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Movement Retraining using Real-time Feedback of Performance
Published on: January 17, 2013
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Efficacy of a Squat Visual Biofeedback Program After ACL Reconstruction: Protocol for a Prospective, Parallel,
Michael J Wellsandt1, Neal Weldon2, Dave M Werner3
1Physical Therapy Program University of Nebraska Medical Center.
International Journal of Sports Physical Therapy
|September 4, 2025
Summary
This study investigates if visual biofeedback during squats can improve knee loading after anterior cruciate ligament reconstruction (ACLR). Early intervention may help prevent knee osteoarthritis (OA) by optimizing joint mechanics.
Area of Science:
- Biomechanical Engineering
- Orthopedic Surgery
- Rehabilitation Science
Background:
- Altered knee joint loading is common and persistent after anterior cruciate ligament reconstruction (ACLR).
- This altered loading pattern is a significant risk factor for developing knee osteoarthritis (OA).
Purpose of the Study:
- To evaluate the efficacy of an eight-week squat visual biofeedback program in individuals early after ACLR.
- To assess the impact of this intervention on knee joint loading and cartilage health.
Main Methods:
- A prospective, parallel, randomized controlled trial involving 34 participants (13-35 years) undergoing ACLR.
- Participants received standard physical therapy plus an eight-week squat program with or without visual biofeedback, initiated at 50% weightbearing.
- Outcomes measured pre- and post-intervention, and at six and nine months post-ACLR.
Main Results:
- Primary outcomes include changes in knee flexion moment impulse interlimb ratio during squatting and cartilage microstructure.
- Secondary outcomes assess knee loading during gait and quadriceps strength.
- Exploratory outcomes cover range of motion, effusion, hop tests, physical activity, biomechanics, and patient-reported data.
Conclusions:
- This trial will determine if early visual biofeedback during squats can normalize knee loading post-ACLR.
- Findings may guide the development of interventions to prevent early knee OA after ACL injuries.
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