Sports Physical TherapyNMTvsCC-ACLNCT06797102
Comparative Effects of Neuromuscular Training Vs Close Chain Exercises in Athletes With Post Operative ACL Injury
A study testing Neuromuscular Exercises and Close Chain Exercises in people with Sports Physical Therapy, run by Riphah International University at 1 site in Pakistan.
Trial summary
The aim of this study is to determine the effects of close chain exercises and neuromuscular training on pain, range of motion, strength and endurance in athletes with post operative ACL injury The study will be randomized control trial with the sample size of 36. Read more about this study
- Who is it for?
- Ages 18 to 35 years, men only
- Conditions the study is for
- Sports Physical Therapy
- What is being tested?
- Neuromuscular Exercises and Close Chain Exercises
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 1 sitePakistan
- Study dates
- 1 Apr 2024to 30 Sep 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 35 years
- Men only
- No healthy volunteers
- Adult
Who may be able to join
- Athletes aged 18 to 35 years
- 6-9 months after ACL reconstruction
- Athletes who sustained unilateral ACL injury treated surgically
- Athletes returning to sports
- minimal to no knee effusion
- normal knee range of motion
- Willing to take post-operative exercise program
Who cannot join
- History of lower extremity fractures surgery or traumatic injuries
- Neuromuscular disease
- Systemic disease
- Patients who had history of prior knee surgery were excluded
Trial locations and contacts
1 site in 1 country.
About this study
The aim of this study is to determine the effects of close chain exercises and neuromuscular training on pain, range of motion, strength and endurance in athletes with post operative ACL injury The study will be randomized control trial with the sample size of 36. Subjects will be enrolled according to inclusion and exclusion criteria. Patients will be divided into two groups, each with 18 patients. Group A will receive Neuromuscular training while Group B will receive Close chain exercises. The participants will receive treatment sessions over 6-week period. The treatment session will be of 60 minutes with a warm up and cool down period of 10 minutes. Outcome measures in both groups will be assessed by International Knee Documentation Committee Evaluation Form. Score for function, Numeric Pain Rating Scale (NPRS) for pain, Goniometer to measure range of motion, single leg hop, squats, triple jump test, push ups for strength and endurance respectively.
Read the detailed description
Objective of my study is to compare the effects of Neuromuscular Training vs Close Chain Exercises on pain, range of motion, strength and endurance in athletes with post operative ACL injury
- Conditions
- Sports Physical Therapy
- Being tested
- Neuromuscular Exercises, Close Chain Exercises
- Keywords
- acl, neuromuscular exercises, close chain exercises, pain, range of motion, strength, endurance, athletes, post operative
- Medical subject headings
- Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Neuromuscular ExercisesOther
Patients in this group received a neuromuscular training protocol along with general treatment for 10 minutes. This included hot packs, lumbar stretches, and ergonomic posture correction divided over 6 weeks The exercises performed included squatting, single leg stance, and balance reach leg and arm exercises with 10 repetitions each. They also did lunge exercises with five repetitions bilaterally, step up and down exercises with 10 repetitions, single leg standing on a balance mat with 10 repetitions and a 10-second hold, single board exercises, and single leg stance with weights and eyes closed for five minutes with a 10-second hold. Additionally, they stood on a wobble board with eyes closed five times with a 10-second hold. The protocol included running on a treadmill and trampoline for five minutes per day, running figure-of-eight patterns, and agility drills at a slow speed for five minutes each.
