Effect of Visual-Guided Balance Training on Knee Motor Function and Biomechanical Characteristics After ACL Reconstruction

Overview

This study aims to investigate the improvement effect of visual-guided balance training on the knee joint function and gait performance of patients after ACLR, and to clarify the advantages of this training program compared to conventional rehabilitation training; at the same time, by including healthy individuals as the control group, it quantifies the differences in knee joint function and gait performance between patients after ACLR and healthy individuals, to verify whether visual-guided balance training can more effectively narrow the functional gap between patients after ACLR and healthy individuals, and promote the recovery of patients' knee joint function and gait closer to the healthy level. Ultimately, it provides scientific theoretical basis and practical guidance for the optimization of the rehabilitation plan after ACLR, and helps patients achieve comprehensive and high-quality recovery.

Detailed description

In this randomized controlled clinical study, patients with primary unilateral anterior cruciate ligament rupture were included. Starting from the 5th week after surgery, in addition to the standardized rehabilitation training content, the traditional group added general balance training, and the intervention group added visual guidance balance training. The analysis was conducted through movement function tests and evaluations, with the healthy group included as the control. The impact of visual guidance balance training on the movement function and biomechanical characteristics after ACLR was explored.

Interventions

• Other Traditional group
  Based on the traditional standardized rehabilitation program, additional universal balance training content has been added. Starting from the 5th week after the surgery and continuing until the 14th week, three times a week for a total of 10 weeks, the training duration was one and a half hours each time.
• Other Intervention Group
  Based on the conventional standardized rehabilitation program, add the content of visual-guided balance training.Starting from the 5th week after the surgery and continuing until the 14th week, three times a week for a total of 10 weeks, the training duration was one and a half hours each time.

Primary outcome measures

• Vicon 3D Gait Testing [Time frame: Preoperative baseline; 14 weeks after the operation; 6 months after the operation]
• Vicon 3D Gait Testing [Time frame: Preoperative baseline; 14 weeks after the operation; 6 months after the operation]
• Vicon 3D Gait Testing [Time frame: Preoperative baseline; 14 weeks after the operation; 6 months after the operation]
• isokinetic muscle strength [Time frame: Preoperative baseline;14 weeks after the operation; 6 months after the operation]
• isokinetic muscle strength [Time frame: Preoperative baseline;14 weeks after the operation; 6 months after the operation]
• isokinetic muscle strength [Time frame: Preoperative baseline;14 weeks after the operation; 6 months after the operation]
• Imoove Balance Training Tester [Time frame: Preoperative baseline; 4 weeks after the operation; 14 weeks after the operation; 6 months after the operation]

Secondary outcome measures (5)

• Lysholm Knee Joint Scoring Scale [Time frame: Preoperative baseline; 4 weeks after the operation; 14 weeks after the operation; 6 months after the operation]
• International Knee Documentation Committee Knee Assessment Scale [Time frame: Preoperative baseline; 4 weeks after the operation; 14 weeks after the operation; 6 months after the operation]
• Visual Analogue Score [Time frame: Preoperative baseline; 4 weeks after the operation; 14 weeks after the operation; 6 months after the operation]
• Tampa Scale for Kinesiophobia-11 [Time frame: Preoperative baseline; 4 weeks after the operation; 14 weeks after the operation; 6 months after the operation]
• ACL Return to Sport after Injury scale [Time frame: Preoperative baseline; 4 weeks after the operation; 14 weeks after the operation; 6 months after the operation]

Eligibility criteria

Inclusion criteria for patients:

• Age between 18 and 45 years old;
• Body Mass Index (BMI) ranging from 18.5 kg/m² to less than 35 kg/m²;
• First unilateral ACL rupture and reconstruction surgery performed at this hospital;
• Autologous hamstring tendon transplantation;
• No or only minor injury to the meniscus, posterior cruciate ligament, medial collateral ligament or lateral collateral ligament;
• Voluntary participation in this study and signing of informed consent form.

Exclusion criteria for patients:

• Patients who underwent ACL reconstruction more than one year after the injury;
• Patients with severe injuries to the posterior cruciate ligament, medial collateral ligament or lateral collateral ligament (more than grade I; grade II is partial tear, thickening and tortuosity of the ligament, partial fiber interruption, and swelling of the surrounding soft tissues; grade III is complete rupture). ； Combined with severe meniscus tear;
• Has a history of previous knee surgery, such as meniscus repair, ligament reconstruction, joint replacement, joint cleaning, etc.;
• Has other knee joint diseases, such as: knee osteoarthritis, knee joint tumor, rheumatoid arthritis, tuberculosis, knee joint infection or inflammatory diseases, fracture, dislocation or other bone injuries, etc.;
• Severe heart, lung, brain diseases or liver and kidney dysfunction, and visual and cognitive impairments.

Inclusion criteria for the healthy control group

• Age 18-45 years old;
• Body Mass Index (BMI) ≥ 18.5 kg/m2 and < 35 kg/m2;
• No surgical history, injury history, or chronic joint diseases of the lower extremities;
• No visual, cognitive impairments or neurological diseases;
• No trauma or diseases that cause abnormal gait. Exclusion criteria

1\. Poor compliance of the subject; 2. The subject withdraws the informed consent form; 3.The subject requests to terminate the study or is unable to complete all the trials for some reason; 4. The investigator believes that the subject's continued participation in the trial may cause significant adverse effects on their physical condition; 5. The ethics review committee decides to terminate the trial.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

China · 1 center

• Peking University Third Hospital — Beijing

Publications

• Ge X, Gao M, Suo L, Tao Y, Ren S, Ao Y. Effects of visual feedback balance training on muscle strength and balance ability in patients after anterior cruciate ligament reconstruction surgery. BMC Musculoskelet Disord. 2026 Apr 17;27(1):354. doi: 10.1186/s12891-026-09823-9. PMID 41998557

Identifiers

NCT: NCT07306221 · M20250822

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