Anterior cruciate ligament (ACL) injuries are among the most common and functionally disabling knee injuries, particularly in physically active individuals. Despite advancements in surgical techniques, optimal post-operative rehabilitation remains critical for successful functional recovery, minimizing re-injury risk, and restoring pre-injury performance levels
Age range: 18-45 years
Male participants only
History of Anterior Cruciate Ligament Reconstruction (ACLR) of 3 to 12 months
No prior ACL surgery on the affected knee
Any type of fracture
Concurrent ligamentous injury or repairable meniscus
Osteochondral defect
Any systemic and/or neurological illness
Parallel
Perturbation Training Group
Other interventionTwo-leg rocker board One-leg rocker board Roller board / stable (weight scale) surface Roller board / BOSU ball TheraBand feedback / perturbation training Simple sport-specific technique on rocker board Moderate demand sport-specific technique on rocker board Advanced sport-specific technique on rocker board This sequence reflects a progressive challenge to knee stability, beginning with bilateral balance tasks, advancing to unilateral control, and culminating in sport-specific perturbation drills.
Task-Oriented Functional Activities Group
Other interventionFunctional Recovery Tasks After ACLR Normal walking gait Bilateral squat Unilateral foundation exercises - Single leg squat Bilateral landing Running - Run on treadmill Bilateral plyometric - Bilateral drop jump Unilateral landing / deceleration - Single leg deceleration Unilateral plyometric - Single leg drop jump Change of direction ability / coordination - 90º cut maneuver Sport-specific movements - Movement control under sport-specific change of direction This sequence reflects a progressive load and skill development pathway, starting from basic gait and bilateral tasks, moving toward unilateral control, plyometrics, and finally sport-specific agility.
Control Group (Standard Rehabilitation Protocol)
Other interventionHeating pad (5-10 minutes) TENS (short bursts, 10-15 minutes, frequency 100 Hz) Stationary cycling Gentle range of motion exercises Passive and active-assisted ROM Isometric quadriceps contractions Straight leg raises Quadriceps setting with a towel under the knee Closed-chain exercises (e.g., wall sits, mini-squats) Hamstring curls Double-leg stance on foam pad This set emphasizes pain relief, mobility restoration, and foundational strength before progressing to advanced neuromuscular or sport-specific tasks.
NPRS for Pain
Numeric Pain Rating Scale (NPRS) it is a unidimensional scale to measure pain intensity, particularly in adults. It is a 10-rating scale and an 11-point numeric scale in the form of a horizontal bar or line
Universal Goniometer for Range of motion
A universal goniometer (UG) will be used to determine the range of motion of the target joint.
The Y-Balance test (YBT)
The Y-Balance test (YBT) is used to assess dynamic balance impairments associated with lower extremity injuries such as ACL injury, patellofemoral pain syndrome, and ankle instability.
International Knee Documentation Committee scores (IKDC)
Patients' knee function is evaluated using the International Knee Documentation Committee's (IKDC) Subjective Knee Form. Through 18 questions, it assesses symptoms, athletic activity, and general knee function; higher scores indicate better knee function.
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