Functional Resistance Training to Improve Knee Function After ACL Reconstruction

Profound quadriceps weakness is ubiquitous after anterior cruciate ligament (ACL)
reconstruction, and current rehabilitation approaches are not successful in optimizing
quadriceps strength and knee function even years after the surgery. We hypothesize that
suboptimal strength and functional outcomes after ACL surgery are due to the lack of
task-specific exercise elements during strength training. This application seeks to assess
whether progressive functional resistance training during gait will significantly improve
quadriceps function, neural excitability, and knee mechanics during gait. The proposed
studies will not only lay the foundation for a novel training paradigm, but will also improve
our understanding of the mechanisms mediating neuromuscular and biomechanical changes after
functional resistance training.

Inclusion Criteria:

- aged 14-40 years

- suffered an acute, complete ACL rupture

- willingness to participate in testing and follow-up as outlined in the protocol

- English-speaking

Exclusion Criteria:

- inability to provide written informed consent

- female subjects who are pregnant or are planning to become pregnant

- previous ACL injury

- previous surgery to either knee

- bony fracture accompanying ACL injury

- patients who experienced a knee dislocation;

- patients who are contraindicated for transcranial magnetic stimulation (e.g., metal
implants in head, unexplained recurrent headaches, history of seizures, epileptogenic
drugs, active psychiatric illness, etc.).