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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2600125617 |
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最近更新日期: Date of Last Refreshed on: |
2026-05-28 17:27:47 |
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注册时间: Date of Registration: |
2026-05-28 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
低能量冲击波对前交叉韧带重建术后早期股四头肌-腘绳肌协同控制及平衡功能的随机对照研究 |
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Public title: |
Effects of Low-Energy Radial Extracorporeal Shockwave Therapy on Quadriceps-Hamstring Co-Contraction Control and Balance Function in Early Post-ACLR Rehabilitation: A Randomized Controlled Trial |
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注册题目简写: |
R-ESWT对ACLR术后早期神经肌肉协同控制的影响 |
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English Acronym: |
Shockwave Therapy for Early Post-ACLR Recovery |
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研究课题的正式科学名称: |
低能量冲击波对前交叉韧带重建术后早期股四头肌-腘绳肌协同控制及平衡功能的随机对照研究 |
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Scientific title: |
Effects of Low-Energy Radial Extracorporeal Shockwave Therapy on Quadriceps-Hamstring Co-Contraction Control and Balance Function in Early Post-ACLR Rehabilitation: A Randomized Controlled Trial |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
吴思琪 |
研究负责人: |
吴思琪 |
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Applicant: |
Wu Siqi |
Study leader: |
Wu Siqi |
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申请注册联系人电话: Applicant telephone: |
+86 178 0598 1231 |
研究负责人电话: Study leader's telephone: |
+86 178 0598 1231 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
wusiqistella@163.com |
研究负责人电子邮件: Study leader's E-mail: |
wusiqistella@163.com |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
中国辽宁省锦州市古塔区人民街五段二号 |
研究负责人通讯地址: |
中国辽宁省锦州市古塔区人民街五段二号 |
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Applicant address: |
2, Section 5, Renmin Street, Guta District, Jinzhou, Liaoning, China |
Study leader's address: |
2, Section 5, Renmin Street, Guta District, Jinzhou, Liaoning, China |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
锦州医科大学 |
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Applicant's institution: |
Jinzhou Medical University |
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研究负责人所在单位: |
锦州医科大学附属第一医院 |
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Affiliation of the Leader: |
Jinzhou Medical University First Affiliated Hospital |
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是否获伦理委员会批准: |
是/Yes |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
2026LL-KY-117 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
锦州医科大学附属第一医院医学科学研究伦理委员会 |
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Name of the ethic committee: |
Medical and Scientific Research Ethics Committee of The First Affiliated Hospital of Jinzhou Medical University |
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伦理委员会批准日期: Date of approved by ethic committee: |
2026-05-08 00:00:00 |
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伦理委员会联系人: |
胡婷嫣 |
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Contact Name of the ethic committee: |
Hu Tingyan |
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伦理委员会联系地址: |
中国辽宁省锦州市古塔区人民街五段二号 |
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Contact Address of the ethic committee: |
2, Section 5, Renmin Street, Guta District, Jinzhou, Liaoning, China |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 416 460 5103 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
iitoffice@163.com |
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研究实施负责(组长)单位: |
锦州医科大学附属第一医院康复医学科 |
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Primary sponsor: |
Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinzhou Medical University |
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研究实施负责(组长)单位地址: |
中国辽宁省锦州市古塔区人民街五段二号 |
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Primary sponsor's address: |
2, Section 5, Renmin Street, Guta District, Jinzhou, Liaoning, China |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
本研究无任何商业赞助,研究团队成员与冲击波设备供应商无利益关联。研究经费来源于研究者自费,用于设备维护及数据分析。设备:sEMG系统、冲击波治疗仪、XPH-A/B平衡仪均为锦州医科大学附属第一医院康复科现有设备,无需额外购置或租赁。 |
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Source(s) of funding: |
No commercial funding was received for this study, and no conflicts of interest exist between the research team and the supplier of extracorporeal shock wave devices. Costs related to equipment maintenance and data analysis are borne by the researchers. All instruments including the sEMG system, extracorporeal shock wave therapy device and XPH-A/B balance tester are existing facilities of the Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinzhou Medical University, with no extra purchase or rental needed. |