Close Chain ExercisesOther
Patients in this group received closed chain exercises for core strengthening along with general treatment for 10 minutes, including hot packs, lumbar stretches, and ergonomic posture correction, divided over 6 weeks. The exercises included sets of squats, lunges, leg presses, wall squats, standing heel raises on a single leg, and single leg dead lifts. Each treatment session lasted 60 minutes, incorporating a warm-up and cool-down period of 10 minutes.
| Study group | Role | What they receive |
|---|---|---|
| Group A neuromuscular training | Experimental | Patients in this group received a neuromuscular training protocol along with general treatment for 10 minutes Receives: Other: Neuromuscular Exercises |
| Group B Close chain exercises | Experimental | Patients in this group will receive close chain exercises for core strengthening along with general treatment for 10 min Receives: Other: Close Chain Exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
International Knee Documentation Committee (IKDC) Subjective Knee Form
The IKDC Questionnaire is a subjective scale that provides patients with an overall function score. The questionnaire looks at 3 categories: symptoms, sports activity, and knee function. The symptoms subscale helps to evaluate things such as pain, stiffness, swelling and giving-way of the knee. The IKDC Subjective Knee Form has been validated in Dutch and Italian as well as English.
Measured: 6 months
Numeric Pain Rating Scale (NPRS)
The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme.
Measured: 6 months
Goniometer:
The range of motion is the measurement of movement around a specific joint or body part. To measure the range of motion, doctors, osteopaths, physical therapists, or other health professionals most commonly use a goniometer, which is an instrument that measures angle motion at a joint.
Measured: 6 months
Functional Strength Tests
Functionality testing following anterior cruciate ligament (ACL) reconstruction can benefit clinicians and patients in determining readiness for return to sport. The goals of testing following ACL reconstruction are to determine the strength of the muscles surrounding the knee, primarily the quadriceps and hamstrings, and evaluate knee stability and functionality through comparing the involved leg with the noninvolved leg.
- Single Leg Hop
- Test Single Leg Squat
- Triple Hop Test
- Treadmill
- Cycling
- Push up test (27)
Measured: 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Jan 2025
- Study start1 Apr 2024
- Primary completion1 Aug 2024
- Study completion30 Sep 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (38)Papers the sponsor has linked to this study.
- Other trials for Sports Physical TherapyStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 36 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Aamir Gul Memon, MS, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06797102
- Sponsor's protocol ID
- REC/RCR & AHS/23/0423
- Acronym
- NMTvsCC-ACL
- Status last verified
- Feb 2025
- First submitted
- 10 Jan 2025
- Last updated
- 21 Feb 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Joreitz R, Lynch A, Rabuck S, Lynch B, Davin S, Irrgang J. PATIENT-SPECIFIC AND SURGERY-SPECIFIC FACTORS THAT AFFECT RETURN TO SPORT AFTER ACL RECONSTRUCTION. Int J Sports Phys Ther. 2016 Apr;11(2):264-78.
PubMed 27104060Cavanaugh JT, Saldivar A, Marx RG. Postoperative rehabilitation after posterior cruciate ligament reconstruction and combined posterior cruciate ligament reconstruction-posterior lateral corner surgery. Operative Techniques in Sports Medicine. 2015;23(4):372-84.
Nelson C, Rajan L, Day J, Hinton R, Bodendorfer BM. Postoperative Rehabilitation of Anterior Cruciate Ligament Reconstruction: A Systematic Review. Sports Med Arthrosc Rev. 2021 Jun 1;29(2):63-80. doi: 10.1097/JSA.0000000000000314.
PubMed 33972483Perriman A, Leahy E, Semciw AI. The Effect of Open- Versus Closed-Kinetic-Chain Exercises on Anterior Tibial Laxity, Strength, and Function Following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2018 Jul;48(7):552-566. doi: 10.2519/jospt.2018.7656. Epub 2018 Apr 23.
PubMed 29685058Kronenberger JN. What is the effectiveness of neuromuscular training versus traditional strength training on restoration of knee function in the rehabilitation of non-operative or post-operative anterior cruciate ligament patients? A Systematic Review: Walsh University; 2018.
Huang DD, Chen LH, Yu Z, Chen QJ, Lai JN, Li HH, Liu G. Effect of suspension training on neuromuscular function, postural control, and knee kinematics in anterior cruciate ligament reconstruction patients. World J Clin Cases. 2021 Apr 6;9(10):2247-2258. doi: 10.12998/wjcc.v9.i10.2247.
