Anterior Cruciate Ligament InjuriesNCT07642752
Perturbation Training vs Functional Activities on Pain, ROM, Balance, and Function Post-ACL
A study testing Perturbation Training Group and Task-Oriented Functional Activities Group in people with Anterior Cruciate Ligament Injuries, run by Riphah International University at 1 site in Pakistan.
Trial summary
Anterior cruciate ligament (ACL) injuries are among the most common and functionally disabling knee injuries, particularly in physically active individuals. Despite advancements in surgical techniques, optimal post-operative rehabilitation remains critical for successful functional recovery, minimizing re-injury risk… Read more about this study
- Who is it for?
- Ages 18 to 45 years
- Conditions the study is for
- Anterior Cruciate Ligament Injuries
- What is being tested?
- Perturbation Training Group and Task-Oriented Functional Activities Group
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 54 participants
- Where
- 1 sitePakistan
- Study dates
- 1 Aug 2026to 26 Nov 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age range: 18-45 years
- Male participants only
- History of Anterior Cruciate Ligament Reconstruction (ACLR) of 3 to 12 months
- No prior ACL surgery on the affected knee
- ACL reconstruction with autograft of hamstrings tendon
- Knee flexion range of motion less than 120°
- Extension lag less than or equal to 10°
- Pain during functional activities
Who cannot join
- Any type of fracture
- Concurrent ligamentous injury or repairable meniscus
- Osteochondral defect
- Any systemic and/or neurological illness
- Rheumatoid arthritis
- Osteomyelitis or any neurological disorders
- Spinal disorders
- Inflammatory conditions such as ankylosing spondylitis
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site, 1 recruiting
- Recruiting
Ghurki Hospital Lahore
Lahore, Punjab Province, 54000
Muhammad Musab, MSOMPT
About this study
Official title: Effects of Perturbation Training Versus Task-oriented Functional Activities on Pain, Range of Motion, Balance and Function in Post-anterior Cruciate Ligament Reconstruction
Anterior cruciate ligament (ACL) injuries are among the most common and functionally disabling knee injuries, particularly in physically active individuals. Despite advancements in surgical techniques, optimal post-operative rehabilitation remains critical for successful functional recovery, minimizing re-injury risk, and restoring pre-injury performance levels
Read the detailed description
This randomized controlled trial aims to compare the effectiveness of perturbation training and task-oriented functional activities in patients following ACL reconstruction surgery. Perturbation training is a neuromuscular re-education strategy that involves controlled, unexpected movements to enhance joint stability and proprioceptive feedback. In contrast, task-oriented functional training focuses on restoring movement through activities that mimic daily or sports-related functional tasks.
This study will be a Randomized Control Trail and will be conducted in physiogic physiotherapy clinic and Ghurki Trust and Teaching Hospital. Non-Probability Convenient Sampling will be used to collect data. Total of 54 Participants of the age 18-45 years with post 12 weeks to 1 year ACL reconstruction will be included in the study. An informed consent will be taken prior study from all the subjects. Outcomes measure will be included Numerical Pain Rating Scale (NPRS) for pain, Universal Goniometer (UG) for Range of Motion, Y balance test for Knee Stability, International Knee Documentation Committee scores, (IKDC) for Knee function
- Conditions
- Anterior Cruciate Ligament Injuries
- Being tested
- Perturbation Training Group, Task-Oriented Functional Activities Group, Control Group (Standard Rehabilitation Protocol)
- Keywords
- Knee, Disability, Range of motion, Balance
- Medical subject headings
- Anterior Cruciate Ligament Injuries
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Perturbation Training GroupOther
Two-leg rocker board
One-leg rocker board
Roller board / stable (weight scale) surface
Roller board / BOSU ball
TheraBand feedback / perturbation training
Simple sport-specific technique on rocker board
Moderate demand sport-specific technique on rocker board
Advanced sport-specific technique on rocker board
This sequence reflects a progressive challenge to knee stability, beginning with bilateral balance tasks, advancing to unilateral control, and culminating in sport-specific perturbation drills.
