Operant Conditioning After ACL Reconstruction

Study Overview
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Brief Summary
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The purpose of this study is to examine if the changes in corticospinal function that accompany ACL reconstruction can be improved through a form of mental coaching and encouragement, known as operant conditioning.

Detailed Description
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It is theorized reduced corticospinal excitability contributes to quadriceps dysfunction after knee injury and joint disease. Current rehabilitation does not directly target the alterations in corticospinal excitability, which may limit recovery. Operant conditioning is an emerging approach capable of increasing corticospinal excitability by directly targeting the corticospinal pathways. However, it remains to be determined whether operant conditioning of the corticospinal pathway may improve corticospinal function after knee trauma. Therefore, this study will evaluate the ability of operant up-conditioning of the corticospinal pathway to improve corticospinal function after ACL reconstruction.

Official Title
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Conditioning Brain Responses for Modulating Corticospinal Excitability After ACL Reconstruction

Conditions
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Anterior Cruciate Ligament Injuries

Intervention / Treatment
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* Behavioral: Operant Conditioning
* Behavioral: Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: aged 14-45 years suffered an acute, complete ACL rupture have undergone ACL reconstructive surgery willingness to participate in testing and follow-up as outlined in the protocol Exclusion Criteria: have suffered a previous ACL injury on the contralateral leg have undergone previous major surgery to the contralateral knee have a history of recent significant knee injury (other than ACL) or lower-extremity fracture have a history of uncontrolled diabetes or hypertension be pregnant or plan to become pregnant have metal implants in the head have electronic devices in their ear or heart (e.g., cochlear implants or cardiac pacemakers) have unexplained recurrent headaches have a recent history of seizure have a history of repeated fainting spells

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 45 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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Operant Conditioning<br>Motor evoked responses will be elicited along with operant conditioning training for about 2 weeks | Behavioral: Operant Conditioning<br>* Active encouragement and feedback to increase motor evoked response during stimulation.<br>|
| Experimental: Control<br>Motor evoked responses will be elicited without operant conditioning training for about 2 weeks | Behavioral: Control<br>* Absence of active encouragement and feedback to increase motor evoked response when stimulated.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in corticospinal excitability | Corticospinal excitability will be measured using transcranial magnetic stimulation at baseline and post-intervention and will be compared between groups. | Baseline (before the start of the intervention) and post-intervention (approximately 2 weeks after baseline) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ACL, Quadriceps