PubMed 33869600Wang K, Cheng L, Wang B, He B. Effect of isokinetic muscle strength training on knee muscle strength, proprioception, and balance ability in athletes with anterior cruciate ligament reconstruction: a randomised control trial. Front Physiol. 2023 Sep 19;14:1237497. doi: 10.3389/fphys.2023.1237497. eCollection 2023.
PubMed 37795267Moubarak EES, Yousef EF, Dawood RS, El Shamy ASAH, Abdelrahem MEA. Effect of Adding Preoperative Exercise to Postoperative Rehabilitation Program of Progressive Exercises on Anterior Cruciate Ligament Reconstruction. Egyptian Journal of Physical Therapy. 2023;15(1):18-26.
Walters SL. EFFECTS OF ACL RECONSTRUCTION ON MUSCULAR STRENGTH, ENDURANCE AND MITOCHONDRIAL CAPACITY: University of Georgia.
Sigit M, Doewes M, Liskustyawati H. The effect of open kinetic chain exercise and close kinetic chain exercise on strength quadriceps femoris muscle post anterior cruciate ligament surgery in terms of age. Advances in Health and Exercise. 2024;4(1):10-6.
Pamboris GM, Pavlou K, Paraskevopoulos E, Mohagheghi AA. Effect of open vs. closed kinetic chain exercises in ACL rehabilitation on knee joint pain, laxity, extensor muscles strength, and function: a systematic review with meta-analysis. Front Sports Act Living. 2024 Jun 3;6:1416690. doi: 10.3389/fspor.2024.1416690. eCollection 2024.
PubMed 38887689Qiu M. Comparison of Modalities and Strength and Motor Control Training Methods after Anterior Cruciate Ligament Reconstruction Surgery and Recommendations. MedScien. 2024;1(7).
Gandhi KM, Ratnani G, Deodhe NP, Shende K. Enhancing Muscle Strength Post Anterior Cruciate Ligament Reconstruction: A Case Report Assessing the Effectiveness of Russian Current. Cureus. 2024 Feb 21;16(2):e54593. doi: 10.7759/cureus.54593. eCollection 2024 Feb.
PubMed 38524050Buckthorpe M. Optimising the Late-Stage Rehabilitation and Return-to-Sport Training and Testing Process After ACL Reconstruction. Sports Med. 2019 Jul;49(7):1043-1058. doi: 10.1007/s40279-019-01102-z.
PubMed 31004279Crank C, MOMT TMP. Rehabilitation Following Anterior Cruciate Ligament and Posterolateral Corner Reconstruction with Medial and Lateral Meniscus Repairs in A High School Athlete: A Retrospective Case Report. Orthopaedic Physical Therapy Practice. 2020;32(2):76-81.
Study at a glance
From the registry record, last updated by the sponsor on 21 Feb 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effects of Neuromuscular Training Vs Close Chain Exercises in Athletes With Post Operative ACL Injury
- ClinicalTrials.gov ID
- NCT06797102
- Acronym / sponsor ID
- NMTvsCC-ACL / REC/RCR & AHS/23/0423
- Conditions
- Sports Physical Therapy
- Keywords
- acl, neuromuscular exercises, close chain exercises, pain, range of motion, strength, endurance, athletes
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 36 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 1 Apr 2024 (actual)
- Primary completion
- 1 Aug 2024 (actual)
- Study completion
- 30 Sep 2024 (actual)
- First posted
- 28 Jan 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this study is to determine the effects of close chain exercises and neuromuscular training on pain, range of motion, strength and endurance in athletes with post operative ACL injury The study will be randomized control trial with the sample size of 36. Subjects will be enrolled according to inclusion and exclusion criteria. Patients will be divided into two groups, each with 18 patients. Group A will receive Neuromuscular training while Group B will receive Close chain exercises. The participants will receive treatment sessions over 6-week period. The treatment session will be of 60 minutes with a warm up and cool down period of 10 minutes. Outcome measures in both groups will be assessed by International Knee Documentation Committee Evaluation Form. Score for function, Numeric Pain Rating Scale (NPRS) for pain, Goniometer to measure range of motion, single leg hop, squats, triple jump test, push ups for strength and endurance respectively.
