What is the Influence of Visual-motor Reliance on Planned and Unplanned Change of Direction Biomechanics 7 Months Post Anterior Cruciate Ligament Reconstruction?

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Brief Title

What is the Influence of Visual-motor Reliance on Planned and Unplanned Change of Direction Biomechanics 7 Months Post Anterior Cruciate Ligament Reconstruction?

Official Title

What is the Influence of Visual-motor Reliance on Planned and Unplanned Change of Direction Biomechanics 7 Months Post Anterior Cruciate Ligament Reconstruction?

Brief Summary

      The majority of anterior cruciate ligament (ACL) injuries occur during non-contact
      mechanisms.This suggests that an individual's movement technique is a significant factor in
      the cause of the injury. Hence, ACL injuries are increasingly being framed as an error in
      motor planning and execution.

      Rehab following an ACL reconstruction (ACLR) commonly follows a pathway of: regaining ROM,
      strength development, power development, running, return to training and then return to
      competition. However, several studies utilising functional brain MRI and electroencephalogram
      have demonstrated dysfunction within the somatosensory and visual systems in the ACLR
      population even after the completion of rehabilitation. This has been suggested to indicate
      that the ACLR population becomes reliant on their visual system during motor planning and
      execution, potentially increasing the risk of reinjury.

Detailed Description

      It has been demonstrated in studies utilising functional brain MRI and EEG that following
      ACLR, individuals have increased activation of the visual system during simple motor tasks as
      compared to healthy controls. This is suggested to represent an increased reliance on the
      visual system during motor planning and execution. Increased reliance on the visual system
      may negatively affect an individual's ability to respond to sporting situations which are
      often chaotic in nature, resulting in an inappropriate movement technique being employed.
      This may then result in an increased risk of reinjury. However, no study to date has been
      able to assess how visual reliance affects change of direction biomechanics.

      The study will recruit individuals who are 7 months post-ACLR and intend on returning to
      multi-directional field sport. Individuals will complete a stepping down task (eyes open
      versus eyes closed) to identify participants who are reliant on their visual system.
      Participants will then complete a 90 deg change of direction task in a planned and then
      unplanned condition. Those who are visually reliant will be compared to those who are aren't
      with regards to their unplanned change of direction biomechanics and also the change in their
      biomechanics from a planned to unplanned condition.

Study Type


Primary Outcome

change of direction biomechanics- planned versus unplanned

Secondary Outcome

 Joint position sense test



Study Arms / Comparison Groups

 ACLR group
Description:  ACLR participants would be 7 months post surgery


* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Information

Estimated Enrollment


Start Date

December 2021

Completion Date

December 2022

Primary Completion Date

August 2022

Eligibility Criteria

        Inclusion Criteria:

          -  Aged 18-35 years old

          -  Playing club level Gaelic football or hurling

          -  They must report that they intend on returning to sport at the same or higher level

          -  Able to give written informed consent and to participate fully in the interventions

          -  At 7 months biomechanical testing, individuals would need to have 70% symmetry of both
             quadriceps and hamstring peak torque as measured on our isokinetic dynamometer with
             the angular velocity set to 60°/s

          -  Individuals should have already commenced linear running and double leg jumping tasks
             as part of their rehabilitation

          -  They are currently attending a gym or can attain gym access for the duration of
             intervention period

        Exclusion Criteria:

          -  They have not commenced running or jumping in their rehabilitation

          -  Revision ACL

          -  They underwent concurrent meniscal repair, chondral repair or extra-articular

          -  Serious medical conditions preventing them from completing high intensity resistance

          -  Any previous: injuries to the visual system, concussion, head injury, unexplained
             seizures or epilepsy

          -  Any previous ankle or knee injuries

          -  Those who are uncomfortable or do not want to hop with their eyes closed (one of the
             assessment tasks will involve hopping on one leg with their eyes open and followed by
             another set in which their eyes are closed




18 Years - 35 Years

Accepts Healthy Volunteers

Accepts Healthy Volunteers


, 00 353 1 526 2030, [email protected]

Location Countries


Location Countries


Administrative Informations



Organization ID


Responsible Party


Study Sponsor

Sports Surgery Clinic, Santry, Dublin

Study Sponsor

, , 

Verification Date

November 2021