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NCT Number: NCT07642752

Perturbation Training vs Functional Activities on Pain, ROM, Balance, and Function Post-ACL

Anterior cruciate ligament (ACL) injuries are among the most common and functionally disabling knee injuries, particularly in physically active individuals. Despite advancements in surgical techniques, optimal post-operative rehabilitation remains critical for successful functional recovery, minimizing re-injury risk, and restoring pre-injury performance levels

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Key information

Conditions

Anterior Cruciate Ligament Injuries Knee Injuries Leg Injuries Wounds and Injuries

Age range

18 year–45 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Ghurki Hospital Lahore

Lahore, Punjab Province, 54000, Pakistan

Location status: Recruiting

About this study

This randomized controlled trial aims to compare the effectiveness of perturbation training and task-oriented functional activities in patients following ACL reconstruction surgery. Perturbation training is a neuromuscular re-education strategy that involves controlled, unexpected movements to enhance joint stability and proprioceptive feedback. In contrast, task-oriented functional training focuses on restoring movement through activities that mimic daily or sports-related functional tasks.

This study will be a Randomized Control Trail and will be conducted in physiogic physiotherapy clinic and Ghurki Trust and Teaching Hospital. Non-Probability Convenient Sampling will be used to collect data. Total of 54 Participants of the age 18-45 years with post 12 weeks to 1 year ACL reconstruction will be included in the study. An informed consent will be taken prior study from all the subjects. Outcomes measure will be included Numerical Pain Rating Scale (NPRS) for pain, Universal Goniometer (UG) for Range of Motion, Y balance test for Knee Stability, International Knee Documentation Committee scores, (IKDC) for Knee function

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age range: 18-45 years
  • Male participants only
  • History of Anterior Cruciate Ligament Reconstruction (ACLR) of 3 to 12 months
  • No prior ACL surgery on the affected knee
  • ACL reconstruction with autograft of hamstrings tendon
  • Knee flexion range of motion less than 120°
  • Extension lag less than or equal to 10°
  • Pain during functional activities

Exclusion criteria

  • Any type of fracture
  • Concurrent ligamentous injury or repairable meniscus
  • Osteochondral defect
  • Any systemic and/or neurological illness
  • Rheumatoid arthritis
  • Osteomyelitis or any neurological disorders
  • Spinal disorders
  • Inflammatory conditions such as ankylosing spondylitis

Treatment and study plan

Perturbation Training Group

Other

Two-leg rocker board

One-leg rocker board

Roller board / stable (weight scale) surface

Roller board / BOSU ball

TheraBand feedback / perturbation training

Simple sport-specific technique on rocker board

Moderate demand sport-specific technique on rocker board

Advanced sport-specific technique on rocker board

This sequence reflects a progressive challenge to knee stability, beginning with bilateral balance tasks, advancing to unilateral control, and culminating in sport-specific perturbation drills.

Task-Oriented Functional Activities Group

Other

Functional Recovery Tasks After ACLR Normal walking gait

Bilateral squat

Unilateral foundation exercises - Single leg squat

Bilateral landing

Running - Run on treadmill

Bilateral plyometric - Bilateral drop jump

Unilateral landing / deceleration - Single leg deceleration

Unilateral plyometric - Single leg drop jump

Change of direction ability / coordination - 90º cut maneuver

Sport-specific movements - Movement control under sport-specific change of direction

This sequence reflects a progressive load and skill development pathway, starting from basic gait and bilateral tasks, moving toward unilateral control, plyometrics, and finally sport-specific agility.

Control Group (Standard Rehabilitation Protocol)

Other

Heating pad (5-10 minutes)

TENS (short bursts, 10-15 minutes, frequency 100 Hz)

Stationary cycling

Gentle range of motion exercises

Passive and active-assisted ROM

Isometric quadriceps contractions

Straight leg raises

Quadriceps setting with a towel under the knee

Closed-chain exercises (e.g., wall sits, mini-squats)

Hamstring curls

Double-leg stance on foam pad

This set emphasizes pain relief, mobility restoration, and foundational strength before progressing to advanced neuromuscular or sport-specific tasks.

Primary outcomes

  1. NPRS for Pain

    Time frame: 6 weeks

    Numeric Pain Rating Scale (NPRS) it is a unidimensional scale to measure pain intensity, particularly in adults. It is a 10-rating scale and an 11-point numeric scale in the form of a horizontal bar or line

  2. Universal Goniometer for Range of motion

    Time frame: 6 weeks

    A universal goniometer (UG) will be used to determine the range of motion of the target joint.

  3. The Y-Balance test (YBT)

    Time frame: 6 weeks

    The Y-Balance test (YBT) is used to assess dynamic balance impairments associated with lower extremity injuries such as ACL injury, patellofemoral pain syndrome, and ankle instability.

  4. International Knee Documentation Committee scores (IKDC)

    Time frame: 6 weeks

    Patients' knee function is evaluated using the International Knee Documentation Committee's (IKDC) Subjective Knee Form. Through 18 questions, it assesses symptoms, athletic activity, and general knee function; higher scores indicate better knee function.

Interested in participating?

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Interested in participating?

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Sponsors and collaborators

Lead sponsor

Riphah International University

Other

Registry information

Official study title

Effects of Perturbation Training Versus Task-oriented Functional Activities on Pain, Range of Motion, Balance and Function in Post-anterior Cruciate Ligament Reconstruction

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jun 11, 2026
Registry last updated
Sep 24, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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