在两种不同的手术技术后进行物理疗法的前交叉韧带损伤患者的膝关节分析:一项随机临床试验。
分析两种不同的手术技术后的物理疗法的膝关节稳定性,功能能力,姿势控制,激活和肌肉强度:一项随机临床试验。
研究概览
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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Paraná
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Londrina、Paraná、巴西、86038-350
- university hospital of the State University of Londrina
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Londrina、Paraná、巴西、86041-263
- State University of Londrina
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参与标准
资格标准
适合学习的年龄
- 成人
接受健康志愿者
描述
纳入标准: - 18至50岁的参与者; - 两个性别; - 久坐; -积极的; - 运动员; - 被诊断为单侧ACL损伤; - 居住在隆德里纳市的患者-PR。
排除标准:-BMI(体重指数)高于35 kg/m2; - 多向韧带松弛; - 相关的多构损伤(PCL和后外侧角); - 以前或当前的下肢骨折; - 先前的ACL重建(修订); - 骨关节炎的迹象; - 半月板缝合线的指示; - 神经疾病; - 孕妇; - 心脏病; - 先前的下肢手术。
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:双倍的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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有源比较器:第1组具有四倍屈肌和常规物理疗法的常规ACL重建
该手术以微创方式借助视频关节镜检查进行。
该过程始于用于ACL重建的肌肉移植物的收集。
将使用半末尾和gracilis肌肉,也称为屈肌肌腱。
所有参与者都将通过手动治疗,体力资源(热,冷,电疗),运动疗法和同动疗法接受康复方案的常规理疗。
所有参与者将以相同的方式进行评估和重新评估。
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第1组将使用四倍屈肌(双gracilis和semitendinosus)进行常规的ACL重建。
所有参与者将接受常规的理疗。
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有源比较器:第2组(ACL +全部重建)和常规物理疗法
第2组将以类似的方式进行常规的ACL +所有重建的方式,该组合具有四倍的屈肌移植物(Triple Semitendinosus和Single Gracilis)。
对于ACL +所有重建的组合,它是通过具有55度角度向导的常规胫骨隧道进行的,并且直径由移植物的厚度定义。
所有参与者都将通过手动治疗,体力资源(热,冷,电疗),运动疗法和同动疗法接受康复方案的常规理疗。
所有参与者将以相同的方式进行评估和重新评估。
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第2组将使用四倍的屈肌(双gracilis和semitendinosus)进行常规的ACL重建 +所有重建。
所有参与者将接受常规的理疗。
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Articular Range of Motion
大体时间:Preoperative and postoperative (5 and 15 days; 1, 2, 4, 6, and 9 months).
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Assessment of hip and knee range of motion (hip internal rotation mobility, lunge test, and flexion/extension).
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Preoperative and postoperative (5 and 15 days; 1, 2, 4, 6, and 9 months).
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Functional Capacity (Questionnaires)
大体时间:Preoperative and postoperative (5 and 15 days; 1, 2, 4, 6, and 9 months).
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Lysholm Scale: Eight questions, with closed answer alternatives, whose final result is expressed in nominal and ordinal form. IKDC: assesses symptoms, function, and sports activity on a scale of 0 to 100 points. ACLRSI: quantifies psychological readiness for return to sport on a scale of 0 to 100 points. |
Preoperative and postoperative (5 and 15 days; 1, 2, 4, 6, and 9 months).
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Isometric Muscle Strength
大体时间:Preoperative and postoperative (2, 4, 6, and 9 months).
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Dynamometer (SP MEDEOR/TECH), connecting it via Bluetooth to the My SP Tech application for verification to check the strength of knee flexors and extensors.
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Preoperative and postoperative (2, 4, 6, and 9 months).
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Gait through the GaitRite program
大体时间:Preoperative and postoperative (5 and 15 days; 1, 2, 4, 6, and 9 months).
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Collection of spatiotemporal parameters related to the gait pattern in the pre and post-operative period using the GaitRite device.
The GaitRite can help identify changes in knee loading, identify neuromuscular asymmetries, which may be caused by muscle weakness and identify movement patterns that may be causative of future injury or disability.
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Preoperative and postoperative (5 and 15 days; 1, 2, 4, 6, and 9 months).
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Functional Tests
大体时间:Postoperative 4, 6, and 9 months.
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Star Excursion Balance Test: Assess the dynamic stability of the lower limbs. The length of the participants' lower limbs will be measured to normalize the data obtained in each direction. Hop test: will require participants to perform a maximum distance jump on the evaluated limb. Crossover hop: will require participants to perform three consecutive jumps, alternately crossing a central line of 15 cm. |
Postoperative 4, 6, and 9 months.
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Analysis of postural control
大体时间:Preoperative and postoperative (1, 2, 4, 6, and 9 months).
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Will be tested on the BIOMEC411 force platform.
The main balance parameters based on the center of pressure (COP) will be computed: the COP ellipse area (A-COP in cm2), average COP oscillation velocity (VEL in cm/s) in the anteroposterior (A/P) and mediolateral (M/L) movement directions, COP oscillation amplitude (cm) in the anteroposterior (A/P) and mediolateral (M/L) directions, and COP oscillation frequency (Hz) in the anteroposterior (A/P) and mediolateral (M/L) directions.
All these variables are computed by the program based on the equilibrium parameters that the platform generates.
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Preoperative and postoperative (1, 2, 4, 6, and 9 months).
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Analysis of muscle activation by surface electromyography
大体时间:Preoperative and postoperative (5 and 15 days; 1, 2, 4, 6, and 9 months).
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The EMG signal will be captured with three pre-amplified active electrodes (gain: 1000) and filtered in a band-pass between 25 and 450 Hz, with a sampling frequency of 2000 Hz.
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Preoperative and postoperative (5 and 15 days; 1, 2, 4, 6, and 9 months).
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Isokinetic Assessment
大体时间:Preoperative and postoperative 6 and 9 months.
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The isokinetic assessment will be conducted using the Biodex Multi-Joint System 3 dynamometer (Biodex Medical Systems, Shirley, NY, USA), following a standardized warm-up on a cycle ergometer.
Muscle performance will be tested in concentric mode at angular velocities of 60, 180, and 300°/s, with peak torque recorded throughout the total range of motion to determine the hamstring/quadriceps muscle balance ratio (I:Q).
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Preoperative and postoperative 6 and 9 months.
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合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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