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| Name | Class |
|---|---|
| University of Extremadura | OTHER |
| University of Évora | OTHER |
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Background Prehabilitation prior to anterior cruciate ligament reconstruction (ACLR) has been shown to improve preoperative knee function, enhance quadriceps strength, and optimize postoperative recovery. However, access to supervised prehabilitation programmes remains limited. Digital health interventions may improve accessibility, adherence, and continuity of care.
Objective To determine whether a structured digital prehabilitation programme is more effective than usual care in improving quadriceps strength and functional outcomes after ACL reconstruction.
Methods/design This study is a single-centre, parallel-group, assessor-blinded randomised controlled trial. Adult participants scheduled for primary ACL reconstruction will be randomly allocated to either a usual care group or a digital prehabilitation group. The intervention group will complete a 4-week structured digital prehabilitation programme prior to surgery. Outcomes will be assessed preoperatively and up to 12 weeks postoperatively.
Expected Results The digital prehabilitation programme is expected to improve preoperative knee status and enhance postoperative quadriceps strength and functional recovery compared to usual care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control Arm: Usual Care | Active Comparator | Participants receive standard preoperative advice without a structured prehabilitation program |
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| Experimental Arm: Digital Prehabilitation Programme. Knee Care@Home Programme | Experimental | Participants will complete a structured 4-week digital prehabilitation programme prior to ACL reconstruction, including: Range of motion exercises Strength training (quadriceps, hamstrings, hip musculature) Neuromuscular and balance training Patient education (surgery, recovery expectations) Lifestyle optimization (pain management, nutrition, emotional support) Frequency: 3 sessions per week Duration: 10-20 minutes per session Delivery mode: Digital platform with guided sessions and remote supervision. Knee Care@Home Programme |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Digital Prehabilitation Programme | Other | Participants in the intervention group will undergo a structured 4-week digital prehabilitation programme prior to anterior cruciate ligament reconstruction.The programme includes:- Range of motion exercises targeting knee extension and flexion- Strength training focusing on quadriceps, hamstrings, and hip musculature- Neuromuscular and balance training- Patient education on surgical procedure, postoperative expectations, and recovery process- Lifestyle optimisation advice including pain management, nutrition, and emotional supportThe intervention will be delivered through a digital platform with guided exercise sessions and remote supervision.Frequency: 3 sessions per weekDuration: approximately 10-20 minutes per sessionThe programme aims to optimise preoperative knee function, improve quadriceps strength, and enhance postoperative recovery outcomes. |
| Measure | Description | Time Frame |
|---|---|---|
| Quadriceps Isometric Strength | Maximum isometric quadriceps strength measured in seated position at 90° knee flexion. Three repetitions will be recorded, and the highest value will be used | 12 weeks postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Knee Extension Range of Motion | Passive knee extension will be measured in degrees using a standard goniometer. Full extension (0°) will be considered optimal preoperative status | Baseline and preoperative (prior to surgery) |
| Knee Pain Intensity |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Alejandro Caña Pino, PhD | Contact | 927251220 | alejandrocp@unex.es | |
| João Paulo Sousa, PhD | Contact | 919662332 | jsousa@uevora.pt |
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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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| Usual Care | Other | Participants in the control group will receive standard preoperative care, which may include general advice and routine clinical follow-up, but no structured prehabilitation programme.Participants will not receive a supervised or digital exercise intervention prior to surgery. |
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Pain intensity will be assessed using a Visual Analogue Scale (VAS), ranging from 0 (no pain) to 100 (worst imaginable pain)
| Up to 12 weeks postoperative |
| Knee Injury and Osteoarthritis Outcome Score (KOOS) | Knee-related symptoms, pain, function in daily living, sport and recreation function, and knee-related quality of life will be assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Each subscale is scored from 0 to 100, where 0 represents extreme problems and 100 represents no problems (best outcome). | Up to 12 weeks postoperative |
| Single Leg Hop Distance | Patients will perform a single-leg hop for maximum distance. The distance will be measured in centimetres | Up to 12 weeks postoperative |
| Pain Catastrophizing | Pain-related catastrophic thinking will be assessed using the Pain Catastrophizing Scale (PCS). The total score ranges from 0 to 52, where higher scores indicate greater levels of pain catastrophizing (worse outcome). | Up to 12 weeks postoperative |
| DASS-21. Depression, Anxiety and Stress | Psychological status will be assessed using the Depression Anxiety Stress Scales (DASS-21). The scale consists of three subscales (depression, anxiety, and stress), each ranging from 0 to 42 after score multiplication. Higher scores indicate greater emotional distress (worse outcome). | Up to 12 weeks postoperative |