gms | German Medical Science

7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation, Annual Assembly of the German and the Austrian Society of Physical Medicine and Rehabilitation

Austrian Society of Physical Medicine and Rehabilitation

26.-29.10.2011, Salzburg, Österreich

Role of rehabilitation in patients with reconstructed anterior cruciate ligaments: Biomechanical and electrophysiological study

Meeting Abstract

7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation. Salzburg, 26.-29.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11esm027

DOI: 10.3205/11esm027, URN: urn:nbn:de:0183-11esm0273

Veröffentlicht: 24. Oktober 2011

© 2011 Naguib et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: To study the biomechanical and electrophysiological changes in the lower limbs after rehabilitation in patients who underwent anterior cruciate ligament (ACL) reconstruction using either closed kinetic chain (CKC) exercises alone or combined closed and open kinetic chain (OKC) exercises.

Material/Methods: The study included 40 patients who were assigned to two groups; group A which carried out CKC exercises and group B which performed combined CKC and OKC exercises. Both groups carried out proprioceptive exercises as well. Before rehabiliation they underwent bilateral knee examination which included thigh girth measurement, range of motion (ROM) assessment, detection of effusion as well as muscle strength assessment for the quadriceps and hamstrings. The biomechanical and posturographic parameters which were determined were the limits of stability (LOS) as well as the vertical projection of the center of gravity (COG) over the base of support. A modified single-legged hop test was performed and the different response parameters were recorded (force, velocity and power). Computerized dynamic posturography was carried out to study the pattern of reflex muscle activity in response to forward and backward translation perturbations and the postural restoration strategy adopted was determined. All the patients underwent re-assessment after completion of the rehabilitation program which lasted for 12 weeks.

Results: Both groups showed a significant increase in knee ROM and thigh girth, however there was no statistically significant difference between the two groups. There was a significant reduction in effusion in both groups. Both groups showed a significant increase in quadriceps and hamstrings muscle strength which was also significantly greater in group B. On performing the modified hop test, the force, velocity and power showed a statistically significant increase in both groups, however there was no statistically significant difference between the two groups. LOS increased significantly in both groups; however it was significantly greater in group B. The COG was centrally projected in 75% of patients in group A and in 50% of patients in group B. There was a statistically significant difference between the 2 groups. In both groups, reflex EMG results showed an improvement which was especially prominent in the tibialis anterior and the gastrocnemius. This reflected its effect on the postural restoration strategy adopted by the patients which generally showed a shift towards ankle strategy rather than hip strategy in both groups with no statistically significant difference between the two groups.

Conclusion: The addition of OKC exercises in rehabilitation programs after ACL reconstruction is essential in restoring adequate muscle strength and postural stability, and is safe when performed in a controlled and supervised manner.


References

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Beynnon BD, Johnson RJ, Fleming BC. The science of anetrior cruciate ligament rehabilitation. Clin Orthop Res. 2002;402:9-20.
2.
Ross M, Denegar C, Winzenreid J. Implementation of open and closed kinetic chain quadriceps strengthening exercises after ACL reconstruction. J strength and conditioning. 2001;15(4):466-73.
3.
Mattacola C, Perrin D, Gasneder B, Gieck JH, Saliba EN, McCue FC. Strength, functional outcome and postural stability after ACL reconstruction. J Athl Train. 2003;37:262-8.