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NCT Number: NCT06206200

The Effects of Cognitive Dual-Tasking in Later Stages of Rehabilitation After ACL Reconstruction

Anterior cruciate ligament (ACL) injuries are common in sports and often require a long and challenging rehabilitation process. Athletes who sustain these injuries typically engage in pivoting and cutting sports, where these motor tasks must be performed simultaneously with cognitive tasks such as decision-making and keeping an eye on the opponent. Directing attention to both cognitive and motor tasks leads to cognitive-motor interference, which is associated with movement patterns that increase the risk of ACL (re)injury.

Therefore, it is crucial that before returning to such demanding sports after ACL reconstruction, athletes sufficiently develop and automate safe yet efficient motor skills to free up attentional capacity for decision-making, thereby reducing the risk of suboptimal movement patterns and reinjury.

However, current rehabilitation programs often primarily focus on the motor component in a single-task manner, giving insufficient attention to the cognitive component that is inseparable from sports.

This randomized controlled trial aims to investigate the effects of implementing motor-cognitive dual tasks in the end phase rehabilitation after ACL reconstruction on muscle function, functional outcomes, and patient-reported outcomes.

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Key information

Conditions

Anterior Cruciate Ligament Reconstruction ACL Injury Anterior Cruciate Ligament Injuries Athrogenic Muscle Responses Knee Injuries Leg Injuries Wounds and Injuries

Age range

18 year–40 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

AZ Delta Roeselare (Campus Brugsesteenweg)

Roeselare, West-Vlaanderen, 8800, Belgium

Location status: Recruiting

Location contact

Thomas Tampere, Dr.

CONTACT

[email protected]

051 23 63 70

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • 18-40 years old.
  • Having suffered an ACL rupture.
  • Undergoing a surgical ACL reconstruction in the AZ Delta hospital in Roeselare (Campus Brugsesteenweg).

Exclusion criteria

  • Revision ACL reconstruction.
  • Other severe injuries to the lower limbs within the past year.
  • Muscle or neurological disorders affecting lower limb functioning.
  • Fibromyalgia or chronic fatigue syndrome.

Treatment and study plan

Cognitive dual task training (intervention group)

Other

Simultaneously performing cognitive tasks and motor rehabilitative exercises.

Standard of care physiotherapy (control group)

Other

The current best physical therapy treatment for patients with anterior cruciate ligament reconstruction based on existing scientific evidence.

Primary outcomes

  1. Psychological readiness to return to sport

    Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)

    Questioned using the ACL-RSI. Scores range from 0 to 100. Higher scores indicate higher psychological readiness.

  2. Quadriceps and hamstrings activity / cocontraction during hop tasks

    Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)

    Electromyographical measurement of quadriceps and hamstrings activation during hop tasks.

  3. Patient reported knee function

    Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)

    Questioned using the Knee Injury and Osteoarthritis Outcome Score (KOOS) with its different subscores. Scores on the KOOS range from 0-100, with 0 representing the greatest possible problems in terms of knee function and 100 representing no problems.

  4. Jumping height in hop tests

    Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)

    Performance in single hop tests and a single leg drop-jump expressed by jump height in centimeters.

  5. Activity level

    Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)

    Questioned using the Tegner Score. The scores range from 0 to 10, with higher scores indicating higher activity levels.

  6. Voluntary quadriceps activation

    Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)

    A force-based isometric biodex measurement using the interpolated twitch/superimposed burst technique.

Secondary outcomes

  1. Quadriceps and hamstrings strength

    Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)

    Measured on the biodex.

  2. Kinesiophobia

    Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)

    Questioned using the Tampa Scale of Kinesiophobia (TSK). Scores on the TSK range from 17 to 68, with higher scores indicating more kinesiophobia.

  3. Subjective knee stability

    Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)

    Questioned using the first question of the Lysholm questionnaire. Scores range from 0 to 25 with 25 indicating no symptoms of subjective instability.

  4. The amount of pain that the subjects experience.

    Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)

    Questioned using a Numeric Rating Scale. The scores range between 0 and 10 with 10 0representing the highest level of pain.

Other outcomes

  1. Duration of ground contact in hop tests

    Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)

    Performance in single hop tests and a single leg drop-jump expressed by the duration of ground contact.

  2. Performance in the T-agility test

    Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)

    It will be measured how much time subjects require to complete a T-agility test.

  3. Strength endurance during timed single leg step down and timed single leg squat

    Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)

    The strength endurance of the subjects will be evaluated by the amount of repetitions they can perform in a time span of 30 seconds.

  4. Expectations regarding return to sport

    Time frame: 5 months post ACL reconstruction (= prior to intervention); 7 months post ACL reconstruction (= after the intervention); 9 months post ACL reconstruction (= after a 2 month retention period)

    Questioned using the Tegner Score: 'how active do you want to be at the end of your rehabilitation?'. The scores range from 0 to 10, with higher scores indicating higher activity levels.

Study contacts

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

Erik Witvrouw, prof. dr.

CONTACT

[email protected]

+32 9 332 26 32

Evy Deschaumes, MSc

CONTACT

[email protected]

+32 9 332 5503

Sponsors and collaborators

Lead sponsor

University Ghent

Other

Collaborators

  • Research Foundation Flanders

Registry information

Acronym: AMIRA

Important dates

Study start
2023
Primary completion
2027
Study completion
2027
First posted
Jan 16, 2024
Registry last updated
Jul 15, 2024

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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