Task-Oriented Functional Activities GroupOther
Functional Recovery Tasks After ACLR Normal walking gait
Bilateral squat
Unilateral foundation exercises - Single leg squat
Bilateral landing
Running - Run on treadmill
Bilateral plyometric - Bilateral drop jump
Unilateral landing / deceleration - Single leg deceleration
Unilateral plyometric - Single leg drop jump
Change of direction ability / coordination - 90º cut maneuver
Sport-specific movements - Movement control under sport-specific change of direction
This sequence reflects a progressive load and skill development pathway, starting from basic gait and bilateral tasks, moving toward unilateral control, plyometrics, and finally sport-specific agility.
Control Group (Standard Rehabilitation Protocol)Other
Heating pad (5-10 minutes)
TENS (short bursts, 10-15 minutes, frequency 100 Hz)
Stationary cycling
Gentle range of motion exercises
Passive and active-assisted ROM
Isometric quadriceps contractions
Straight leg raises
Quadriceps setting with a towel under the knee
Closed-chain exercises (e.g., wall sits, mini-squats)
Hamstring curls
Double-leg stance on foam pad
This set emphasizes pain relief, mobility restoration, and foundational strength before progressing to advanced neuromuscular or sport-specific tasks.
| Study group | Role | What they receive |
|---|---|---|
| Perturbation Training Group | Experimental | Participants undergo perturbation-based exercises designed to improve knee stability. It includes balance boards, BOSU balls, and manual perturbation techniques. Receives: Other: Perturbation Training Group; Other: Control Group (Standard Rehabilitation Protocol) |
| Task-Oriented Functional Activities Group | Active comparator | Participants engage in functional movement exercises that mimic daily activities. It includes step training, agility drills, and controlled landing mechanics. Receives: Other: Task-Oriented Functional Activities Group; Other: Control Group (Standard Rehabilitation Protocol) |
| Control Group (Standard Rehabilitation Protocol) | Sham comparator | Participants follow traditional ACL rehabilitation without perturbation or task-oriented interventions. It includes strength training, range-of-motion exercises, and proprioceptive drills. Receives: Other: Control Group (Standard Rehabilitation Protocol) |
What is being measured
The primary outcome is the main question the study is designed to answer.
NPRS for Pain
Numeric Pain Rating Scale (NPRS) it is a unidimensional scale to measure pain intensity, particularly in adults. It is a 10-rating scale and an 11-point numeric scale in the form of a horizontal bar or line
Measured: 6 weeks
Universal Goniometer for Range of motion
A universal goniometer (UG) will be used to determine the range of motion of the target joint.
Measured: 6 weeks
The Y-Balance test (YBT)
The Y-Balance test (YBT) is used to assess dynamic balance impairments associated with lower extremity injuries such as ACL injury, patellofemoral pain syndrome, and ankle instability.
Measured: 6 weeks
International Knee Documentation Committee scores (IKDC)
Patients' knee function is evaluated using the International Knee Documentation Committee's (IKDC) Subjective Knee Form. Through 18 questions, it assesses symptoms, athletic activity, and general knee function; higher scores indicate better knee function.
Measured: 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Jun 2026
- Study start1 Aug 2026
- Primary completion15 Nov 2026 (estimated)
- Study completion26 Nov 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Anterior Cruciate Ligament InjuriesStudies 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
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 54 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Hira Shaukat, Mphill, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07642752
- Sponsor's protocol ID
- REC/RCR&AHS/25/0118
- Status last verified
- Sep 2026
- First submitted
- 8 Jun 2026
- Last updated
- 24 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Carter HM, Littlewood C, Webster KE, Smith BE. The effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction: a systematic review. BMC Musculoskelet Disord. 2020 Oct 3;21(1):647. doi: 10.1186/s12891-020-03676-6.
PubMed 33010802Hetsroni I, Mann G, Arami E, van Stee M, Marom N, Ohana N. Young men undergoing anterior cruciate ligament reconstruction with patellar tendon autograft and anteromedial drilling outperform at 5- to 10-year follow-up in terms of graft stability and activity levels compared to those undergoing reconstruction with hamstring autograft and transtibial drilling. J ISAKOS. 2024 Aug;9(4):540-548. doi: 10.1016/j.jisako.2024.04.001. Epub 2024 Apr 3.
PubMed 38580054Nawasreh Z, Logerstedt D, Marmon A, Snyder-Mackler L. Clinical and Biomechanical Efficacies of Mechanical Perturbation Training After Anterior Cruciate Ligament Rupture. J Sport Rehabil. 2019 Nov 1;28(8):877-886. doi: 10.1123/jsr.2017-0363.
