Clinical trial NCT05121857: What is the Effect of Vision on Movement Control in Anterior Cruciate Ligament Reconstructed Patients 7 Months Post-surgery?
Official title: What is the Effect of Vision on Movement Control in Anterior Cruciate Ligament Reconstructed Patients 7 Months Post-surgery?
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: ACL
Lead sponsor: Sports Surgery Clinic, Santry, Dublin
Sponsor class: OTHER
First posted: 2021-11-16
Enrollment: 90
Sex: MALE
Minimum age (years): 18
Maximum age (years): 35
Standard ages: ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients would be recruited from those undergoing an ACLR under the care of orthopaedic surgeons at the Sports Surgery Clinic (Dublin, Ireland). At present, patients attend the Sports Medicine Department at Sports Surgery Clinic for strength, power and 3D biomechanical analysis at 7 months post-operatively prior to their reviews with their surgeon

Brief summary: The anterior cruciate ligament (ACL) is thought to have two main roles within the body: (1) providing a physical restraint to excessive rotation and forwards translation within the knee and (2) providing sensory information to the sensorimotor cortex (contributes to motor planning and motor task execution). Therefore, an ACL injury is thought to be not just a physical injury but also one which affects an individual's ability to plan and execute motor tasks. It has been suggested in previous research that following an ACL injury and even post-ACL reconstruction, individuals may become reliant on the visual-motor system when planning and executing movements. Therefore, this study aims to compare an ACLR population against healthy controls to see if it is possible to identify those who may be visually-motor reliant by accessing movement control in the absence of vision

Detailed description: This study will compare a male ACLR cohort against matched healthy controls. The study population will be between 18-35 year old males who are competing multi-directional field sport. The ACLR cohort will be 7 months post-surgery. The main outcome measure will be time to stability during the stepdown task (from a 20cm step). The stepdown task will be completed first with their eyes open and then with their eyes closed, thereby allowing for the creation of an index reporting how time to stability changes following the obstruction of vision. Strength and lower limb power measures will be collected as potential confounding factors.

The testing battery that participants complete are:

* visual processing ability via a sensory station which contains neurocognitive and visual acuity testing
* 3D biomechanical tests:

  1. double leg countermovement jump
  2. single leg countermovement jump
  3. double leg drop jump
  4. single leg drop jump
  5. stepdown test (eyes open and eyes closed)
  6. joint position sense test
  7. single leg balance (eyes open and eyes closed)
* isokinetic strength testing of quadriceps and hamstrings at 60deg/sec. 3 sets of 5
* questionnaires:

  1. international knee documentation committee
  2. tampa scale of kinesiophobia
  3. ACL- return to sport after injury

Eligibility criteria: Inclusion Criteria:

* Aged 18-35 years old
* Playing club level Gaelic football or hurling
* They must report that they intend on returning to sport at the same or higher level
* Able to give written informed consent and to participate fully in the interventions
* At 7 months biomechanical testing, individuals would need to have 70% symmetry of both quadriceps and hamstring peak torque as measured on our isokinetic dynamometer with the angular velocity set to 60°/s
* Individuals should have already commenced linear running and double leg jumping tasks as part of their rehabilitation
* They are currently attending a gym or can attain gym access for the duration of intervention period

Exclusion Criteria:

* They have not commenced running or jumping in their rehabilitation
* Revision ACL
* They underwent concurrent meniscal repair, chondral repair or extra-articular augmentation
* Serious medical conditions preventing them from completing high intensity resistance exercise
* Any previous: injuries to the visual system, concussion, head injury, unexplained seizures or epilepsy
* Any previous ankle or knee injuries
* Those who are uncomfortable or do not want to hop with their eyes closed (one of the assessment tasks will involve hopping on one leg with their eyes open and followed by another set in which their eyes are closed

Primary outcomes:
measure: Time to stability during stepdown task (eyes open versus eyes closed)
timeFrame: at 7 months post-ACLR
Secondary outcomes:
measure: Joint position sense testing
timeFrame: at 7 months post-ACLR
measure: single leg balance (eyes closed versus eyes open)
timeFrame: at 7 months post-ACLR
measure: Quadriceps and hamstrings strength
timeFrame: at 7 months post-ACLR
measure: Countermovement jump- double leg and single leg
timeFrame: at 7 months post-ACLR
measure: Drop jump- double leg and single leg
timeFrame: at 7 months post-ACLR
measure: anterior cruciate ligament return to sport after injury (ACL-RSI) questionnaire
timeFrame: at 7 months post-ACLR
measure: International knee documentation committee (IKDC) Questionnaire
timeFrame: at 7 months post-ACLR
measure: Tampa scale of kinesiophobia
timeFrame: at 7 months post-ACLR
measure: Near far quickness score (as part of visual processing software)
timeFrame: at 7 months post-ACLR
measure: Near far quickness reaction time to target (as part of visual processing software)
timeFrame: at 7 months post-ACLR
measure: Perception span (as part of visual processing software)
timeFrame: at 7 months post-ACLR
measure: multiple object tracking score (as part of visual processing software)
timeFrame: at 7 months post-ACLR
measure: Reaction time (as part of visual processing software)
timeFrame: at 7 months post-ACLR
Other outcomes:
Locations:
city: Dublin
country: Ireland
facility: Sports Surgery Clinic
state: Leinster
Study officials:
References: