After ACL Reconstruction. Sports Med. 2019 Jul;49(7):1043-1058. doi: 10.1007/s40279-019-01102-z.

Reference Type BACKGROUND
PMID: 31004279 (View on PubMed)

Crank C, MOMT TMP. Rehabilitation Following Anterior Cruciate Ligament and Posterolateral Corner Reconstruction with Medial and Lateral Meniscus Repairs in A High School Athlete: A Retrospective Case Report. Orthopaedic Physical Therapy Practice. 2020;32(2):76-81.

Reference Type BACKGROUND

Welling W, Benjaminse A, Lemmink K, Dingenen B, Gokeler A. Progressive strength training restores quadriceps and hamstring muscle strength within 7 months after ACL reconstruction in amateur male soccer players. Phys Ther Sport. 2019 Nov;40:10-18. doi: 10.1016/j.ptsp.2019.08.004. Epub 2019 Aug 9.

Reference Type BACKGROUND
PMID: 31425918 (View on PubMed)

Joreitz R, Lynch A, Popchak A, Irrgang J. CRITERION-BASED REHABILITATION PROGRAM WITH RETURN TO SPORT TESTING FOLLOWING ACL RECONSTRUCTION: A CASE SERIES. Int J Sports Phys Ther. 2020 Dec;15(6):1151-1173. doi: 10.26603/ijspt20201151.

Reference Type BACKGROUND
PMID: 33344032 (View on PubMed)

Herman ZJ, Reddy RP, Fails A, Lin A, Popchak A. Rehabilitation and Return to Sport following Operative and Nonoperative Treatment of Anterior Shoulder Instability. Clin Sports Med. 2024 Oct;43(4):705-722. doi: 10.1016/j.csm.2024.03.025. Epub 2024 Apr 23.

Reference Type BACKGROUND
PMID: 39232575 (View on PubMed)

Simonsson R, Piussi R, Hogberg J, Sundberg A, Hamrin Senorski E. Rehabilitation and Return to Sport After Anterior Cruciate Ligament Reconstruction. Clin Sports Med. 2024 Jul;43(3):513-533. doi: 10.1016/j.csm.2023.07.004. Epub 2023 Aug 23.

Reference Type BACKGROUND
PMID: 38811125 (View on PubMed)

Ashoury H, Yalfani A, Arjipour M. The effects of open/closed kinetic chain exercises in water on the electrical activity of selected lumbar muscles, lumbopelvic control, ground reaction force and psychological factors in men with chronic non-specific low back pain: A study protocol for a randomized clinical trial. J Bodyw Mov Ther. 2024 Oct;40:2147-2154. doi: 10.1016/j.jbmt.2024.10.065. Epub 2024 Oct 25.

Reference Type BACKGROUND
PMID: 39593577 (View on PubMed)

Forelli F, Mazeas J, Zeghoudi Y, Vandebrouck A, Duffiet P, Ratte L, Kakavas G, Hewett TE, Korakakis V, Rambaud AJM. Intrinsic graft laxity variation with open kinetic chain exercise after anterior cruciate ligament reconstruction: A non-randomized controlled study. Phys Ther Sport. 2024 Mar;66:61-66. doi: 10.1016/j.ptsp.2024.01.009. Epub 2024 Feb 6.

Reference Type BACKGROUND
PMID: 38335650 (View on PubMed)

Girdwood M, Culvenor AG, Patterson B, Haberfield M, Rio EK, Hedger M, Crossley KM. No sign of weakness: a systematic review and meta-analysis of hip and calf muscle strength after anterior cruciate ligament injury. Br J Sports Med. 2024 Apr 25;58(9):500-510. doi: 10.1136/bjsports-2023-107536.

Reference Type BACKGROUND
PMID: 38537939 (View on PubMed)

Trabka R, Maicki T, Kaminski P, Pawelczyk A, Zielinski P, Wilk-Franczuk M. Outcomes Following Arthroscopic Single and Double Bundle Anterior Cruciate Ligament (ACL) Reconstruction Supported by the Comprehensive Early Rehabilitation Program (CERP). Med Sci Monit. 2020 May 12;26:e921003. doi: 10.12659/MSM.921003.

Reference Type BACKGROUND
PMID: 32396534 (View on PubMed)

Λιγνού Ε-Ά. Prevalence of central sensitizationsymptomsand psychosocial factors in athletes after ACL reconstruction and return to play 2020.

Reference Type BACKGROUND

HEDYA WM. Effect of different exercise rehabilitation programs with body weight reduction on reducing the time of injured limb efficient restoration before and after low knee osteotomy surgery. International Journal of Sports Science and Arts. 2019;4(04):59-78.

Reference Type BACKGROUND

Lopez-Valenciano A, Ayala F, De Ste Croix M, Barbado D, Vera-Garcia FJ. Different neuromuscular parameters influence dynamic balance in male and female football players. Knee Surg Sports Traumatol Arthrosc. 2019 Mar;27(3):962-970. doi: 10.1007/s00167-018-5088-y. Epub 2018 Aug 7.

