Muscle Architecture and Anterior Cruciate Ligament

Study Overview
=================
Brief Summary
-----------------
The aim of this study is to examine the effects of plyometric training on biceps femoris longus (BFl) and vastus lateralis (VL) muscle architecture in individuals with anterior cruciate ligament reconstruction (ACLR). Individuals will be randomly placed into training and control groups. Measurements of muscle architecture will be taken bilaterally from BFl and VL muscles by means of an ultrasound device. Functional performance will be evaluated with the International Knee Documentation Committee score and the single leg jump test. Following the initial evaluations, individuals in the training group will receive plyometric training. Evaluations of muscle architecture and functional performance will be taken again from the individuals in the training and control groups at the end of the 4th and 8th weeks. The received ultrasound images will be calculated through the MicroDicom software. In-group and between-group comparisons will be analyzed using the Statistical Package for the Social Sciences program and appropriate tests.

Detailed Description
-----------------
Anterior cruciate ligament (ACL) injuries are common, especially in young individuals participating in rolling and jumping activities. After injury, many people undergo ACL reconstruction (ACLR) surgery. The aim of this study is to examine the effects of plyometric training on biceps femoris longus (BFl) and vastus lateralis (VL) muscle architecture (fiber length, penation angle and muscle thickness) in individuals with ACLR. Individuals who have undergone ACLR in this study, which is designed as a parallel group randomized controlled study, will be randomly placed into two different groups, the training group and the control group. Imagery ability, self-efficacy and motivation will be evaluated with various questionnaires and scales in order to compare the homogeneity of the groups. Measurements of muscle architecture will be taken bilaterally from BFl and VL muscles by means of an ultrasound device. Functional performance will be evaluated with the International Knee Documentation Committee score and the single leg jump test. Following the initial evaluations, individuals in the training group will receive plyometric training consisting of ten different exercises for 8 weeks, 3 sessions per week. In this training, individuals will not participate in a real plyometric training. Volunteers will watch videos to be prepared (action observation) and imagine them performing those exercises (motor imagery). Except for one session that will be applied every two weeks, all other trainings will be given on the basis of telerehabilitation via distance education tools. Cognitive fatigue at the beginning and end of the session; at the end of each session, the technical quality and efficiency of the training will be evaluated. Evaluations of muscle architecture and functional performance will be taken again from the individuals in the control and training groups at the end of the 4th and 8th weeks. The received ultrasound images will be calculated through the MicroDicom software. In-group and between-group comparisons will be analyzed using the Statistical Package for the Social Sciences program and appropriate tests.

Official Title
-----------------
The Effects of Plyometric Training on Vastus Lateralis and Biceps Femoris Muscle Architectures in Individuals Undergoing Anterior Cruciate Ligament Reconstruction

Conditions
-----------------
Anterior Cruciate Ligament Injuries

Intervention / Treatment
-----------------
* Other: Plyometric Exercise


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Volunteers with unilateral anterior cruciate ligament reconstruction (ACLR) Volunteers using hamstring autograft in their ACLR Volunteers who have passed 1-5 years after their ACLR Exclusion Criteria: Those who underwent same-side meniscus repair other than ACLR Those who have had revision surgery Those who had posterior cruciate ligament rupture in addition to anterior cruciate ligament Third-degree tears in the lateral or medial collateral ligaments Those with 2nd or 3rd degree strain injuries in hamstring and quadriceps muscle groups Those with a history of congenital, neurological, orthopedic, rheumatologic and cardiopulmonary pathology or anomalies, Those with serious systemic diseases Relative Exclusion Criteria: Those with acute infection or pain Those with joint instability Those with a body mass index of 30 and above Those receiving energy supplements or ergogenic assistance during or during the 6-month period prior to work

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 35 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Parallel group randomized controlled trial
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Plyometric Training Group<br>Individuals in the plyometric training group will receive plyometric training. In this training, individuals will not participate in a real plyometric training. Volunteers will watch videos to be prepared (action observation) and imagine them performing those exercises (motor imagery). Except for one session that will be applied every two weeks, all other trainings will be given on the basis of telerehabilitation via distance education tools. | Other: Plyometric Exercise<br>* Plyometric training consisting of ten different exercises [vertical unilateral and bilateral counter movement jump, horizontal unilateral and bilateral counter movement jump, drop jump (30 cm), squat jump, step-hop (20 cm), 180 degree rotation in transverse plane, frontal plane hurdle jump (20 cm) and sagittal plane hurdle jump (20 cm)] for 8 weeks, 3 sessions per week. Individuals will not participate in a real plyometric training. Volunteers will watch videos to be prepared (action observation) and imagine them performing those exercises (motor imagery)<br>|
| No Intervention: Control Group<br>Volunteers in this group will not participate in any training. | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Muscle Architecture Change-1 | Fiber length of the vastus lateralis and biceps femoris longus muscles | Before, at the end of the fourth week and the eighth week | 
| Muscle Architecture Change-2 | Pennation angle of the vastus lateralis and biceps femoris longus muscles | Before, at the end of the fourth week and the eighth week | 
| Muscle Architecture Change-3 | Muscle thickness of the vastus lateralis and biceps femoris longus muscles | Before, at the end of the fourth week and the eighth week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional Performance Change-1 | International knee documentation committee score. (Minimum score: 0 Maximum score: 100. Higher scores mean a better outcome. | Before, at the end of the fourth week and the eighth week | 
| Functional Performance Change-2 | Single leg jump distance | Before, at the end of the fourth week and the eighth week | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
biceps femoris, vastus lateralis, muscle architecture, anterior cruciate ligament, plyometric training, action observation, motor imagery, fiber length, pennation angle, muscle thickness, function