Effect of Contralateral NMES on Quadriceps Activation After ACL Injury or Surgery

A major complication after cruciate ligament injury and surgery is arthrogenic muscle inhibition of the quadriceps, which is characterised by a deficit in voluntary muscle activation in the affected leg. This can hinder rehabilitation processes, lead to impaired knee function, and negatively impact the patients' quality of life. The primary objective of this study is to assess whether voluntary quadriceps activation on the injured side is facilitated by the concomitant application of neuromuscular electrical stimulation (NMES) on the contralateral quadriceps.

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Key information

Conditions

ACL Injury Anterior Cruciate Ligament Injuries Knee Injuries Leg Injuries Wounds and Injuries

Age range

18 year–50 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

The primary objective of this study is to assess whether injured-side voluntary quadriceps activation before and after ACL surgery is facilitated by the concomitant application of NMES on the contralateral quadriceps (uninjured side), in comparison to a control (CTRL) condition that does not involve any contralateral activity (passive rest) and to a voluntary (VOL) condition that involves a maximal voluntary contraction of the contralateral quadriceps.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

Patients undergoing ACL surgery with semitendinosus tendon autograft in the Schulthess Clinic
Unilateral and primary ACL injury (with/without diagnoses of additional meniscus injury)

Exclusion criteria

Previous surgery/ligament rupture in injured or uninjured knee or hip
Severe pain in the uninjured-side quadriceps or knee joint
Ongoing pregnancy
BMI >30 kg/m²
Neuromuscular disease
Open wounds or tissue injuries on the anterior aspect of the thigh
Additional rupture of other knee ligaments (posterior cruciate ligament, medial collateral ligament, lateral collateral ligament)
Implanted metallic/electronic devices (cardiac pacemakers, defibrillators)
Patients getting a femoralis block (peripheral nerve block) after surgery will be excluded for the post-surgical appointment
Insufficient language comprehension

Treatment and study plan

Neuromuscular Electrical Stimulation

Device

Studies in healthy individuals have demonstrated that NMES applied to the quadriceps of one limb induces short-term increases in strength and neural drive in the contralateral homologous muscle. Since these effects have only been observed in healthy individuals, it is essential to investigate whether similar responses occur in ACL patients.

Primary outcomes

EMG activity

Time frame: Data will be collected at two time points: after ACL injury (within two weeks prior to surgery) and following ACL reconstruction (within three days post-surgery).

EMG data will be recorded from the vastus medialis, vastus lateralis and rectus femoris muscles.

Study contacts

Contact information is provided by the study sponsor or research team.

Nicola Angelo Maffiuletti, PhD

CONTACT

[email protected]

+41 44 385 75 79

Sponsors and collaborators

Lead sponsor

Schulthess Klinik

Other

Registry information

Official study title

Does NMES Applied to the Contralateral Uninjured Side Facilitate Voluntary Quadriceps Activation Before and After ACL Surgery?

Acronym: ACLQuadAct

Important dates

Study start: 2025
Primary completion: 2026
Study completion: 2026
First posted: Sep 5, 2025
Registry last updated: Sep 5, 2025

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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