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Target disease: |
Range of motion limitation after anterior cruciate ligament reconstruction |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
其它 | ||||||||||||||||||||||
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Study phase: |
N/A |
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研究设计: |
随机平行对照 |
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Study design: |
Parallel |
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研究目的: |
主要目的: 评估低能量冲击波联合常规康复训练对ACLR术后早期(2-6周)患者膝关节活动度(ROM)的改善效果,以术后12周伸直缺失角度和"达全范围ROM"比例(伸直缺失<=5°且屈曲>=130°)为主要评价指标。 次要目的: 1.探讨冲击波对股四头肌-腘绳肌协同控制的影响(通过表面肌电图CCR指标评估) 2.评估冲击波对平衡功能的改善作用(通过XPH-A/B系统重心动摇轨迹长度和包络面积评估) 3.分析冲击波治疗的安全性(记录局部不良反应、VAS疼痛评分) 4.探索神经肌肉协同改善与ROM恢复的相关性(为机制研究提供初步证据) |
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Objectives of Study: |
Primary Objective: To evaluate the efficacy of low-energy extracorporeal shock wave therapy (ESWT) combined with conventional rehabilitation training on knee range of motion (ROM) in patients during early postoperative period (2-6 weeks) following anterior cruciate ligament reconstruction (ACLR). Primary outcome measures include extension deficit at 12 weeks post-surgery and the proportion of patients achieving full ROM (extension deficit <=5° and flexion >=130°). Secondary Objectives: 1.To investigate the effects of ESWT on quadriceps-hamstring co-contraction control assessed by surface electromyography co-contraction ratio (CCR) 2.To evaluate the improvement in balance function assessed by center of pressure trajectory length and envelope area using XPH-A/B system 3.To assess the safety profile of ESWT by documenting local adverse events and Visual Analogue Scale (VAS) pain scores 4.To explore the correlation between neuromuscular coordination improvement and ROM recovery as preliminary evidence for mechanistic investigation |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
1. 诊断标准:经 MRI 确诊单侧 ACL 完全断裂,并接受关节镜下 ACL 重建术(采用腘绳肌腱自体移植); 2. 术后时间:术后 2 周(+/-3 天),切口愈合良好(无红肿、渗液、感染征象); 3. 功能状态:膝关节伸直缺失<=20°(相对健侧),伸直缺失>20°者排除; 4. 年龄与性别:18-45 岁,男女不限; 5. 依从性:自愿参加研究,签署知情同意书,能配合 4 周(每周 2 次)冲击波治疗及多次随访评估。 |
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Inclusion criteria |
1. Diagnostic criteria: Complete rupture of unilateral ACL was confirmed by MRI, and arthroscopic ACL reconstruction surgery (using autologous hamstring tendon transplantation) was performed; 2. Postoperative time: 2 weeks (+/-3 days) after the operation, the incision healed well (no signs of redness, swelling, exudate or infection); 3. Functional status: Knee extension loss <=20° (relative to the healthy side), and those with extension loss >20° are excluded; 4. Age and gender: 18-45 years old, gender not limited; 5. Compliance: Voluntarily participate in the study, sign the informed consent form, and be able to cooperate with 4-week (twice a week) shock wave therapy and multiple follow-up evaluations. |
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排除标准: |
1. 合并损伤:合并同侧后交叉韧带(PCL)、内外侧副韧带断裂,或半月板修复术(切除术不排除); 2. 神经系统疾病:既往神经系统疾病史(如脑卒中、周围神经病),影响肌肉控制评估; 3. 骨科疾病:膝关节骨性关节炎(Kellgren-Lawrence 分级>=2 级)、既往膝关节手术史(ACL 初次重建术除外); 4. 冲击波禁忌证:局部感染、开放性伤口、深静脉血栓形成、恶性肿瘤、妊娠或哺乳期; 5. 设备禁忌:体内植入心脏起搏器或金属植入物(膝关节固定螺钉除外); 6. 依从性问题:无法配合随访或拒绝签署知情同意书。 |
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Exclusion criteria: |
1. Combined injury: Combined rupture of the posterior cruciate ligament (PCL) on the same side, medial and lateral collateral ligaments, or meniscus repair (resection is not excluded); 2. Neurological diseases: Previous history of neurological diseases (such as stroke, peripheral neuropathy), affecting muscle control assessment; 3. Orthopedic diseases: Knee osteoarthritis (Kellgren-Lawrence grade >=2), previous history of knee joint surgery (excluding primary ACL reconstruction); 4. Contraindications for shock waves: local infection, open wounds, deep vein thrombosis, malignant tumors, pregnancy or lactation; 5. Equipment contraindications: Implantation of cardiac pacemakers or metal implants in the body (except for knee joint fixation screws); 6. Compliance issues: Inability to cooperate with follow-up or refusal to sign the informed consent form. |
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研究实施时间: Study execute time: |
从 From 2026-03-01 00:00:00至 To 2026-11-01 00:00:00 |
征募观察对象时间: Recruiting time: |
从From 2026-05-31 00:00:00 至 To 2026-09-30 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
随机序列生成: 1.采用计算机生成随机数字表(由独立统计学专家使用R软件randomizr包生成),按1:1比例分配至试验组和对照组 2.随机化单位:个体患者 3.分层因素:无分层(考虑到样本量较小,不进行基线特征分层) 4.区组随机:采用区组随机化(block randomization),区组大小为4,确保两组样本量在招募过程中保持平衡 分配隐藏机制: 1.随机序列由独立第三方(锦州医科大学统计学专业)生成并保管 2.采用不透明密封信封法:将分组信息装入不透明信封,按入组顺序编号(001-060),由负责招募的研究助理在患者签署知情同意书后按顺序开启信封 3.分配序列表由第三方统计师保存,研究人员在基线评估完成前无法获取分组信息 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
