Perturbation Training vs Functional Activities on Pain, ROM, Balance, and Function Post-ACL

Официальное название

Effects of Perturbation Training Versus Task-oriented Functional Activities on Pain, Range of Motion, Balance and Function in Post-anterior Cruciate Ligament Reconstruction

Обзор

Anterior cruciate ligament (ACL) injuries are among the most common and functionally disabling knee injuries, particularly in physically active individuals. Despite advancements in surgical techniques, optimal post-operative rehabilitation remains critical for successful functional recovery, minimizing re-injury risk, and restoring pre-injury performance levels

Подробное описание

This randomized controlled trial aims to compare the effectiveness of perturbation training and task-oriented functional activities in patients following ACL reconstruction surgery. Perturbation training is a neuromuscular re-education strategy that involves controlled, unexpected movements to enhance joint stability and proprioceptive feedback. In contrast, task-oriented functional training focuses on restoring movement through activities that mimic daily or sports-related functional tasks.

This study will be a Randomized Control Trail and will be conducted in physiogic physiotherapy clinic and Ghurki Trust and Teaching Hospital. Non-Probability Convenient Sampling will be used to collect data. Total of 54 Participants of the age 18-45 years with post 12 weeks to 1 year ACL reconstruction will be included in the study. An informed consent will be taken prior study from all the subjects. Outcomes measure will be included Numerical Pain Rating Scale (NPRS) for pain, Universal Goniometer (UG) for Range of Motion, Y balance test for Knee Stability, International Knee Documentation Committee scores, (IKDC) for Knee function

Вмешательства

• Другое Perturbation Training Group
  Two-leg rocker board One-leg rocker board Roller board / stable (weight scale) surface Roller board / BOSU ball TheraBand feedback / perturbation training Simple sport-specific technique on rocker board Moderate demand sport-specific technique on rocker board Advanced sport-specific technique on rocker board This sequence reflects a progressive challenge to knee stability, beginning with bilateral balance tasks, advancing to unilateral control, and culminating in sport-specific perturbat
• Другое Task-Oriented Functional Activities Group
  Functional Recovery Tasks After ACLR Normal walking gait Bilateral squat Unilateral foundation exercises - Single leg squat Bilateral landing Running - Run on treadmill Bilateral plyometric - Bilateral drop jump Unilateral landing / deceleration - Single leg deceleration Unilateral plyometric - Single leg drop jump Change of direction ability / coordination - 90º cut maneuver Sport-specific movements - Movement control under sport-specific change of direction This sequence reflects a p
• Другое Control Group (Standard Rehabilitation Protocol)
  Heating pad (5-10 minutes) TENS (short bursts, 10-15 minutes, frequency 100 Hz) Stationary cycling Gentle range of motion exercises Passive and active-assisted ROM Isometric quadriceps contractions Straight leg raises Quadriceps setting with a towel under the knee Closed-chain exercises (e.g., wall sits, mini-squats) Hamstring curls Double-leg stance on foam pad This set emphasizes pain relief, mobility restoration, and foundational strength before progressing to advanced neuromuscula

Первичные конечные точки

• NPRS for Pain [Срок оценки: 6 weeks]
• Universal Goniometer for Range of motion [Срок оценки: 6 weeks]
• The Y-Balance test (YBT) [Срок оценки: 6 weeks]
• International Knee Documentation Committee scores (IKDC) [Срок оценки: 6 weeks]

Критерии участия

Критерии включения

• Age range: 18-45 years

Male participants only

History of Anterior Cruciate Ligament Reconstruction (ACLR) of 3 to 12 months

No prior ACL surgery on the affected knee

ACL reconstruction with autograft of hamstrings tendon

Knee flexion range of motion less than 120°

Extension lag less than or equal to 10°

Pain during functional activities

Критерии исключения

• Any type of fracture

Concurrent ligamentous injury or repairable meniscus

Osteochondral defect

Any systemic and/or neurological illness

Rheumatoid arthritis

Osteomyelitis or any neurological disorders

Spinal disorders

Inflammatory conditions such as ankylosing spondylitis

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Двойное слепое

Основная цель

Лечение

Центры проведения

Пакистан · 1 центр

• Ghurki Hospital Lahore — Lahore

Публикации

• Carter HM, Littlewood C, Webster KE, Smith BE. The effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction: a systematic review. BMC Musculoskelet Disord. 2020 Oct 3;21(1):647. doi: 10.1186/s12891-020-03676-6. PMID 33010802
• Hetsroni I, Mann G, Arami E, van Stee M, Marom N, Ohana N. Young men undergoing anterior cruciate ligament reconstruction with patellar tendon autograft and anteromedial drilling outperform at 5- to 10-year follow-up in terms of graft stability and activity levels compared to those undergoing reconstruction with hamstring autograft and transtibial drilling. J ISAKOS. 2024 Aug;9(4):540-548. doi: 10 PMID 38580054
• Nawasreh Z, Logerstedt D, Marmon A, Snyder-Mackler L. Clinical and Biomechanical Efficacies of Mechanical Perturbation Training After Anterior Cruciate Ligament Rupture. J Sport Rehabil. 2019 Nov 1;28(8):877-886. doi: 10.1123/jsr.2017-0363. PMID 30300071
• Brown SR, Washabaugh EP, Dutt-Mazumder A, Wojtys EM, Palmieri-Smith RM, Krishnan C. Functional Resistance Training to Improve Knee Strength and Function After Acute Anterior Cruciate Ligament Reconstruction: A Case Study. Sports Health. 2021 Mar;13(2):136-144. doi: 10.1177/1941738120955184. Epub 2020 Dec 18. PMID 33337984

Идентификаторы

NCT: NCT07642752 · REC/RCR&AHS/25/0118

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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