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| ID | Type | Description | Link |
|---|---|---|---|
| 5P20GM109090-03 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| University of Nebraska | OTHER |
| National Institutes of Health (NIH) | NIH |
| National Institute of General Medical Sciences (NIGMS) | NIH |
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Quantify differences in quadriceps function and gait biomechanics in individuals within 2 years of ACL reconstruction compared to a healthy comparison group and establish the feasibility of conducting a progressive strengthening program to improve clinical and patient-oriented outcomes in individuals who are within 2 years of ACL reconstruction
A maximal isometric muscle contraction of the quadriceps will be used to examine neural and peripheral contributions to quadriceps strength. Neural influences will be quantified using the interpolated twitch technique (voluntary activation) and early RTD. Peripheral influences will be quantified by examining the stimulus-evoked torque with the quadriceps relaxed (resting twitch) and late RTD. Knee joint biomechanics during treadmill walking and running will include sagittal plane (flexion, extension) movement variability (Lyapunov Exponent and approximate entropy), peak knee flexion angle, and peak external knee flexion and adduction moments. Additionally, the clinical relevance of impairments in the ACL reconstruction group will be determined by examining the relationship with performance on jumping tasks and patient function (secondary outcomes).
The progressive strengthening program will be performed for 6 weeks and emphasize development of strength and power. Feasibility will be established if the researchers can recruit up to 8 participants and retain at least 80% over the 3 week intervention program. The researchers will determine effect sizes for changes outcome measures.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Progressive strengthening program | Experimental | Subjects identified as having a clinically relevant strength deficit will be asked to participate in physical therapy sessions 3 times per week for 3 weeks. The strengthening program will consist of an individualized, progressive exercise program with an emphasis on increasing lower extremity strength, power, and biomechanics. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Progressive strengthening program | Other | The progressive strengthening program will be performed for 3 weeks and emphasize development of strength and power. Feasibility will be established if we can recruit up to 8 participants and retain at least 80% over the 3 week intervention program. We will determine effect sizes for changes outcome measures. |
| Measure | Description | Time Frame |
|---|---|---|
| Quadriceps Rate of Torque Development (RTD) Maximum | slope of the torque-time tracing (change in torque/change in time) (Nm/kg*s-1) | Change from Baseline Quadriceps RTD at 3 weeks |
| Knee Joint biomechanics during gait (nonlinear) | Sagittal plane (knee flexion) movement variability (calculated using Lyapunov Exponent and approximate entropy) | Change from Baseline nonlinear knee joint biomechanics at 3 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Quadriceps percent activation | Supramaximal electrical stimulus (interpolated twitch technique) used to augment a voluntary muscle contraction | Change from Baseline Quadriceps percent activation at 3 weeks |
| Knee Joint biomechanics during gait (traditional) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Terry L Grindstaff, PhD, PT, ATC | Creighton University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Creighton University | Omaha | Nebraska | 68178 | United States |
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| ID | Term |
|---|---|
| D000070598 | Anterior Cruciate Ligament Injuries |
| ID | Term |
|---|---|
| D007718 | Knee Injuries |
| D007869 | Leg Injuries |
| D014947 | Wounds and Injuries |
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Physical therapy exercises (progressive strengthening program)
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|
peak external knee flexion moment (Nm/kgm) |
| Change from Baseline knee joint biomechanics at 3 weeks |
| Patient reported function | International Knee Documentation Committee (IKDC) subjective form | Change from Baseline IKDC at 3 weeks |
| Jumping performance | single leg hop for distance (cm) | Change from Baseline single leg hop for distance at 3 weeks |