Detailed description
Objective of my study is to compare the effects of Neuromuscular Training vs Close Chain Exercises on pain, range of motion, strength and endurance in athletes with post operative ACL injury
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group A neuromuscular training | Experimental | Other: Neuromuscular ExercisesPatients in this group received a neuromuscular training protocol along with general treatment for 10 minutes |
| Group B Close chain exercises | Experimental | Other: Close Chain ExercisesPatients in this group will receive close chain exercises for core strengthening along with general treatment for 10 min |
Who may qualify
- Ages
- 18 to 35 years
- Sex
- Male only
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (7 listed)
- Athletes aged 18 to 35 years
- 6-9 months after ACL reconstruction
- Athletes who sustained unilateral ACL injury treated surgically
- Athletes returning to sports
- minimal to no knee effusion
Key exclusion criteria (4 listed)
- History of lower extremity fractures surgery or traumatic injuries
- Neuromuscular disease
- Systemic disease
- Patients who had history of prior knee surgery were excluded
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Neuromuscular ExercisesPatients in this group received a neuromuscular training protocol along with general treatment for 10 minutes. This included hot packs, lumbar stretches, and ergonomic posture correction divided over 6 weeks The exercises performed included squatting, single leg stance, and balance reach leg and arm exercises with 10 repetitions each. They also did lunge exercises with five repetitions bilaterally, step up and down exercises with 10 repetitions, single leg standing on a balance mat with 10 repetitions and a 10-second hold, single board exercises, and single leg stance with weights and eyes closed for five minutes with a 10-second hold. Additionally, they stood on a wobble board with eyes closed five times with a 10-second hold. The protocol included running on a treadmill and trampoline for five minutes per day, running figure-of-eight patterns, and agility drills at a slow speed for five minutes each. | Other | Group A neuromuscular training |
| Close Chain ExercisesPatients in this group received closed chain exercises for core strengthening along with general treatment for 10 minutes, including hot packs, lumbar stretches, and ergonomic posture correction, divided over 6 weeks. The exercises included sets of squats, lunges, leg presses, wall squats, standing heel raises on a single leg, and single leg dead lifts. Each treatment session lasted 60 minutes, incorporating a warm-up and cool-down period of 10 minutes. | Other | Group B Close chain exercises |
Primary outcome
International Knee Documentation Committee (IKDC) Subjective Knee Form
Time frame: 6 months
The IKDC Questionnaire is a subjective scale that provides patients with an overall function score. The questionnaire looks at 3 categories: symptoms, sports activity, and knee function. The symptoms subscale helps to evaluate things such as pain, stiffness, swelling and giving-way of the knee. The IKDC Subjective Knee Form has been validated in Dutch and Italian as well as English.
Numeric Pain Rating Scale (NPRS)
Time frame: 6 months
The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme.
Goniometer:
Time frame: 6 months
The range of motion is the measurement of movement around a specific joint or body part. To measure the range of motion, doctors, osteopaths, physical therapists, or other health professionals most commonly use a goniometer, which is an instrument that measures angle motion at a joint.
Functional Strength Tests
Time frame: 6 months
Functionality testing following anterior cruciate ligament (ACL) reconstruction can benefit clinicians and patients in determining readiness for return to sport. The goals of testing following ACL reconstruction are to determine the strength of the muscles surrounding the knee, primarily the quadriceps and hamstrings, and evaluate knee stability and functionality through comparing the involved leg with the noninvolved leg. * Single Leg Hop * Test Single Leg Squat * Triple Hop Test * Treadmill * Cycling * Push up test (27)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Feb 2025.
