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Trial registered on ANZCTR
Registration number
ACTRN12617000406303
Ethics application status
Approved
Date submitted
7/11/2016
Date registered
20/03/2017
Date last updated
20/03/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Knee strengthening exercises after ACL reconstruction
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Scientific title
Comparison of two knee strengthening protocols after ACL reconstruction: a cluster randomized controlled trial
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Secondary ID [1]
290483
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
ACL reconstruction
300861
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Condition category
Condition code
Musculoskeletal
300683
300683
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Rehabilitation protocol with knee strengthening exercises performed with the hip in neutral position (see attached protocol on the ANZCTR website). The intervention will be delivered on an individual basis, face to face at a physical therapy clinic by licensed physical therapists. The treatment will last for 6 months, starting 2 weeks after surgery with sessions for 3 times per week for the first 2 postoperative months, reduced to twice per week for the next 2 months and reduced to once a week for the final two months. The attendance to the prescribed sessions will be documented by the clinic. Each session will last 30-60 minutes depending on the rehabilitation phase. As described in detail in the protocol, the treatment involves manual therapy techniques, range of motion exercises, strengthening exercises, proprioceptive exercises, and sports-specific activities,
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Intervention code [1]
296341
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Rehabilitation
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Comparator / control treatment
Rehabilitation protocol with knee strengthening exercises performed in the traditional seated position with the hip at 90 degrees of flexion (see attached protocol on the ANZCTR website). The intervention will be delivered on an individual basis, face to face at a physical therapy clinic by licensed physical therapists. The treatment will last for 6 months, starting 2 weeks after surgery with sessions for 3 times per week for the first 2 postoperative months, reduced to twice per week for the next 2 months and reduced to once a week for the final two months. The attendance to the prescribed sessions will be documented by the clinic. Each session will last 30-60 minutes depending on the rehabilitation phase. As described in detail in the protocol, the treatment involves manual therapy techniques, range of motion exercises, strengthening exercises, proprioceptive exercises, and sports-specific activities,
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Control group
Active
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Outcomes
Primary outcome [1]
300103
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Isokinetic flexion peak torque by a Cybex isokinetic dynamometer
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Assessment method [1]
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Timepoint [1]
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3, 4, 6 and 9 months post-surgery
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Primary outcome [2]
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IKDC
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Assessment method [2]
300104
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Timepoint [2]
300104
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3, 4, 6 and 9 months post-surgery
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Secondary outcome [1]
329049
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KOOS
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Assessment method [1]
329049
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Timepoint [1]
329049
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3, 4, 6 and 9 months post-surgery
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Secondary outcome [2]
329050
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hop tests
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Assessment method [2]
329050
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Timepoint [2]
329050
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3, 4, 6 and 9 months post-surgery
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Secondary outcome [3]
329051
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Tegner activity level
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Assessment method [3]
329051
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Timepoint [3]
329051
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3, 4, 6 and 9 months post-surgery
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Secondary outcome [4]
329052
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compliance with exercises via a weekly exercise log
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Assessment method [4]
329052
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Timepoint [4]
329052
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3, 4, 6 and 9 months post-surgery
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Secondary outcome [5]
329053
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Isokinetic extension peak torque with a Cybex isokinetic dynamometer
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Assessment method [5]
329053
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Timepoint [5]
329053
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3, 4, 6 and 9 months post-surgery
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Eligibility
Key inclusion criteria
ACL reconstruction with quadruple hamstrings graft
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Minimum age
18
Years
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Maximum age
50
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
a previous injury or operation to either knee, simultaneous fracture, concurrent ligamentous injury, evidence of osteoarthritis on radiograph, or articular cartilage lesions that required treatment. Patients with meniscal tears that were repaired were excluded, whereas those with tears that required no treatment or were treated with partial meniscectomy were included.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
allocation involved contacting the holder of the allocation schedule who was "off-site" or at central administration site
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
cluster randomisation by computerised sequence generation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Other
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Other design features
cluster randomisation
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
14 participants in each group are needed to detect a large effect size with 80% power at a level of 0.05. To account for loss to follow-up we plan to recruit 16 participants in each group. Linear mixed models will be employed to investigate the effect of group allocation on the primary and secondary outcomes at 3, 4, 6, and 9 months
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
3/04/2017
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Actual
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Date of last participant enrolment
Anticipated
2/04/2018
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Actual
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Date of last data collection
Anticipated
4/03/2019
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Actual
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Sample size
Target
32
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
8376
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Greece
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State/province [1]
8376
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Thessaloniki
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Funding & Sponsors
Funding source category [1]
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Other
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Name [1]
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Rehabilitation and Physiotherapy Centre
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Address [1]
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Ethnikis Antistasews 16, Kalamaria,, 55133 Thessaloniki, Greece
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Country [1]
294899
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Australia
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Primary sponsor type
Individual
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Name
Evangelos Pappas
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Address
University of Sydney, 75 East str, Lidcombe, NSW 2141
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Country
Australia
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Secondary sponsor category [1]
293737
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None
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Name [1]
293737
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Address [1]
293737
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Country [1]
293737
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296276
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General Hospital Papanikolaou
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Ethics committee address [1]
296276
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Leoforos Papanikolaou, Hortiatis, 57010 Thessaloniki
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Ethics committee country [1]
296276
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Greece
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Date submitted for ethics approval [1]
296276
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14/08/2014
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Approval date [1]
296276
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27/08/2014
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Ethics approval number [1]
296276
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958/14.08.2014
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Summary
Brief summary
We have previously demonstrated that knee flexion deficits after ACL reconstruction remain when tested in a functional position with the hip in neutral even after several months and extensive rehabilitation. This may be due to the position of the hip (90 degrees of flexion) that is typically used for knee flexion strengthening exercises. We hypothesize that strengthening withe the hip in a more functional position (neutral) will result in lower strength deficits and better outcomes
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
1584
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/AnzctrAttachments/371670-ACLR protocol for both groups ANZCTR.pdf
(Protocol)
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Contacts
Principal investigator
Name
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A/Prof Evangelos Pappas
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Address
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University of Sydney, 75 East str, Lidcombe, NSW 2141
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Country
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Australia
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Phone
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+61293519188
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Evangelos Pappas
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Address
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University of Sydney, 75 East str, Lidcombe, NSW 2141
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Country
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Australia
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Phone
69739
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+61293519188
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Fax
69739
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Email
69739
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[email protected]
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Contact person for scientific queries
Name
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Evangelos Pappas
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Address
69740
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University of Sydney, 75 East str, Lidcombe, NSW 2141
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Country
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Australia
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Phone
69740
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+61293519188
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Fax
69740
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Email
69740
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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