Joint Manipulation for ACL Reconstruction Rehabilitation

(ACLs SUCK Trial)

Overseen By Gannon Brochin, DC, MS

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of North Carolina, Chapel Hill

Disqualifiers: Concussion, Pregnancy, Neurological disorders, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

30 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether knee joint manipulation, a physical therapy technique, can improve thinking and muscle control after ACL reconstruction surgery. It targets individuals who have undergone this surgery and experience delays in reaction time. Participants will take tests to measure cognitive and neuromuscular performance before and after the treatment. Suitable candidates should have had ACL surgery 4 months to 5 years ago due to a sports-related injury and notice delays in reaction time. As an unphased trial, this study offers a unique opportunity to contribute to understanding how physical therapy can enhance recovery after ACL surgery.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that knee joint manipulation is safe for post-ACLR rehabilitation?

Research has shown that knee joint manipulation, often used after surgery, is generally well-tolerated. Studies indicate it can improve muscle coordination and control, assist with knee movement, and lower the risk of future injuries. Although the sources provided do not specify negative effects from joint manipulation, evidence suggests it is a safe recovery method after ACL surgery. While this study is not in a specific phase, which may limit detailed safety data, joint manipulation remains a common rehabilitation practice. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Joint manipulation is unique because it offers a hands-on approach that could enhance recovery for those undergoing ACL reconstruction. Unlike typical physical therapy, which often focuses on exercises and gradual strengthening, this technique uses grade III+ measures, a specific type of manual therapy, to directly manipulate the knee joint. Researchers are excited about this method as it may accelerate rehabilitation by potentially improving joint mobility and reducing stiffness more effectively than conventional methods.

What evidence suggests that knee joint manipulation is effective for ACL reconstruction rehabilitation?

Research has shown that specific knee joint movements can enhance recovery after ACL surgery. Participants in this trial will receive knee joint manipulations as part of their rehabilitation program. Patients in organized rehab programs that include these joint movements often experience improved knee function and muscle strength. This method can lead to better movement and stronger muscles earlier in recovery. Although limited data exists on knee joint movements alone, combining them with other rehab techniques appears to accelerate recovery and improve performance after surgery. This suggests that these movements might also enhance brain and muscle coordination in individuals recovering from ACL surgery. ^{1 3 6 7 8}

Who Is on the Research Team?

Shelby Baez, PhD, ATC

Principal Investigator

University of North Carolina, Chapel Hill

Are You a Good Fit for This Trial?

This trial is for individuals aged 18-35 who have had anterior cruciate ligament reconstruction (ACLR) between 4 months and 5 years ago and are experiencing slower reaction times. The study aims to see if knee joint manipulation can help improve their brain function and muscle control.

Inclusion Criteria

Provided informed consent prior to any study procedures that are performed

Injured knee playing or training for sports (recreational or organized) or during physical activity

Are at least the minimally clinical important difference (MCID) above the normative reaction time average for our methods as established by previous literature in at least 1 reaction time task

Exclusion Criteria

I have a neurological disorder, such as epilepsy.

I have injured my leg in the last 3 months.

History of concussion in the past 3 months

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-Intervention Assessment

Participants complete a battery of neurocognitive and neuromuscular assessments, including visuomotor reaction time and dual-task hop testing

1 day

1 visit (in-person)

Intervention

Participants receive knee joint manipulation(s) to assess the impact on neurocognitive and neuromuscular performance

1 day

1 visit (in-person)

Post-Intervention Assessment

Participants complete post-intervention assessments to measure changes in neurocognitive and neuromuscular performance

90 minutes

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after intervention

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Joint Manipulation

Trial Overview The study tests the effects of knee joint manipulation on neurocognitive performance in people with ACLR. Participants will undergo cognitive and physical assessments before and after the treatment to measure any improvements in reaction time and coordination.

How Is the Trial Designed?

Group I: Knee manipulation post ACLR Experimental Treatment 1 Intervention

This group, which comprises the entire cohort, will receive knee joint manipulations coinciding with grade III+ measures.

Who Is Running the Clinical Trial?

University of North Carolina, Chapel Hill

Lead Sponsor

Trials

1,588

Recruited

4,364,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9460090/

ACL Reconstruction Rehabilitation: Clinical Data, Biologic ... Feucht et al reported that 100% of patients expected normal or near normal knee function after ACLR surgery, 91% expected to RTS at the same level and 98% ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S2059775422000943

Rehabilitation following surgical reconstruction for anterior ... This article discusses how postoperative rehabilitation following ACL reconstruction (ACLR) has changed from the 1960s to the present day.

3. bmcmusculoskeletdisord.biomedcentral.com bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-025-08876-6

The impact of exercise therapy on rehabilitation outcomes ... The study results show that WR training is the most effective in enhancing knee joint function and muscle strength post-ACL reconstruction.

4. jospt.org jospt.org/doi/10.2519/jospt.2012.3741

Recent Advances in the Rehabilitation of Anterior Cruciate ... Howe et al also reported improved outcomes—greater motion, improved muscular strength, and enhanced earlier function—with formal, supervised rehabilitation ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12412367/

a systematic review and meta-analysis - PMC This study aims to systematically evaluate and compare the clinical effectiveness of HBR protocols versus supervised rehabilitation programs in ...

6. sciencedirect.com sciencedirect.com/science/article/pii/S2666061X24000142

Manipulation Under Anesthesia and Lysis of Adhesions ... Most studies identified manipulation under anesthesia and/or LOA as the treatment among both adult and pediatric patients.

7. mdpi.com mdpi.com/2077-0383/13/10/2994

Impact of Surgical Timing on Functional Outcomes after ... This study aimed to determine the effects of acute ACLR on postoperative outcomes, including muscle strength, performance, and return to sports.

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4739537/

Anterior cruciate ligament reconstruction and rehabilitation Surgical reconstruction of an injured anterior cruciate ligament (ACL) leads to full recovery of function and sports activity in a high percentage of cases.