External Focus of Attention Posttraumatic Osteoarthritis

Study Overview
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Brief Summary
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Knee injuries, especially those to the ACL, are common among physically active people. These injuries are frequently treated with surgical reconstruction (ACL reconstruction; ACLR). While ACLR restores stability it does not protect against future injury, long-term pain, disability, and arthritis associated with these injuries. Our study is going to examine new ways to provide feedback about the way people move to determine if these are better at modifying movement patterns that are known risk factors of posttraumatic osteoarthritis development than current standard treatments. If you participate, you will be asked to undergo a movement analysis in a research laboratory while you perform tasks such as walking and hopping. After this initial assessment, you will be randomly allocated to one of 2 treatment groups. Each treatment group will perform 4 weeks (3x/week) of exercises to change the way people walk. Participants will then report for follow-up movement analysis testing 1- and 4-weeks after completing the intervention.

Official Title
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External Focus of Attention Feedback to Mitigate Posttraumatic Osteoarthritis Risk After ACL Reconstruction

Conditions
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Anterior Cruciate Ligament Injuries, Anterior Cruciate Ligament Rupture, Anterior Cruciate Ligament Tear, Osteo Arthritis Knee

Intervention / Treatment
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* Other: Internal focus of attention feedback
* Other: External focus of attention feedback


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: history of primary, unilateral ACL reconstruction 6-24 months prior to enrollment cleared to return to full activity by treating orthopedic surgeon Exclusion Criteria: Body mass index >35 kg/m2 History of musculoskeletal injury sustained 3 months prior to enrollment Current participation in formal post-operative rehabilitation

Ages Eligible for Study
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Minimum Age: 18 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: Internal focus of attention feedback<br>Participants will complete 12 sessions over 3 weeks receiving visual feedback in a mirror of their movement patterns. | Other: Internal focus of attention feedback<br>* Participants will complete 12 sessions over a 3-week period of functional movement retraining while receiving mirror feedback. Participants will be instructed to perform each functional task in a manner that keeps their knee in line with their toes.<br>|
| Experimental: External focus of attention feedback<br>Participants will complete 12 sessions over 3 weeks receiving visual feedback of their movement patterns from a laser. | Other: External focus of attention feedback<br>* Participants will complete 12 sessions over a 3-week period of functional movement retraining while receiving visual feedback via laser. Participants will be instructed to perform each functional task in a manner that does causes the laser to move up and down but not side-to-side.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes from baseline in lower extremity biomechanics during walking | Knee and hip angles and loads measured via 3D biomechanics | 1-week post-intervention, 4-weeks post-intervention | 
| Knee cartilage health | Knee cartilage thickness measured using diagnostic ultrasound imaging | 1-week post-intervention, 4-weeks post-intervention |