Combined Compared to Sequential Cognitive and Physical Training in Anterior Cruciate Ligament Reconstructed Individuals (DUACL)

Dual-Task Training in an Immersive Environment Compared to Single Task Training in Anterior Cruciate Ligament Reconstructed Individuals

The goal of this clinical trial is to investigate changes in cognitive and physical performance after 10 weeks of dual or single task training in anterior cruciate ligament (ACL) reconstructed individuals. The main questions it aims to answer are:

• Does cognitive performance in ACL reconstructed individuals change after multiple training sessions incorporating single versus dual-task?
• Does physical performance and intrinsic motivation for training change over the course of 10 weeks when performing single versus dual-task training sessions?
• What movement patterns do ACL reconstructed individuals show during a dual-task training in an immersive environment?

Researchers will compare a combined dual-task training (combined physical and cognitive training) to a single task training (physical and cognitive training separately) to see if there are changes on cognitive performance depending on the training type.

Participants will:

• Perform dual-task or single task training twice per week for 10 weeks
• Visit the clinic before and after the training period for tests
• Visit the movement laboratory once for analysis of movement patterns

Study Overview

• Status: Terminated
• Conditions: Anterior Cruciate Ligament Reconstruction Rehabilitation
• Intervention / Treatment: Other: Dual-task training; Other: Single task training

• Study Type: Interventional
• Enrollment (Actual): 2
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Switzerland
  • Winterthur, Switzerland, 8000
    • KSW Kantonsspital Winterthur
  • Winterthur, Switzerland, 8000
    • ZHAW Zurich University of Applied Sciences

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• 18-40 years old
• At least 6 months after ACL injury
• Surgically reconstructed ACL
• At least 2 hours of sports participation before the injury
• Written consent of the attending surgeon to perform intensified training methods including one-legged jumps at 6 months after surgery after the first visit
• Ability to give informed consent as documented by signature
• Ability to understand instructions in German or English
• BMI < 28 kg/m^2
• Availability to take part in at least 70% of all training sessions

Exclusion Criteria:

• Surgery on the contralateral leg during the last 12 months
• Acute or chronic musculoskeletal, neurological, or cardiopulmonary disorders
• Unadjusted vision problems
• Concussion during the last 6 months
• Pregnancy
• Breastfeeding
• Amputation
• Inflammatory pain or swelling during exercising

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Dual-task training	Other: Dual-task training; Combined simultaneous physical and cognitive training in an immersive environment
Active Comparator: Single task training	Other: Single task training; Sequential cognitive and then physical training

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Interference	Measured by the difference in reaction time of congruent and incongruent stimuli of the Flanker task.	Baseline, after 5 weeks of training, after 10 weeks of training
Response inhibition	Measured by the accuracy of Go/No-Go-stimuli	Baseline, after 5 weeks of training, after 10 weeks of training

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Jumping performance - contact time	Contact time during jumping on force plates.	Baseline and after 10 weeks of training
Jumping performance - peak force	Peak force during jumping on force plates.	Baseline and after 10 weeks of training
Strength	Peak force of hamstring, quadriceps, hip abduction, and hip adduction	Baseline and after 10 weeks of training
Intrinsic motivation	German version of the short scale for intrinsic motivation (Kurzskala Intrinsische Motivation). For each of the 12 items there is a 5-point Likert-Scale resulting in values of 0-4. Therefore, the total score ranges from 0 to 48. The higher the score, the higher the intrinsic motivation.	At the end of each training session (2x/week for 10 weeks)
Kinematics and kinetics of the lower extremities	Hip, knee, and ankle angles and moments and ground reaction forces	During dual-task training in an immersive environment
Kinematics and kinetics of the lower extremities	Ground reaction forces, angles and moments of hip, knee, and ankle during functional tasks	Baseline and after 10 weeks of training

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Kujala	The German version of the 13-item Kujala questionnaire will be used for assessment of anterior knee pain. Questions involve ability to do several activities and symptoms of patients. All scores of the 13 items are summed up to give a total score ranging from 0 to 100. High scores indicate a good outcome.	Baseline and after 10 weeks of training
ACL-Return to Sport after Injury Scale	The German version of the ACL-RSI will be used. The ACL-Return to Sport after Injury Scales includes 12 items which are each answered on a Likert-scale from 0 to 100. For the total score, individual scores of each item are added and subsequently divided by the numer of questions. Hence total score ranges from 0 to 120. High scores indicate a positive psychological evaluation.	Baseline and after 10 weeks of training
Tegner Activity Scale	The German version of the Tegner Activity Scale including 11 different stages will be used. Each stage includes activities in sports and work of patients after ACL injury. Stages range from 0 to 10.	Baseline and after 10 weeks of training
Socio-demographic data	Sex, age, time since ACL reconstruction, injury history	Baseline
Subjective Cognitive Load	Measured by the NASA-TLX questionnaire	At the end of each training session (2x/week for 10 weeks)

Collaborators and Investigators

• Sponsor: Michelle C. Haas
• Collaborators: Kantonsspital Winterthur KSW; ZHAW DIZH Fellowship Program

Study record dates

Study Major Dates

• Study Start (Actual): June 5, 2025
• Primary Completion (Actual): June 12, 2025
• Study Completion (Actual): October 8, 2025

Study Registration Dates

• First Submitted: February 13, 2025
• First Submitted That Met QC Criteria: February 19, 2025
• First Posted (Actual): February 25, 2025

Study Record Updates

• Last Update Posted (Actual): December 8, 2025
• Last Update Submitted That Met QC Criteria: December 1, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: anterior cruciate ligament injury; motor-cognitive training; dual-task training; return to competition
• Additional Relevant MeSH Terms: Wounds and Injuries; Leg Injuries; Knee Injuries; Anterior Cruciate Ligament Injuries
• Other Study ID Numbers: DUACL

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Individual participant data will be shared if ethically and legally possible.

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