The Effect of Cognitive Dual-task Rehabilitation on Arthrogenic Muscle Responses After ACL Reconstruction

After anterior cruciate ligament reconstruction, altered muscle responses around the knee joint are seen, known as arthrogenic muscle responses (AMR). Despite their initially protective function, prolonged presence of these AMR may potentially lead to knee joint pathomechanics, which in turn could contribute to an increased risk of early knee osteoarthritis. In this trial, the treatment effect of standard physiotherapy on long-term AMR will be compared to the effects of physiotherapy incorporating cognitive dual-task training. Based on earlier strong indications of supraspinal physiopathological mechanisms for AMR, our hypothesis is that exercise therapy combined with cognitive dual-task training will lead to a more natural and less anxious muscle control, thereby reducing AMR. The presence of AMR will be evaluated 5 months post-operatively in ACL reconstructed patients. Patients who display AMR will be included in this randomized controlled trial. These individuals will be randomly assigned to one of the two treatment strategies and will undergo the respective therapy for six weeks (twice a week). Afterwards, the same test procedure conducted five months after the operation will be repeated two more times to assess the evolution of the AMR: at seven months post-operation to assess the training effect and at nine months post-operation to evaluate the retention of this effect.