PubMed 30300071Brown SR, Washabaugh EP, Dutt-Mazumder A, Wojtys EM, Palmieri-Smith RM, Krishnan C. Functional Resistance Training to Improve Knee Strength and Function After Acute Anterior Cruciate Ligament Reconstruction: A Case Study. Sports Health. 2021 Mar;13(2):136-144. doi: 10.1177/1941738120955184. Epub 2020 Dec 18.
PubMed 33337984
Study at a glance
From the registry record, last updated by the sponsor on 24 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Perturbation Training Versus Task-oriented Functional Activities on Pain, Range of Motion, Balance and Function in Post-anterior Cruciate Ligament Reconstruction
- ClinicalTrials.gov ID
- NCT07642752
- Acronym / sponsor ID
- REC/RCR&AHS/25/0118
- Conditions
- Anterior Cruciate Ligament Injuries
- Keywords
- Knee, Disability, Range of motion, Balance
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 54 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 1 Aug 2026 (actual)
- Primary completion
- 15 Nov 2026 (estimated)
- Study completion
- 26 Nov 2026 (estimated)
- First posted
- 11 Jun 2026 (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.
Anterior cruciate ligament (ACL) injuries are among the most common and functionally disabling knee injuries, particularly in physically active individuals. Despite advancements in surgical techniques, optimal post-operative rehabilitation remains critical for successful functional recovery, minimizing re-injury risk, and restoring pre-injury performance levels
Detailed description
This randomized controlled trial aims to compare the effectiveness of perturbation training and task-oriented functional activities in patients following ACL reconstruction surgery. Perturbation training is a neuromuscular re-education strategy that involves controlled, unexpected movements to enhance joint stability and proprioceptive feedback. In contrast, task-oriented functional training focuses on restoring movement through activities that mimic daily or sports-related functional tasks.
This study will be a Randomized Control Trail and will be conducted in physiogic physiotherapy clinic and Ghurki Trust and Teaching Hospital. Non-Probability Convenient Sampling will be used to collect data. Total of 54 Participants of the age 18-45 years with post 12 weeks to 1 year ACL reconstruction will be included in the study. An informed consent will be taken prior study from all the subjects. Outcomes measure will be included Numerical Pain Rating Scale (NPRS) for pain, Universal Goniometer (UG) for Range of Motion, Y balance test for Knee Stability, International Knee Documentation Committee scores, (IKDC) for Knee function
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Perturbation Training Group | Experimental | Other: Perturbation Training Group, Other: Control Group (Standard Rehabilitation Protocol)Participants undergo perturbation-based exercises designed to improve knee stability. It includes balance boards, BOSU balls, and manual perturbation techniques. |
| Task-Oriented Functional Activities Group | Active comparator | Other: Task-Oriented Functional Activities Group, Other: Control Group (Standard Rehabilitation Protocol)Participants engage in functional movement exercises that mimic daily activities. It includes step training, agility drills, and controlled landing mechanics. |
| Control Group (Standard Rehabilitation Protocol) | Sham comparator | Other: Control Group (Standard Rehabilitation Protocol)Participants follow traditional ACL rehabilitation without perturbation or task-oriented interventions. It includes strength training, range-of-motion exercises, and proprioceptive drills. |
Who may qualify
- Ages
- 18 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (8 listed)
- Age range: 18-45 years
- Male participants only
- History of Anterior Cruciate Ligament Reconstruction (ACLR) of 3 to 12 months
- No prior ACL surgery on the affected knee
- ACL reconstruction with autograft of hamstrings tendon
Key exclusion criteria (8 listed)
- Any type of fracture
- Concurrent ligamentous injury or repairable meniscus
- Osteochondral defect
- Any systemic and/or neurological illness
- Rheumatoid arthritis
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 |
|---|---|---|
| Perturbation Training GroupTwo-leg rocker board One-leg rocker board Roller board / stable (weight scale) surface Roller board / BOSU ball TheraBand feedback / perturbation training Simple sport-specific technique on rocker board Moderate demand sport-specific technique on rocker board Advanced sport-specific technique on rocker board This sequence reflects a progressive challenge to knee stability, beginning with bilateral balance tasks, advancing to unilateral control, and culminating in sport-specific perturbation drills. | Other | Perturbation Training Group |
