Reduction of Risk Factors for ACL Re-injuries Using a Novel Biofeedback Approach
Condition: Anterior Cruciate Ligament Injury
MeSH terms: Wounds and Injuries; Anterior Cruciate Ligament Injuries; Reinjuries
Study type: Interventional

Summary: 
      ACL injuries are common among athletes and due to residual muscle weakness, limited knee
      motion and asymmetrical movement patterns after surgery many of these athletes will sustain
      secondary ACL injuries following return to sports. This project seeks to determine if a novel
      biofeedback-based rehabilitation approach can decrease a known risk factor for secondary
      injuries to the ACL. The project specifically focuses on correcting asymmetric movement
      patterns, a known risk factor for secondary injury that is not directly addressed by existing
      interventions through a 6 week therapy based biofeedback intervention.
    

Detailed description: 
      Nearly 1 in 60 adolescent athletes will suffer ACL injuries. Approximately 90% of these
      injured athletes will undergo an ACL reconstruction at an estimated annual cost of $3
      billion. While reconstruction and subsequent rehabilitation allow these athletes to return to
      sports, they have a 15 fold increased risk of secondary ACL injuries, a tear of the ACL graft
      or the contralateral ACL. As a result, development of an intervention to reduce the incidence
      of secondary ACL tears would meet a critical need. One area in which existing interventions
      might be improved is through an increased emphasis on correcting asymmetric movement
      patterns-a known risk factor for secondary injury. Thus, our long-term objective is to
      decrease the number of secondary ACL tears by decreasing side-to-side movement and loading
      asymmetry. The modification of post-operative rehabilitation to focus on movement and loading
      symmetry with shift the rehabilitation paradigm. Specifically, we propose to evaluate a novel
      biofeedback training program that focuses on altering loading and movement patterns to
      improve symmetry and overall lower extremity mechanics in a group of 40 (20 control, 20
      intervention) adolescent ACL reconstructed patients. There are two core hypotheses of this
      study: 1) biofeedback training will decrease known risk factors for secondary ACL injuries
      immediately following the biofeedback program and these changes will be retained 6 week after
      the completion of the biofeedback program; and 2) we will be able to recruit and enroll 40
      patients and retain 80% of the patients through the end of the follow-up assessment
      demonstrating the feasibility of the biofeedback intervention. Implementation of a
      biofeedback program prior to returning to dynamic athletic activities could improve physical
      performance outcomes, decrease secondary injury risk factors and ultimately decrease the
      long-term joint degeneration and development of osteoarthritis that has been associated with
      ACL reconstruction. Ultimately this work will lead to additional investigations to
      definitively determine the impact of this novel biofeedback program, which could shift the
      post-operative rehabilitation paradigm following ACL reconstruction to improve long-term
      joint health in these adolescent patients.
    

Intervention name(s): Biofeedback Intervention
Intervention type(s): Other
Intervention description(s): Visual and Tactile Biofeedback
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This study involves one active intervention group and an attention control group
Masking: Double (Care Provider, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Secondary ACL Injury Prevention; Visual Biofeedback; Tactile Biofeedback