Neuroplasticity Associated With Anterior Cruciate Ligament Reconstruction.
Dustin R Grooms, Stephen J Page, Deborah S Nichols-Larsen...
https://pubmed.ncbi.nlm.nih.gov/27817301Actively Recruiting
Phase Not Applicable
Age: 15Years - 35Years
All Genders
ID07243535
Comparison of Walking Synchronized to Fractal versus Isochronous Visual Cues on Gait and Brain Measures in Athletes After ACL Reconstruction: A Randomized Crossover Trial
Led by Egas Moniz - Cooperativa de Ensino Superior, CRL · Updated on 2025-11-24
36
Participants Needed
1
Research Sites
N/A
Total Duration
On this page
AI-Summary
What this Trial Is About
Anterior cruciate ligament (ACL) injuries are common and limit knee function in athletes, especially those involved in sports with pivoting movements. Despite surgical reconstruction and rehabilitation, many athletes experience ongoing motor control problems and variable walking patterns, increasing the risk of re-injury and joint damage. These issues stem from biomechanical problems and disrupted brain signals, yet traditional rehabilitation often overlooks this neural aspect. This trial explores new ways to improve walking patterns and brain function after ACL reconstruction using specialized visual cues. The study compares two types of visual cues during treadmill walking: fractal cueing, which mimics natural walking variability, and isochronous cueing, which uses fixed timing cues. Each participant will complete two separate 12-minute walking sessions, one with fractal and one with isochronous cues, in random order with a one-week break between. Visual cues appear as a moving bar on a screen, and participants will synchronize their reconstructed leg's heel strikes to these cues. Gait data and brain excitability will be measured using specialized equipment during and after the sessions. Participants will undergo assessments including gait variability analysis from treadmill sensors and brain function testing using transcranial magnetic stimulation while performing muscle contractions. Knee strength will also be measured. The study will analyze changes before and after each session to determine how the cues affect walking patterns and brain activity. Participants will receive personalized reports and follow-up assessments over 12 months. The trial aims to find if fractal cueing can enhance neuroplasticity and restore healthier gait variability in athletes recovering from ACL reconstruction.
CONDITIONS
Brief Title
Fractal vs Isochronous Cueing in Athletes After ACL Reconstruction
Who Can Participate
Age: 15Years - 35Years
All Genders
Eligibility Criteria
You may qualify if you...
- Underwent unilateral ACL reconstruction less than 2 years ago
- Have medical clearance for full weight-bearing on the injured leg for at least 2 weeks
- Able to walk independently without pain
- Are sports athletes who regularly train, compete, or are registered with a sports federation or association
- Able to understand and perform the study tasks
You will not qualify if you...
- Previous surgery on either knee
- More than 3 months between ACL injury and surgery
- More than 2 weeks between surgery and start of physical therapy
- Any other musculoskeletal injury in the lower limb within the past 6 months
- Any other musculoskeletal surgery within the past 18 months
- History of nervous system, cardiovascular, pulmonary, skin, or endocrine disorders
- Vestibular or sensory system problems or visual impairments that limit ability to see the metronome cues
- Use of medications affecting walking or balance
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
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2
3
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Intervention Sessions
Duration - Approximately 3 weeks including washout
Participants complete two treadmill walking sessions synchronized to visual cues: one with fractal cueing and one with isochronous cueing, with a 1-week washout period between sessions.
2 visits (in-person), each including treadmill walking synchronized to visual cues lasting about 12 minutes plus pre- and post- uncued walking trials and assessments
Post-Intervention Assessments
Duration - Concurrent with intervention sessions
Participants undergo assessments of gait variability and corticospinal excitability immediately before and after each intervention session.
Assessments conducted during the 2 intervention visits
Trial Site Locations
Total: 1 location
1
Egas Moniz School of Health & Science
Almada, Monte de Caparica, Portugal, 2829-511
Actively Recruiting
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Research Team
I
Inês D Ribeiro, MSC Student
C
Catarina S Pino, MSC Student
How is the study designed?
Study Type
INTERVENTIONAL
Masking
DOUBLE
Allocation
RANDOMIZED
Model
CROSSOVER
Primary Purpose
BASIC_SCIENCE
Number of Arms
2
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Published Research Related To This Trial
Visuomotor therapy modulates corticospinal excitability in patients following anterior cruciate ligament reconstruction: A randomized crossover trial.
Stephan G Bodkin, Amelia S Bruce, Jay Hertel...
https://pubmed.ncbi.nlm.nih.gov/33234323Anterior cruciate ligament reconstruction results in alterations in gait variability.
Constantina O Moraiti, Nicholas Stergiou, Haris S Vasiliadis...
https://pubmed.ncbi.nlm.nih.gov/20591671Synchronization dynamics modulates stride-to-stride fluctuations when walking to an invariant but not to a fractal-like stimulus.
João R Vaz, Boman R Groff, Douglas A Rowen...
https://pubmed.ncbi.nlm.nih.gov/30922850Gait complexity is acutely restored in older adults when walking to a fractal-like visual stimulus.
João R Vaz, Brian A Knarr, Nick Stergiou
https://pubmed.ncbi.nlm.nih.gov/33069099