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This study is withdrawn due to a lack of available recruitment within the researchers' timeframe.
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After rehabilitation completion, there remains large deficiencies between the operative (OP) and non-operative (NOP) limbs in lower-limb outcomes (e.g., size, strength, and function) and these deficits can persist for years. Therefore, further specialized training protocols, such as the ones in the present study, are required to determine if these deficits can be lessened. The proposed project will evaluate the effect of 8-weeks of single-leg and double-leg lower-body resistance training on musculoskeletal function in individuals with a previous anterior cruciate ligament (ACL) reconstruction (ACLR) in a randomized control trial. The study will recruit 30-40 males and females between 18-35 years of age that have undergone a previous ACLR. Participants will be randomized to either the single-leg/unilateral (UL) or double-leg/bilateral (BL) training groups. Training will occur three times per week for 8-weeks. The UL group will participate in exercises such as split squats, single-leg deadlifts, or single-leg squats. The BL group will utilize exercises such as double-leg squats, conventional deadlifts, and leg presses. One week prior to (PRE) and one week after (POST) the training program, all participants will undergo a testing battery. Musculoskeletal ultrasound will measure quadriceps and hamstrings muscle cross-sectional area (mCSA), fascicle length (FL), and pennation angle (PA) of both OP and NOP limbs. Strength will be assessed through maximal voluntary isometric contractions (MVIC) for the quadriceps and hamstrings, and one-repetition maximum tests for single-leg leg extensions, leg curls, and leg press. Lower-limb function will be assessed through single-leg and double-leg jumps on a dual force plate system for jump height, impulse, rate of force development, and peak force. Data will be analyzed via separate mixed-factorial analyses of variance for the within-subjects factor of leg (OP vs. NOP) and time (PRE vs. POST) and the between-subjects factor of biological sex (male vs. female) and group (UL vs. BL). Post-hoc analyses will include lower-order ANOVAs and t-tests as pairwise comparisons when significance is detected. Significance will be established at p≤0.05. The results of this study will assist practitioners, coaches, sport scientists, and most importantly, the athletes, in the development of post-rehabilitative strength training protocols designed to reduce between-limb discrepancies.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Unilateral strength training | Experimental | Resistance training three times per week for 8-weeks on one leg at a time per exercise. |
|
| Bilateral strength training | Active Comparator | Resistance training three times per week for 8-weeks on both legs at a time per exercise. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Resistance exercise program- UL | Behavioral | Unilateral group: Exercise sessions supervised by an exercise professional. Exercises will include single-leg squats, split squats, single-leg deadlifts, single-leg leg extensions, etc. Repetition range and volume (sets performed) will target strength and hypertrophy range with linear periodization utilized to ensure progression. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in isometric strength of the quadriceps femoris | Change in maximal voluntary isometric contraction (MVIC) peak torque (Nm) of the quadriceps from PRE (baseline) to POST | 9-weeks |
| Change in muscle cross-sectional area of the quadriceps femoris | Change in absolute muscle cross-sectional area (mCSA, cm^2) of the quadriceps femoris (vastus lateralis, rectus femoris, vastus medialis) from PRE (baseline) to POST | 9-weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Change in muscle cross-sectional area strength of the hamstrings | Change in absolute muscle cross-sectional area (mCSA, cm^2) of the hamstrings (biceps femoris, semimembranous, semitendinosus) from PRE (baseline) to POST | 9-weeks |
| Change in isometric strength of the hamstrings femoris |
| Measure | Description | Time Frame |
|---|---|---|
| Change in dynamic strength of the quadriceps and hamstrings | Change in dynamic strength (kg) of the knee extensors, knee flexors, and total thigh musculature assessed by one-repetition maximum (1-RM) testing for single-leg leg extension, single-leg leg curl, and double-leg press from PRE (baseline) | 9-weeks |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Kansas Edwards Campus | Overland Park | Kansas | 66213 | United States |
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| ID | Term |
|---|---|
| D000070598 | Anterior Cruciate Ligament Injuries |
| D009133 | Muscular Atrophy |
| ID | Term |
|---|---|
| D007718 | Knee Injuries |
| D007869 | Leg Injuries |
| D014947 | Wounds and Injuries |
| D020879 | Neuromuscular Manifestations |
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|
| Resistance exercise program- BL | Behavioral | Bilateral group: Exercise sessions supervised by an exercise professional. Exercises will include double-leg squats, double-leg deadlifts, double-leg leg extensions, etc. Repetition range and volume (sets performed) will target strength and hypertrophy range with linear periodization utilized to ensure progression. |
|
Change in maximal voluntary isometric contraction (MVIC) peak torque (Nm) of the hamstrings PRE (baseline) to POST |
| 9-weeks |
| Change in jump height of both limbs | Change in jump height (cm) during countermovement jumps from PRE (baseline) | 9-weeks |
| Change in jump impulse of both limbs | Change in vertical jump impulse (N/kg/s) during countermovement jumps from PRE (baseline) | 9-weeks |
| Change in body composition | Change in body composition (body fat percentage (%)) assessed by bioelectrical impedance analysis (BIA) from PRE (baseline). | 9-weeks |
| Change in segmental body composition | Change in segmental (legs) fat-free mass (kg) as assessed by bioelectrical impedance analysis | 9-weeks |
| D009461 |
| Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D001284 | Atrophy |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012816 | Signs and Symptoms |