Proprioceptive Training for Gait and Knee Function After Anterior Cruciate Ligament Reconstruction

Condition(s) studied

Investigational drug(s) / intervention(s)

Standard Rehabilitation: A standard rehabilitation program adapted from the Massachusetts General Brigham Sports Medicine Anterior cruciate ligament Reconstruction Rehabilitation Protocol. The program consists of supervised rehabilitation sessions conducted twice per week for 12 weeks. The protocol includes four progressive phases focusing on graft protection, restoration of knee range of motion, quadriceps activation, balance training, and progressive strengthening exercises. No proprioceptive training components are included in this intervention.

Proprioceptive Training: A structured 12-week proprioceptive training program performed in addition to standard rehabilitation. The program is adapted from validated progressive proprioceptive exercise protocols using Swiss balls and BOSU balls. Training sessions are supervised by a physiotherapist and conducted three times per week. Exercises progress through three stages (initial: weeks 1-5, intermediate: weeks 5-8, and advanced: weeks 8-12) and include balance, coordination, and neuromuscular control activities. Participants advance to the next level only when exercises can be performed with adequate balance control and without pain.

Study summary

Anterior cruciate ligament reconstruction (ACLR) is commonly performed to restore knee stability after injury, but many patients continue to experience gait abnormalities and reduced knee function during rehabilitation. Proprioceptive training is frequently included in rehabilitation programs to improve joint position sense, neuromuscular control, and movement coordination, yet its specific effects on gait performance and knee function after ACLR are not fully understood.

This study aims to investigate the effects of a 12-week proprioceptive training program on gait performance and knee function in patients who have undergone ACLR. Patients who meet the inclusion criteria will undergo baseline assessments, including gait analysis and knee function tests. They will then participate in a structured 12-week proprioceptive training program as part of their rehabilitation, followed by post-intervention assessments using the same measures.

The primary outcomes include changes in gait performance, such as walking speed, step length, cadence, support time, knee motion, and knee joint angles and moments during walking. Secondary outcomes include changes in knee function, including isokinetic muscle strength, joint position sense, and patient-reported outcomes measured by the Lysholm score and the International Knee Documentation Committee (IKDC) questionnaire. The findings from this study may help to clarify the functional benefits of proprioceptive training and support the development of more targeted and effective rehabilitation strategies for patients recovering from Anterior cruciate ligament (ACL) injuries.

Eligibility

Primary outcome measure(s)

• Walking Speed — Baseline and 12 weeks post-intervention
  Walking speed during level walking measured using 3D gait analysis. Unit of measure: meters per second (m/s).
• Step Length — Baseline and 12 weeks post-intervention.
  Step length measured during level walking using 3D gait analysis. Unit of measure: meters (m).
• Cadence — Baseline and 12 weeks post-intervention.
  Cadence during level walking measured using 3D gait analysis. Unit of measure: steps per minute (steps/min).
• Single Support Time — Baseline and 12 weeks post-intervention.
  Single support time of the gait cycle measured using 3D gait analysis. Unit of measure: seconds (s).
• Double Support Time — Baseline and 12 weeks post-intervention.
  Double support time of the gait cycle measured using 3D gait analysis. Unit of measure: seconds (s).
• Peak Knee Flexion Angle — Baseline and 12 weeks post-intervention.
  Peak knee flexion angle during the stance phase measured using 3D gait analysis. Unit of measure: degrees (°).
• Peak Knee Extension Angle — Baseline and 12 weeks post-intervention.
  Peak knee extension angle during the stance phase measured using 3D gait analysis. Unit of measure: degrees (°).
• Peak Knee Flexion Moment — Baseline and 12 weeks post-intervention.
  Peak external knee flexion moment measured during walking using 3D gait analysis. Unit of measure: Newton-meters per kilogram (Nm/kg).
• Peak Knee Extension Moment — Baseline and 12 weeks post-intervention.
  Peak external knee extension moment measured during walking using 3D gait analysis. Unit of measure: Newton-meters per kilogram (Nm/kg).
• Knee Range of Motion — Baseline and 12 weeks post-intervention.
  Total sagittal plane knee range of motion measured during level walking using 3D gait analysis. Unit of measure: degrees (°).

Trial sites (1)

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