Purpose

Following anterior cruciate ligament reconstruction (ACLR) there are neuroplastic changes in motor cortices and corticospinal tract pathways that lead to postoperative weakness. Arthrogenic muscle inhibition (AMI) is a limiting factor following arthroscopic ACLR surgery and is the cause for a patient’s inability to activate the affected muscle groups postoperatively. Neurofeedback visualization training (NFVT) through a brain computer interface is a novel, non-invasive, rehabilitation technique that may expedite muscle activation postoperatively by preventing inhibition of neural corticospinal pathways. Our purpose is to quantify the effects of NFVT following ACLR.

Materials And Methods

This is a randomized, single masked, control trial with an intervention arm and control arm each with 30 patients (Total n = 60). Participants in the intervention group and control will follow the same physical therapy rehabilitation protocols with the addition of NFVT (iBrainTech™) twice a week, 20-minute sessions, for 8-weeks postoperatively to the intervention arm. Primary outcomes will include range of motion, peak torque measured by dynamometer, muscle activity measured by surface EMG, and proprioception/balance. Outcomes will be measured preoperatively and at 6 weeks, 3 months, and 6 months postoperatively. Data analysis will be carried out using t-tests and ANOVA.

Results

We hypothesize that patients who undergo NFVT will display earlier postoperative muscle activation recovery in comparison to controls. Specifically, ROM, peak torque, muscle activity, and balance may approach clinically and statistically meaningful improvements.

Conclusion

NFVT is a novel rehabilitation technique that could offer a non-invasive way to accelerate recovery and prevent atrophy of neuromuscular pathways. This new rehabilitation technique is hypothesized to reduce rehabilitation times following ACLR.