| Task-Oriented Functional Activities GroupFunctional Recovery Tasks After ACLR Normal walking gait Bilateral squat Unilateral foundation exercises - Single leg squat Bilateral landing Running - Run on treadmill Bilateral plyometric - Bilateral drop jump Unilateral landing / deceleration - Single leg deceleration Unilateral plyometric - Single leg drop jump Change of direction ability / coordination - 90º cut maneuver Sport-specific movements - Movement control under sport-specific change of direction This sequence reflects a progressive load and skill development pathway, starting from basic gait and bilateral tasks, moving toward unilateral control, plyometrics, and finally sport-specific agility. | Other | Task-Oriented Functional Activities Group |
| Control Group (Standard Rehabilitation Protocol)Heating pad (5-10 minutes) TENS (short bursts, 10-15 minutes, frequency 100 Hz) Stationary cycling Gentle range of motion exercises Passive and active-assisted ROM Isometric quadriceps contractions Straight leg raises Quadriceps setting with a towel under the knee Closed-chain exercises (e.g., wall sits, mini-squats) Hamstring curls Double-leg stance on foam pad This set emphasizes pain relief, mobility restoration, and foundational strength before progressing to advanced neuromuscular or sport-specific tasks. | Other | Control Group (Standard Rehabilitation Protocol), Perturbation Training Group, Task-Oriented Functional Activities Group |
Primary outcome
NPRS for Pain
Time frame: 6 weeks
Numeric Pain Rating Scale (NPRS) it is a unidimensional scale to measure pain intensity, particularly in adults. It is a 10-rating scale and an 11-point numeric scale in the form of a horizontal bar or line
Universal Goniometer for Range of motion
Time frame: 6 weeks
A universal goniometer (UG) will be used to determine the range of motion of the target joint.
The Y-Balance test (YBT)
Time frame: 6 weeks
The Y-Balance test (YBT) is used to assess dynamic balance impairments associated with lower extremity injuries such as ACL injury, patellofemoral pain syndrome, and ankle instability.
International Knee Documentation Committee scores (IKDC)
Time frame: 6 weeks
Patients' knee function is evaluated using the International Knee Documentation Committee's (IKDC) Subjective Knee Form. Through 18 questions, it assesses symptoms, athletic activity, and general knee function; higher scores indicate better knee function.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Sep 2026.
- Background: PubMed 33010802Carter HM, Littlewood C, Webster KE, Smith BE. The effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction: a systematic review. BMC Musculoskelet Disord. 2020 Oct 3;21(1):647. doi: 10.1186/s12891-020-03676-6.
- Background: PubMed 38580054Hetsroni I, Mann G, Arami E, van Stee M, Marom N, Ohana N. Young men undergoing anterior cruciate ligament reconstruction with patellar tendon autograft and anteromedial drilling outperform at 5- to 10-year follow-up in terms of graft stability and activity levels compared to those undergoing reconstruction with hamstring autograft and transtibial drilling. J ISAKOS. 2024 Aug;9(4):540-548. doi: 10.1016/j.jisako.2024.04.001. Epub 2024 Apr 3.
- Background: PubMed 30300071Nawasreh Z, Logerstedt D, Marmon A, Snyder-Mackler L. Clinical and Biomechanical Efficacies of Mechanical Perturbation Training After Anterior Cruciate Ligament Rupture. J Sport Rehabil. 2019 Nov 1;28(8):877-886. doi: 10.1123/jsr.2017-0363.
- Background: PubMed 33337984Brown SR, Washabaugh EP, Dutt-Mazumder A, Wojtys EM, Palmieri-Smith RM, Krishnan C. Functional Resistance Training to Improve Knee Strength and Function After Acute Anterior Cruciate Ligament Reconstruction: A Case Study. Sports Health. 2021 Mar;13(2):136-144. doi: 10.1177/1941738120955184. Epub 2020 Dec 18.
- 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.
Hira Shaukat, Mphill 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 Perturbation Training Group and Task-Oriented Functional Activities Group in people with Anterior Cruciate Ligament Injuries, 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 8 inclusion and 8 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: looking for participants now, as of the sponsor's last update on 24 Sep 2026. 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. Some participants in this study may receive a placebo. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Imran Amjad, PhD (03324390125, Imran.amjad@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
NPRS for Pain (time frame: 6 weeks). 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 NCT07642752, which also lists 4 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 24 Sep 2026.