Dietary Protein Intake and Rehabilitation From Anterior Cruciate Ligament Surgery

July 29, 2021 updated by: Wake Forest University Health Sciences

The Effects of Providing Protein and Nutritional Guidance on Healing Times After ACL Surgery

Protein supplementation may promote increases in strength and hypertrophy in the context of resistance training (RT) and reduce markers of inflammation, while sufficient levels of protein are necessary for healing certain wounds and maintenance of muscle mass in a protein depleted state. Protein supplementation could be useful to improve clinical outcomes.

Study Overview

Status

Withdrawn

Conditions

Intervention / Treatment

Detailed Description

Protein supplementation may promote increases in strength and hypertrophy in the context of resistance training (RT) and reduce markers of inflammation, while sufficient levels of protein are necessary for healing certain wounds and maintenance of muscle mass in a protein depleted state. Despite this, no studies have investigated the role of protein provision in the context of physical therapy (PT) or musculoskeletal rehabilitation, including following surgical interventions. Survey data of Americans in the highest protein consuming age range (19-30 year old consuming 91 g/kg body weight/day), show they have an adequate protein intake to maintain nitrogen balance at baseline (85 g/kg). However, if patients under consume protein, as apparent in older adults (mean intake of 66 g/kg) these individuals will require more during times of tissue healing or could benefit with more in attempting to build back their strength through RT or PT. Thus, protein supplementation could be useful to improve clinical outcomes.

Study Type

Interventional

Phase

  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

16 years and older (ADULT, OLDER_ADULT, CHILD)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Participants with a complete ACL tear and received a hamstring autograft ACL repair surgery (within 8 months of injury) and plan to complete physical therapy and follow up treatment with WFBH at D1 outpatient rehabilitation
  • Subjects must have a smartphone capable of running the nutrition tracking app (My Fitness Pal)

Exclusion Criteria:

  • Subjects must not have other ligamentous involvement, or complications during the surgical procedure.
  • They must not have had a concurrent meniscal repair (debridement is acceptable).
  • They must not have post-operative limitations that interfere with rehabilitation.
  • Patients determined by the referring surgeon to be poor candidates for the study for any medical (including history of eating disorder, phenylketonuria, maple syrup urine disease, food allergies, lactose intolerance, kidney or liver disease) or other reasons that deem them inappropriate to complete the intervention (driving distance from facility, work schedule that prohibits therapy treatments, dietary restrictions) will be excluded.
  • Females who are pregnant will not be permitted in the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: SUPPORTIVE_CARE
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: SINGLE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: Physical Therapy plus Protein Supplement
Participants will be randomized to the protein supplementation group, PROT, and will receive education from a dietary counselor on how to monitor protein intake using a smartphone app.
Dietary supplement: Protein (PROT)
Participants will receive Combat Protein Powder made by MusclePharm in an amount sufficient to take 80g daily until their next visit. They will be encouraged to ingest 40 g after exercise and 40 g before bed which will partly comprise their daily goal. They will be educated on the concept of complete high quality proteins, and that some proteins can facilitate muscle growth greater than others. Additionally, they will receive meal plan ideas and shopping tips that will facilitate healthy and economical protein consumption up to or beyond their daily goal.
ACTIVE_COMPARATOR: Physical Therapy Control
Participants will be randomized to the enhanced-care control group, CONT, and will receive education from a dietary counselor on how to monitor protein intake using a smartphone app.
Other: Control (CONT)
Instructed not to alter their diet based on the app, and to continue to eat as they normally would.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of individuals that complied with treatment/intervention
Time Frame: up to 6 months
Compliance among treatment group in meeting 2 g/kg protein goal as measured by protein tracking app and in protein supplements provided will be measured.
up to 6 months
Percentage of frequency individuals successfully used the protein tracking app
Time Frame: up to 6 months
Compliance in usage of protein tracking app will be recorded. The number of days they logged in and recorded their intake vs. total potential days to provide % value of diet protein compliance.
up to 6 months
Percentage of physical therapy visits attended by individuals
Time Frame: up to 6 months
Compliance in physical therapy will be recorded.
up to 6 months
Percentage counseling sessions attended by individuals
Time Frame: up to 6 months
Compliance in attending nutritional counseling sessions will be recorded.
up to 6 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Single Leg Hop Test
Time Frame: baseline and up to 6 month
Functional healing time based on single leg hop test. The distance the participant hopped on one leg will be recorded and measured in centimeters. This will be done three times and an average will be given.
baseline and up to 6 month
Six Meter Timed Hop Test
Time Frame: baseline and up to 6 month
Functional healing time based six meter timed hop test. The time it took the participant to hop six meters on foot will be measured and recorded.
baseline and up to 6 month
Change in strength in leg flexion and extension
Time Frame: baseline and up to 6 month
Strength in leg flexion and extension, as measured by Biodex machine
baseline and up to 6 month
Change in muscle hypertrophy
Time Frame: baseline and up to 6 month
depth of vastus medialis as measured at each nutritional advising appointment with counselor via ultrasound and thigh circumference.
baseline and up to 6 month

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Wake Forest University Health Sciences

Investigators

  • Principal Investigator: Gary Miller, Ph.D., Wake Forest University Health Sciences

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ANTICIPATED)

October 1, 2021

Primary Completion (ANTICIPATED)

January 1, 2022

Study Completion (ANTICIPATED)

June 1, 2022

Study Registration Dates

First Submitted

July 25, 2018

First Submitted That Met QC Criteria

July 31, 2018

First Posted (ACTUAL)

August 3, 2018

Study Record Updates

Last Update Posted (ACTUAL)

August 2, 2021

Last Update Submitted That Met QC Criteria

July 29, 2021

Last Verified

July 1, 2020

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IRB00046590

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

The IPD will be available for health history, surgery type, clinical outcomes, and length of time in study.

IPD Sharing Time Frame

The data will be available once the study is completed for a 12-month period.

IPD Sharing Access Criteria

Interested parties should contact the PI- Gary Miller - for access

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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