Effects of Hip Focused Exercises in Patients With Post Operative Anterior Cruciate Ligament Rehabilitation

Effects of Hip Focused Exercises on Pain, Range of Motion, Functional Disability, Muscle Strength and Endurance in Patients With Post Operative Anterior Cruciate Ligament Rehabilitation

A Randomized Controlled Trial will be conducted at Mahaban Medical and Research Hospital through consecutive sampling technique on 66 patients which will be allocated using simple random sampling through sealed opaque enveloped into Group A and Group B. Group A will be treated with hip focused exercises and standard rehabilitation protocol while Group B will be treated with traditional exercises at the frequency of 2 sets with 10 repetitions and thrice a week. Outcome measures will be conducted through pain, range of motion, functional disability, muscle strength and endurance after 12 weeks. Data will be analyzed during SPSS software version 21. After assessing normality of data by Shapiro-wilk test, it will be decided either parametric or non- parametric test will be used within a group or between two groups.

Study Overview

• Status: Completed
• Conditions: Post Operative Anterior Cruciate Ligament Rehabilitation
• Intervention / Treatment: Other: Hip focused; Other: Standard rehabilitation

Detailed Description

Anterior cruciate ligament plays an important role in knee stability and is prone to contact and and non-contact injuries. ACL reconstruction followed by proper rehabilitation is the most successful procedure to restore knee stability and ROM. Keeping in mind the lower limb kinematics and biomechanics the aim of this study will be to see the effects of hip focused exercises on pain, range of motion, functional disability, muscle strength and endurance in patients with post-operative ACL rehabilitation. A Randomized Controlled Trial will be conducted at Mahaban Medical and Research Hospital through consecutive sampling technique on 66 patients which will be allocated using simple random sampling through sealed opaque enveloped into Group A and Group B. Group A will be treated with hip focused exercises and standard rehabilitation protocol while Group B will be treated with traditional exercises at the frequency of 2 sets with 10 repetitions and thrice a week. Outcome measures will be conducted through pain, range of motion, functional disability, muscle strength and endurance after 12 weeks. Data will be analyzed during SPSS software version 21. After assessing normality of data by Shapiro-wilk test, it will be decided either parametric or non- parametric test will be used within a group or between two groups.

• Study Type: Interventional
• Enrollment (Actual): 47
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab
    • Lahore, Punjab, Pakistan, 54000
      • Riphah Rehab Clinic

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

Both males and females of age group between 18 and 45 years

• Patients with ACL reconstruction in early rehabilitation phase.
• Physically or recreationally active a minimum of three times per week.(26)
• 1-5 day post operatively(26)
• Physically healthy and without patients with other medical history or joint deformities
• Patients without severe meniscus or cartilage damage (27)
• Complaints of pain (NPRS 3-7) and swelling in the operated knee

Exclusion Criteria:

Patients with multiple ligament injuries in the knee joint

• Patients with knee osteoarthritis
• Patients with joint infection (27)
• An associated chondral defect requiring surgical intervention
• A meniscus tear requiring a repair.
• Patients with incomplete follow-up (28)
• Presence of unstable medical conditions preventing the patient from participating in the rehabilitation program.
• History of ipsi-lateral hip replacement
• Ipsi-lateral hip osteoarthritis or lateral hip pain
• Neurological or any other conditions affecting strength or function of lower limbs.

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
Experimental: Hip focused exercises; will receive hip focused exercises and standard rehabilitation protocol with the frequency of 2 sets and 10 repetitions thrice per week for a total of 12 weeks. Pre and post intervention values will be taken on 1st day and after 12 weeks.	Other: Hip focused; Group A will be treated with hip focused exercises and standard rehabilitation protocol. Hip focused exercises will be comprised of following exercises in phase 1 will be Side lying hip abduction, Hip abduction in standing, Hip extension from prone, Single leg bridge, Side lying clam with resistance while exercises in phase 2 will be same with more repetitions in addition to Side lunges, Forward lunges; Other: Standard rehabilitation; Group B will be only be treated with standard rehabilitation protocol. When participant reach full ROM of knee, perform four sets of 20 repetitions of straight leg raising with full extension, and maintain one minute single leg balance on a solid surface with the affected side, subject can transfer to phase 2
Active Comparator: Standerd rehab protocol; will receive only standard rehabilitation protocol with the frequency of 2 sets and 10 repetitions thrice per week for a total of 12 weeks. Pre and post intervention values will be taken on 1st day and after 12 weeks	Other: Standard rehabilitation; Group B will be only be treated with standard rehabilitation protocol. When participant reach full ROM of knee, perform four sets of 20 repetitions of straight leg raising with full extension, and maintain one minute single leg balance on a solid surface with the affected side, subject can transfer to phase 2

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Numeric Pain Rating Scale (NPRS)	The Numeric Pain Rating Scale (NPRS) is commonly used in the clinical setting and is convenient to administer and interpret. The NPRS is a numbered scale that begins with zero and ends at ten. Zero indicates no pain, while ten is the worst intensity of pain that individual can imagine	6 WEEK
Universal Goniometer	The goniometer is used to objectively assess active and passive joint ROM. The universal or standard plastic, long armed, 360 degree goniometer is frequently recommended for measurement of knee ROM as the longer arm is thought to reduce error resulting from incorrect placement of the goniometric axis	6th week
WOMAC	The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to measure the physical function of the knee. This scale was shown to be a valid and reliable tool, which was utilized to assess the physical function in patients with knee surgery. This tool comprises 24 questions: 5 questions about pain (0-20 points), 2 questions about stiffness (0-8 points), and 17 questions about physical functions difficulty (0-68 points), which may be completed in less than 5 minutes.	6th week

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Rabiya Noor, PhD, Riphah International University

Publications and helpful links

General Publications

• Sanders TL, Maradit Kremers H, Bryan AJ, Larson DR, Dahm DL, Levy BA, Stuart MJ, Krych AJ. Incidence of Anterior Cruciate Ligament Tears and Reconstruction: A 21-Year Population-Based Study. Am J Sports Med. 2016 Jun;44(6):1502-7. doi: 10.1177/0363546516629944. Epub 2016 Feb 26.
• Matsumoto H, Suda Y, Otani T, Niki Y, Seedhom BB, Fujikawa K. Roles of the anterior cruciate ligament and the medial collateral ligament in preventing valgus instability. J Orthop Sci. 2001;6(1):28-32. doi: 10.1007/s007760170021.
• Petersen W, Tillmann B. Structure and vascularization of the cruciate ligaments of the human knee joint. Anat Embryol (Berl). 1999 Sep;200(3):325-34. doi: 10.1007/s004290050283.

Study record dates

Study Major Dates

• Study Start (Actual): October 15, 2024
• Primary Completion (Actual): November 10, 2024
• Study Completion (Actual): November 20, 2024

Study Registration Dates

• First Submitted: December 20, 2024
• First Submitted That Met QC Criteria: December 20, 2024
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: December 20, 2024
• Last Verified: December 1, 2024

More Information

Terms related to this study

• Keywords: pain; Range of Motion; Anterior cruciate ligament Rehabilitation; Hip focused Exercises
• Other Study ID Numbers: REC/RCR & AHS/24/0109

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No