Reference Type BACKGROUND
PMID: 30088029 (View on PubMed)

Buckthorpe M, La Rosa G, Villa FD. RESTORING KNEE EXTENSOR STRENGTH AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A CLINICAL COMMENTARY. Int J Sports Phys Ther. 2019 Feb;14(1):159-172.

Reference Type BACKGROUND
PMID: 30746302 (View on PubMed)

Mayer MA, Deliso M, Hong IS, Saltzman BM, Longobardi RS, DeLuca PF, Rizio L. Rehabilitation and Return to Play Protocols After Anterior Cruciate Ligament Reconstruction in Soccer Players: A Systematic Review. Am J Sports Med. 2025 Jan;53(1):217-227. doi: 10.1177/03635465241233161. Epub 2024 Apr 15.

Reference Type BACKGROUND
PMID: 38622858 (View on PubMed)

Taş B, Ok E, Akalp U, Bingül BM, Gelen E. Effect of lower extremity joint distraction exercises during warm-up on range of motion, flexibility, and jump performance in female volleyball players. Pedagogy of Physical Culture and Sports. 2024;28(4):283-91.

Reference Type BACKGROUND

Sievert ZA. The Effects of Anterior Cruciate Ligament Thickness, Knee Joint Laxity, Activity Level, Neuromuscular Imbalances and Lower Extremity Muscular Activation Patterns on Anterior Cruciate Ligament Loading: Old Dominion University; 2019.

Reference Type BACKGROUND

Peel SA, Schroeder LE, Weinhandl JT. Lower extremity muscle contributions to ACL loading during a stop-jump task. J Biomech. 2021 May 24;121:110426. doi: 10.1016/j.jbiomech.2021.110426. Epub 2021 Apr 9.

Reference Type BACKGROUND
PMID: 33873112 (View on PubMed)

Piskin D, Benjaminse A, Dimitrakis P, Gokeler A. Neurocognitive and Neurophysiological Functions Related to ACL Injury: A Framework for Neurocognitive Approaches in Rehabilitation and Return-to-Sports Tests. Sports Health. 2022 Jul-Aug;14(4):549-555. doi: 10.1177/19417381211029265. Epub 2021 Jul 8.

Reference Type BACKGROUND
PMID: 34236003 (View on PubMed)

Bram JT, Magee LC, Mehta NN, Patel NM, Ganley TJ. Anterior Cruciate Ligament Injury Incidence in Adolescent Athletes: A Systematic Review and Meta-analysis. Am J Sports Med. 2021 Jun;49(7):1962-1972. doi: 10.1177/0363546520959619. Epub 2020 Oct 22.

Reference Type BACKGROUND
PMID: 33090889 (View on PubMed)

Bloom DA, Wolfert AJ, Michalowitz A, Jazrawi LM, Carter CW. ACL Injuries Aren't Just for Girls: The Role of Age in Predicting Pediatric ACL Injury. Sports Health. 2020 Nov/Dec;12(6):559-563. doi: 10.1177/1941738120935429. Epub 2020 Aug 11.

Reference Type BACKGROUND
PMID: 32780637 (View on PubMed)

Colombo V, Valencic T, Steiner K, Skarabot J, Folland J, O'Sullivan O, Kluzek S. Comparison of Blood Flow Restriction Interventions to Standard Rehabilitation After an Anterior Cruciate Ligament Injury: A Systematic Review. Am J Sports Med. 2024 Dec;52(14):3641-3650. doi: 10.1177/03635465241232002. Epub 2024 Apr 9.

Reference Type BACKGROUND
PMID: 38591459 (View on PubMed)

Ong MT, Chan JS, Man GC, Qiu J, He X, Wang Q, Yung PS. Effect of eccentric isokinetic exercise on muscle strength and functional recovery after anterior cruciate ligament reconstruction. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2023 Nov 24;35:20-26. doi: 10.1016/j.asmart.2023.11.002. eCollection 2024 Jan.

Reference Type BACKGROUND
PMID: 38075532 (View on PubMed)

Wong CT, Mok KM, Yung SP. Secondary Anterior Cruciate Ligament Injury Prevention Training in Athletes: What Is the Missing Link? Int J Environ Res Public Health. 2023 Mar 9;20(6):4821. doi: 10.3390/ijerph20064821.

Reference Type BACKGROUND
PMID: 36981735 (View on PubMed)

Piussi R, Krupic F, Senorski C, Svantesson E, Sundemo D, Johnson U, Hamrin Senorski E. Psychological impairments after ACL injury - Do we know what we are addressing? Experiences from sports physical therapists. Scand J Med Sci Sports. 2021 Jul;31(7):1508-1517. doi: 10.1111/sms.13959. Epub 2021 Apr 6.

Reference Type BACKGROUND
PMID: 33772890 (View on PubMed)

Other Identifiers

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REC/RCR & AHS/23/0423

Identifier Type: -

Identifier Source: org_study_id

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