Effect of the Hockey Slideboard Training Combined With Blood Flow Restriction (BFR) in the Rehabilitation Following Anterior Cruciate Ligament Surgical Reconstruction (ACL-R)

ACL injuries represent a major health and economic burden. The overall incidence of ACL injuries has increased and is likely to continue to increase, in part due to increased sports participation.

In the acute post-surgical phase there is a period of physiologic recovery from the surgical injury and subsequent relative muscle disuse that is associated with atrophy loss of strength and anterior knee pain. Therefore, improvement of muscle function is a priority in the rehabilitation and reathletization process.

To achieve significant muscle hypertrophy as well as a possible subsequent increase in strength, it is widely accepted that resistance exercises with relevant load (~70% of the one repetition maximum - 1RM) are necessary; however, in patients undergoing anterior cruciate ligament reconstruction (ACL-R), exercises with high loads are considered unsafe in the early stages and could increase the risk of re-injury.

BFR training is an established muscle training and rehabilitation technique in which the blood supply to and from the muscles involved in the exercise is restricted using an external device.

Although the physiological mechanisms related to this intervention are not yet well understood, it is thought that in BFR training, despite the low level of mechanical tension, the main driver of myocellular hypertrophy could be metabolic stress that is realized by local accumulation of metabolites. Thus, it seems that hypertrophic adaptations can be induced with much lower exercise intensities using BFR. In fact, when combined with low-load resistance training (e.g., 20% 1RM), training with BFR has shown positive results in increasing muscle volume and strength after ACL-R in complete safety comparable to standard training without BFR.

It has also already been demonstrated how incorporating the use of the hockey slideboard into the rehabilitation procedure following ACL-R gives benefits in terms of strength recovery of the extensor muscles of the operated limb with the same safety profiles as standard rehabilitation.

Study Overview

• Status: Recruiting
• Conditions: Anterior Cruciate Ligament Rupture; Rehabilitation After ACL Reconstruction
• Intervention / Treatment: Other: Hockey slideboard combined with BFR training; Other: Hockey slideboard

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Claudia I Nedelcu, Master, BSc; Phone Number: 0040728258216; Email: iuliaclaudy@gmail.com
• Study Contact Backup: Name: Sebastiano Nutarelli, Master, BSc; Phone Number: 0041779501650; Email: s.nutarelli@mail.ch

Study Locations

• Romania
  • Odorheiu Secuiesc, Romania, 535600
    • Recruiting
    • Spital Municipal Odorheiu Secuiesc
    • Contact: Claudia I Nedelcu, Master, BSc; Phone Number: 0040728258216; Email: iuliaclaudy@gmail.com
    • Contact: Claudia I Nedelcu, Master, BSc
    • Contact: Toma Vasilescu, Master, BSc

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• having undergone ACL-R following a unilateral rupture, with reconstructive surgical technique by bone-patellar tendon-bone autograft (BPTB) or semitendinosus-gracilis autograft (STG)
• ACL-R including associated meniscal lesions treated with selective meniscectomy and/or non-complex meniscal suture

Exclusion Criteria:

• not having undergone ACL-R following a unilateral rupture, with reconstructive surgical technique by bone-patellar tendon-bone autograft (BPTB) or semitendinosus-gracilis autograft (STG)

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: ACL-R with hockey slideboard training combined with blood flow restriction (BFR); Patients underwent ACL-R who undergo a reathletization program as usual together with the use of the hockey slideboard combined with BFR training	Other: Hockey slideboard combined with BFR training; Hockey slideboard combined with BFR training
Active Comparator: ACL-R with hockey slideboard training; Patients underwent ACL-R who undergo a reathletization program as usual together with the use of the hockey slideboard	Other: Hockey slideboard; Hockey slideboard

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adductor muscles maximal voluntary isometric contraction (MVIC)	Adductor muscles' maximal voluntary isometric contraction (MVIC) measured via hand-held dynamometer test in a supine position	Before the study intervention (T0) and after the study intervention lasting for four weeks (T1)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Abductor muscles maximal voluntary isometric contraction (MVIC)	Abductor muscles' maximal voluntary isometric contraction (MVIC) measured via hand-held dynamometer test in a supine position	Before the study intervention (T0) and after the study intervention lasting for four weeks (T1)
Adductor/abductor isometric strength (MVIC) ratio	Adductor and abductor muscles' maximal voluntary isometric (MVIC) strength ratio measured via hand-held dynamometer test in a supine position	Before the study intervention (T0) and after the study intervention lasting for four weeks (T1)
Y-balance test (YBT) composite score	The YBT assessment demands that the athlete maintain balance on one leg while extending the opposite leg as far as feasible in three different directions: anterior, posterolateral, and posteromedial. The YBT composite score is calculated by summing the three reach distances and normalizing them to the lower limb length.	Before the study intervention (T0) and after the study intervention lasting for four weeks (T1)
Triple hop test for distance	Triple hop test executed, calculating the maximum reached distance and comparing the healthy limb result with the involved leg.	After the study intervention lasting for four weeks (T1)
Single hop test for distance	Single hop test executed, calculating the maximum reached distance and comparing the healthy limb result with the involved leg.	After the study intervention lasting for four weeks (T1)
Side hop test	The participant is required to hop from side to side on one limb outside two parallel strips of tape 40 cm apart, and instructed to hop as many hops as possible for 30 seconds.	After the study intervention lasting for four weeks (T1)

Collaborators and Investigators

• Sponsor: Spitalul Municipal Odorheiu Secuiesc

Study record dates

Study Major Dates

• Study Start (Actual): April 10, 2025
• Primary Completion (Estimated): April 10, 2026
• Study Completion (Estimated): April 15, 2026

Study Registration Dates

• First Submitted: April 24, 2025
• First Submitted That Met QC Criteria: April 24, 2025
• First Posted (Actual): May 2, 2025

Study Record Updates

• Last Update Posted (Actual): May 2, 2025
• Last Update Submitted That Met QC Criteria: April 24, 2025
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries; Rupture
• Other Study ID Numbers: SOCT1

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