Exercise With Audible Cues on Motor Unit Behavior in Athletes With Anterior Cruciate Ligament Reconstruction

Terminal Knee Extension Exercise Synchronize With Audible Cues on Motor Unit Behavior of Vastus Medialis Muscle in Athletes With Anterior Cruciate Ligament Reconstruction

The closed kinetic chain (CKC) of terminal knee extension exercise (TKE) is designed to activate VM activity for knee injury training. This CKC exercise is effective for highest recruiting muscle activity, especially safe for post-operative knee surgery. The study of ACL reconstruction rehabilitation guideline suggests that exercises can be applied within the early phase of rehabilitation to prevent knee laxity and less knee pain compared to open chain exercise. Therefore, it is interesting to investigate the effects of TKE exercise synchronized with metronome pace on change of VM motor unit behavior in post operative ACL reconstruction. This study focuses on the immediate effect of 1-seesion TKE and expects that adding metronome during TKE will enhance neuromuscular control of VM and may change motor unit behavior.

This study investigates the effect of exercise with sensory integration technique on neuromuscular control in athletes with anterior cruciate ligament reconstruction.

Inclusion Criteria:

• Male or female participants who receive primary ACL reconstruction within 2 weeks with or without meniscus repair
• No or mild resting pain (Numeric rating scale ≤ 3)
• Reconstruction procedures using autograft including hamstrings or bone-patella bone grafts
• Age range 18-35 years (33).
• BMI of 18.5-25 kg/m² (34).
• Tegner activity scale ≥ level 4

Exclusion Criteria:

• Non-weight bearing within 2 weeks after the operation (prescription from surgeon)
• Hearing problem, such as being unable to hear the metronome sound or being unable to synchronize exercises with the metronome correctly
• Limitations in knee extension range caused by joint stiffness evaluated by using passive knee range of motion
• Unable to perform active and passive ≥ 30º knee flexion on the operative side
• History of serious injury or operation of lower back and lower extremities such as fracture
• Lower back or lower extremities pain within 6 months before the study
• On the pain killer medication