- Background: PubMed 27104060Joreitz R, Lynch A, Rabuck S, Lynch B, Davin S, Irrgang J. PATIENT-SPECIFIC AND SURGERY-SPECIFIC FACTORS THAT AFFECT RETURN TO SPORT AFTER ACL RECONSTRUCTION. Int J Sports Phys Ther. 2016 Apr;11(2):264-78.
- BackgroundCavanaugh JT, Saldivar A, Marx RG. Postoperative rehabilitation after posterior cruciate ligament reconstruction and combined posterior cruciate ligament reconstruction-posterior lateral corner surgery. Operative Techniques in Sports Medicine. 2015;23(4):372-84.
- Background: PubMed 33972483Nelson C, Rajan L, Day J, Hinton R, Bodendorfer BM. Postoperative Rehabilitation of Anterior Cruciate Ligament Reconstruction: A Systematic Review. Sports Med Arthrosc Rev. 2021 Jun 1;29(2):63-80. doi: 10.1097/JSA.0000000000000314.
- Background: PubMed 29685058Perriman A, Leahy E, Semciw AI. The Effect of Open- Versus Closed-Kinetic-Chain Exercises on Anterior Tibial Laxity, Strength, and Function Following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2018 Jul;48(7):552-566. doi: 10.2519/jospt.2018.7656. Epub 2018 Apr 23.
- BackgroundKronenberger JN. What is the effectiveness of neuromuscular training versus traditional strength training on restoration of knee function in the rehabilitation of non-operative or post-operative anterior cruciate ligament patients? A Systematic Review: Walsh University; 2018.
- Background: PubMed 33869600Huang DD, Chen LH, Yu Z, Chen QJ, Lai JN, Li HH, Liu G. Effect of suspension training on neuromuscular function, postural control, and knee kinematics in anterior cruciate ligament reconstruction patients. World J Clin Cases. 2021 Apr 6;9(10):2247-2258. doi: 10.12998/wjcc.v9.i10.2247.
- Background: PubMed 37795267Wang K, Cheng L, Wang B, He B. Effect of isokinetic muscle strength training on knee muscle strength, proprioception, and balance ability in athletes with anterior cruciate ligament reconstruction: a randomised control trial. Front Physiol. 2023 Sep 19;14:1237497. doi: 10.3389/fphys.2023.1237497. eCollection 2023.
- BackgroundMoubarak EES, Yousef EF, Dawood RS, El Shamy ASAH, Abdelrahem MEA. Effect of Adding Preoperative Exercise to Postoperative Rehabilitation Program of Progressive Exercises on Anterior Cruciate Ligament Reconstruction. Egyptian Journal of Physical Therapy. 2023;15(1):18-26.
- BackgroundWalters SL. EFFECTS OF ACL RECONSTRUCTION ON MUSCULAR STRENGTH, ENDURANCE AND MITOCHONDRIAL CAPACITY: University of Georgia.
- BackgroundSigit M, Doewes M, Liskustyawati H. The effect of open kinetic chain exercise and close kinetic chain exercise on strength quadriceps femoris muscle post anterior cruciate ligament surgery in terms of age. Advances in Health and Exercise. 2024;4(1):10-6.
- Background: PubMed 38887689Pamboris GM, Pavlou K, Paraskevopoulos E, Mohagheghi AA. Effect of open vs. closed kinetic chain exercises in ACL rehabilitation on knee joint pain, laxity, extensor muscles strength, and function: a systematic review with meta-analysis. Front Sports Act Living. 2024 Jun 3;6:1416690. doi: 10.3389/fspor.2024.1416690. eCollection 2024.
- BackgroundQiu M. Comparison of Modalities and Strength and Motor Control Training Methods after Anterior Cruciate Ligament Reconstruction Surgery and Recommendations. MedScien. 2024;1(7).
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Aamir Gul Memon, MS principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Neuromuscular Exercises and Close Chain Exercises in people with Sports Physical Therapy, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 21 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
International Knee Documentation Committee (IKDC) Subjective Knee Form (time frame: 6 months). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06797102, which also lists 38 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Feb 2025.