Randomization Method: Computer-generated random number table created by independent statistician using R software (randomizr package) with 1:1 allocation ratio to intervention and control groups. Individual randomization without stratification due to limited sample size. Block randomization employed with block size of 4 to maintain balanced group allocation throughout recruitment. Allocation Concealment: Random sequence generated and maintained by independent third party (Department of Statistics, Jinzhou Medical University). Sequentially numbered opaque sealed envelopes (001-060) containing group assignments opened by research assistant following informed consent acquisition. Allocation sequence list stored by third-party statistician, inaccessible to investigators prior to baseline assessment completion. |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
不公开/Private |
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盲法: |
盲法的必要性与局限性: 本研究采用单盲设计(评估者盲),具体说明如下: 为何仅采用评估者盲: 1.降低测量偏倚:ROM、sEMG、平衡功能等指标的测量结果可能受评估者主观预期影响,通过评估者盲法确保测量客观性 2.干预差异明显:试验组接受冲击波治疗(有明显敲击感和声音),对照组仅接受常规康复训练(不涉及任何模拟操作),患者能明确感知干预差异,因此无法实施受试者盲法 3.伦理考量:对照组采用常规康复方案(已被临床实践证实有效),而非"假冲击波"安慰剂,符合伦理规范,确保对照组患者获得标准治疗 盲法实施细节: 治疗环节: 1.试验组:接受真实冲击波治疗(能量流密度0.15-0.3 mJ/mm^2,频率4-8Hz)+ 常规康复训练 2.对照组:仅接受常规康复训练(ROM练习、股四头肌等长收缩、直腿抬高、本体感觉训练),不接受任何形式的冲击波治疗(包括假冲击波) 3.两组常规康复训练强度、频率完全一致(每周>=4次,每次30分钟) 评估环节: 1.评估者在独立评估室工作,不接触治疗记录 2.评估前统一告知患者:“请勿向评估老师透露您接受了哪种治疗” 3.评估者记录数据时采用代码(如"患者001-T0-ROM"),不出现分组信息 |
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Blinding: |
Rationale and Limitations of Blinding: Single-blind design (assessor blinding) employed to minimize measurement bias in ROM, sEMG, and balance assessments susceptible to evaluator expectation effects. Participant blinding not feasible due to distinct sensory characteristics of interventions (shock wave therapy produces audible sound and palpable percussion versus conventional rehabilitation alone). Therapist blinding not possible due to operational requirements of shock wave equipment. Intervention Protocol: Intervention group receives radial extracorporeal shock wave therapy (energy flux density 0.15-0.3 mJ/mm^2, frequency 4-8Hz) plus standardized rehabilitation. Control group receives identical standardized rehabilitation (ROM exercises, quadriceps isometric contractions, straight leg raises, proprioceptive training; >=4 sessions/week, 30 minutes/session) without shock wave therapy or sham procedure. Assessor Blinding Implementation: Outcome assessors conduct evaluations in separate rooms isolated from treatment records. Participants instructed to avoid disclosing treatment details to assessors. Data recorded using coded identifiers (e.g., "Patient 001-T0-ROM") without group information. Post-study blinding effectiveness assessed via assessor questionnaire. Ethical Justification: Control group receives evidence-based standard rehabilitation rather than sham therapy, ensuring ethical provision of effective treatment while maintaining scientific rigor. |
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是否共享原始数据: IPD sharing |
Yes |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
去标识化的个体参与者数据可在合理学术请求下共享。请求者需:(1)提供研究方案和数据使用计划;(2)签署数据使用协议;(3)承诺仅用于学术目的且不再识别参与者。请联系通讯作者提交正式申请,研究团队将在30个工作日内评估并回复。数据共享将在研究主要成果发表后12个月开始,持续5年。 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
De-identified individual participant data are available upon reasonable request. Requestors must provide a research proposal, sign a data use agreement, and commit to academic use only. Contact the corresponding author for formal requests. Data will be available 12 months post-publication for 5 years. |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
数据采集采用标准化病例记录表(CRF)记录人口学信息、基线特征、干预细节和结局指标。采用电子数据采集系统(EDC)进行数据录入、存储和管理。所有数据使用唯一受试者编码以维护保密性。ROM测量使用量角器记录,sEMG数据通过表面肌电采集系统获取,平衡功能评估使用XPH-A/B平衡测试训练系统完成。通过定期监查、数据范围核查和双人录入验证确保数据质量。数据库在统计分析前锁定,访问权限仅限授权研究人员。 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
Data will be collected using standardized case report forms (CRFs) documenting demographics, baseline characteristics, interventions, and outcomes. An electronic data capture (EDC) system will be used for data entry, storage, and management. All participants will be assigned unique identifiers to ensure confidentiality. ROM will be measured with a goniometer, sEMG will be recorded using a surface electromyography system, and balance function will be assessed using the XPH-A/B Balance Testing and Training System. Data quality will be maintained through regular monitoring, range checks, and double-entry verification. The database will be locked before statistical analysis, with access limited to authorized personnel. |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
暂未确定/Not yet |