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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, Austria

Proprioceptive function after ACL reconstructed athletes

Meeting Abstract

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  • corresponding author presenting/speaker Yukio Urabe - Graduate School of Health Science, Hiroshima University, Hiroshima, Japan
  • author Noriaki Maeda - Graduate School of Health Science, Hiroshima University, Hiroshima, Japan
  • author Junpei Sasadai - Graduate School of Health Science, Hiroshima University, Hiroshima, Japan

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. Doc11esm074

DOI: 10.3205/11esm074, URN: urn:nbn:de:0183-11esm0740

Published: October 24, 2011

© 2011 Urabe et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective: Proprioception is the ability to sense the joint position and movement or motion of limb segments both individually and relative to one another. This ability is very important to athletes. It was earlier believed that high-level athletes have good proprioceptive function. However, this is yet to be verified. In 2001, we created a device for the measurement of proprioceptive function of the knee joint. This device was manufactured by Sensor and Measurement Co. Ltd. (Japan, Figure 1 [Fig. 1]) and named a proprioceptive function measurement instrument. An ACL is an important mechanical structure, which maintains knee joint integrity movement. However knee joint function is complex and does not depend on mechanical stability alone. It is also based on sensoriomotor function. ACL injury leads to a disturbance of the sensorimotor system due to a loss or damage of the mechanoreceptors causing changes in motor behavior.

Proprioceptive function is often examined after anterior ACL injury and its reconstruction. The purpose of this study was evaluate of the influences joint position sense (JPS) and kinesthesis after reconstructed ACL.

Material/Methods: JPS was evaluated using a passive angle reproduction test. The subjects memorized the degree of an angle and later reproduced the same angle passively at random or at 1 d/s. The absolute error was considered as the joint position. Knee joint position was evaluated at knee flexion angles of 20° and 45°. The subjects of this study were 40 (20 male and 20 female) healthy athletes, 40 (20 male and 20 female) athletes who had ACL injury, and same athletes who had undergone reconstruction for ACL injury. Kinesthesis was evaluated the threshold for detecting passive motion (TTDPT). This device (Figure 1 [Fig. 1]) can evaluate from 0.1 d/s and the study were selected 0.1 d/s, 0.2d/s, and 0.3 d/s which represents extremely slow movement.

Results: The absolute error was fixed from the flexion angle of 20° extension of JPS; it was uncertain from 45°. The absolute error was 4 to 5° in almost all the athletes. The incidence ratio of ACL injury was higher in female athletes. However, with regard to joint position sense, there was no difference between male and female athletes and between athletes who had injured their ACL and those who had not. The absolute error on the ACL-ruptured side was larger. However, no difference was found between the injured and uninjured side. In some cases, the absolute error was found to be larger in the initial stages after reconstruction. The TTDPT for knee extension direction form 20°of knee flexion is showed the normal subject can aware the movement easily only 3.9 seconds, but ACL injured athletes was delayed 6.5 second significantly with 0.1 d/s (p<0.05). And it decrease 3 months and later. Six months and 12 months were not significant change compared with normal subjects. Passive motion at 0.2 d/s is easier to detect than that at 0.1 d/s. The 0.2 d/s demonstrate same results with 0.1 d/s, however 0.3 d/s is not significant difference each conditions. So, the angular velocity of 0.1 and 0.2 d/s are important to consider the ACL influenced athletes. The TTDPT for knee flexion angle at 45°indicate similar results at 20°of flexion.

Conclusion: This study showed similar results as other reports on joint position sense. Thus far, the lowest speed of motion at which kinesthesis has been measured is 1 d/s. However, it lacks the ability to detect passive motion. The authors measured kinesthesis by using an instrument that can measure movement sense from 0.1 d/s. It is reported that proprioception can recover after reconstruction; however, this is yet to be confirmed. Although the importance of proprioception is recognized by many researchers, it can not be measured accurately in the absence of an efficient measurement tool.


References

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Shidahara H, Deie M, Niimoto T, Shimada N, Adachi N, Hirata K, Urabe Y, Ochi M. Prospective study of kinesthesia after ACL reconstruction. Int J Sports Med. 2011;32(1):1-7.