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

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.

Study Overview

• Status: Recruiting
• Conditions: Therapeutic Exercise; Physical Therapy Techniques; Neuromuscular Function
• Intervention / Treatment: Behavioral: Exercise; Behavioral: audible cues

Detailed Description

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

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Komsak Sinsurin, PT, Ph.D., DPT; Phone Number: 6855547313; Email: komsak.sin@mahidol.edu
• Study Contact Backup: Name: Sakda Nitkotom, B.Sc.; Phone Number: 0869853212; Email: Sakda.nit@hotmail.com

Study Locations

• Thailand
  • Changwat Nakhon Pathom
    • Salaya, Changwat Nakhon Pathom, Thailand, 73170
      • Recruiting
      • Faculty of Physical Therapy, Mahidol University
      • Contact: Wanida Sawangnat, M.Sc.; Phone Number: 20220 +66 24415450; Email: wanida.swa@mahidol.ac.th

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Exercise without audible cues; Terminal knee extension exercise without audible cues	Behavioral: Exercise; Terminal knee extension exercise
Experimental: Exercise with audible cues; Terminal knee extension exercise with audible cues	Behavioral: audible cues; Terminal knee extension exercise with audible cues; Other Names: Exercise with audible cues

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Average motor unit firing rate (pulse per second, pps)	Motor unit behavior of vastus medialis muscle: Average motor unit firing rate (pulse per second, pps)	From enrollment to the end of treatment at 2 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Peak motor unit action potential (mV)	Motor unit behavior of vastus medialis muscle: Peak motor unit action potential (mV)	From enrollment to the end of treatment at 2 weeks

Collaborators and Investigators

• Sponsor: Mahidol University

Study record dates

Study Major Dates

• Study Start (Actual): October 20, 2024
• Primary Completion (Estimated): October 19, 2026
• Study Completion (Estimated): December 30, 2026

Study Registration Dates

• First Submitted: October 25, 2024
• First Submitted That Met QC Criteria: October 26, 2024
• First Posted (Actual): October 29, 2024

Study Record Updates

• Last Update Posted (Actual): December 12, 2025
• Last Update Submitted That Met QC Criteria: December 11, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: ACLR
• Additional Relevant MeSH Terms: Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Exercise
• Other Study ID Numbers: MU-CIRB 2024/242.3009

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No