External Focus of Attention Posttraumatic Osteoarthritis

Overview

Knee injuries, especially those to the ACL, are common among physically active people. These injuries are frequently treated with surgical reconstruction (ACL reconstruction; ACLR). While ACLR restores stability it does not protect against future injury, long-term pain, disability, and arthritis associated with these injuries. Our study is going to examine new ways to provide feedback about the way people move to determine if these are better at modifying movement patterns that are known risk factors of posttraumatic osteoarthritis development than current standard treatments. If you participate, you will be asked to undergo a movement analysis in a research laboratory while you perform tasks such as walking and hopping. After this initial assessment, you will be randomly allocated to one of 2 treatment groups. Each treatment group will perform 4 weeks (3x/week) of exercises to change the way people walk. Participants will then report for follow-up movement analysis testing 1- and 4-weeks after completing the intervention.

Full Title of Study: “External Focus of Attention Feedback to Mitigate Posttraumatic Osteoarthritis Risk After ACL Reconstruction”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Double (Investigator, Outcomes Assessor)
  • Study Primary Completion Date: May 31, 2024

Interventions

  • Other: Internal focus of attention feedback
    • Participants will complete 12 sessions over a 3-week period of functional movement retraining while receiving mirror feedback. Participants will be instructed to perform each functional task in a manner that keeps their knee in line with their toes.
  • Other: External focus of attention feedback
    • Participants will complete 12 sessions over a 3-week period of functional movement retraining while receiving visual feedback via laser. Participants will be instructed to perform each functional task in a manner that does causes the laser to move up and down but not side-to-side.

Arms, Groups and Cohorts

  • Active Comparator: Internal focus of attention feedback
    • Participants will complete 12 sessions over 3 weeks receiving visual feedback in a mirror of their movement patterns.
  • Experimental: External focus of attention feedback
    • Participants will complete 12 sessions over 3 weeks receiving visual feedback of their movement patterns from a laser.

Clinical Trial Outcome Measures

Primary Measures

  • Changes from baseline in lower extremity biomechanics during walking
    • Time Frame: 1-week post-intervention, 4-weeks post-intervention
    • Knee and hip angles and loads measured via 3D biomechanics
  • Knee cartilage health
    • Time Frame: 1-week post-intervention, 4-weeks post-intervention
    • Knee cartilage thickness measured using diagnostic ultrasound imaging

Participating in This Clinical Trial

Inclusion Criteria

  • history of primary, unilateral ACL reconstruction 6-24 months prior to enrollment – cleared to return to full activity by treating orthopedic surgeon Exclusion Criteria:

  • Body mass index >35 kg/m2 – History of musculoskeletal injury sustained 3 months prior to enrollment – Current participation in formal post-operative rehabilitation

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 35 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of North Carolina, Charlotte
  • Collaborator
    • Arthritis Foundation
  • Provider of Information About this Clinical Study
    • Principal Investigator: Abbey Thomas, PhD, Assistant Professor – University of North Carolina, Charlotte

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