Optimizing Plyometric Training for Functional Recovery Post-ACL Reconstruction

Study Overview
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Brief Summary
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While surgical anterior cruciate ligament reconstruction (ACLR) of the knee restores passive stability, studies are showing consistently poor long-term outcomes. Unusually high risks of early-onset osteoarthritis and re-injury, and low rate of return to sport following ACLR all seem to be related to a chronic tendency to land stiff-legged from a jump or hop, which itself may be due to fear of re-injury. Decreased knee bending for force absorption simultaneously decreases performance level and increases risk for injury and arthritic changes. The purpose of the proposed study is to compare a current best-practice plyometric training program to one utilizing body weight support to increase repetition and improve performance in the initial phases. The investigators hypothesize that we will see larger improvements in absorptive capacity of the knee and better confidence in activity immediately following body weight support training, as well as improved retention of training effects after a two-month period.

Official Title
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Optimizing Plyometric Training for Functional Recovery Post-ACL Reconstruction

Conditions
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Anterior Cruciate Ligament Injury, Knee Injury

Intervention / Treatment
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* Procedure: Standard Plyometric Training
* Procedure: Plyometric Training with BWS


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: speak and understand English age between 12-35 years unilateral anterior cruciate ligament reconstruction between 6-48 months prior activity level greater than or equal to level 5 on the Tegner Activity Scale Exclusion Criteria: Weight in excess of 300 pounds (136 kg) contralateral/bilateral ACL reconstruction or an unreconstructed ACL injury history of a posterior cruciate ligament injury lower extremity of back injury or other condition (e.g. cerebral palsy) that has limited their normal activities of daily living within the last 6 months

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Standard Plyometric Training<br>Participants will undergo treatment 2 times a week for 8 weeks with plyometric exercises deemed to be consistent with best practice delivered at a standard dosage of sets and repetitions. | Procedure: Standard Plyometric Training<br>* Participants will undergo individualized practice exercises of jumping, hopping, and cutting tasks consistent with standard published exercises.<br>|
| Experimental: Plyometric Training with BWS<br>Participants will undergo treatment 2 times a week for 8 weeks with plyometric exercises deemed to be consistent with best practice with a treatment volume of sets and repetitions that exceeds standard practice. Higher number of practice trials will be completed with body weight support (BWS) to reduce load. Participants will start at 30 percent of body weight and will be slowly weaned away over time. | Procedure: Plyometric Training with BWS<br>* Participants will undergo individualized practice exercises of jumping, hopping, and cutting tasks consistent with standard published exercises while their body weight is supported via adjustable harness.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in sagittal plane knee kinetics and kinematics |  | Baseline and after 8 weeks of training | 
| Change in psychological readiness for sports activities via survey scores |  | baseline and after 8 weeks of training | 
| Change in motor patterning via electromyography of quadriceps and hamstring muscles |  | Baseline and after 8 weeks of training | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Retention of Biomechanical Adaptions in Knee kinetics and kinematics |  | Change from end of 8 weeks of training to 2 month follow-up | 
| Retention of adaptations in Psychological Readiness for Sport via survey |  | Change from end of 8 weeks of training to 2 month follow-up | 
| Retention of adaptations in motor patterning via electromyography |  | Change from end of 8 weeks of training to 2 month follow-up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Knee, plyometrics, motor learning, psychological factors