Proprioception recovery after anterior cruciate ligament reconstruction – isokinetic versus dynamic exercises

Abstrakt

  • Dragana M Dragicević-Cvjetković Zavod za fizikalnu medicinu i rehabilitaciju ''Dr M. Zotović'' Banja Luka
  • Tatjana Erceg - Rukavina Zavod za fizikalnu medicinu i rehabilitaciju ''Dr M. Zotović'' Banja Luka, RS, BiH
  • Siniša Nikolić Zavod za fizikalnu medicinu i rehabilitaciju ''Dr M. Zotović'' Banja Luka, RS, BiH
Keywords: Propriocepcija, Rehabilitacija, Prednji ukršteni ligament

Abstract


Background / Aim: Proprioception recovery is one of the main postoperative rehabilitation goals after the anterior cruciate ligament (ACL) reconstruction. The aim of this study was to examine the level of proprioception recovery in patients 9 months after the ACL reconstruction using hamstring graft.
Methods: A prospective study followed 70 male subjects (mean age 27.36 ± 5.94) divided into two groups depending on the type of proprioceptive exercise applied. Group A patients (n = 35) underwent proprioceptive training on a Biodex 4 Pro System isokinetic dynamometer for 10 minutes 5 times per week. In group B, patients underwent proprioception exercises in the gym for 10 minutes 5 times per week. The degree of recovery of proprioception was measured on an isokinetic dynamometer preoperatively and 9 months after ACL reconstruction. Flexion angles in the operated knee of 15, 30 and 45 degrees were monitored. The Chi-square test was used for statistical analyses. The value of p ˂ 0.05 was considered significant.
Results: A significant difference was found in the recovery of proprioception in patients depending on the type of training applied. Statistically significant recovery of proprioception was observed in patients from both groups 9 months after ACL reconstruction, but it was better in patients of group A (p ˂ 0.05).
Conclusion: Applying proprioceptive training on an isokinetic dynamometer achieves better proprioceptive recovery in patients 9 months after ACL reconstruction versus dynamic exercises in the gym.

Author Biographies

Dragana M Dragicević-Cvjetković, Zavod za fizikalnu medicinu i rehabilitaciju ''Dr M. Zotović'' Banja Luka

Republika Srpska, Bosna i Hercegovina

Tatjana Erceg - Rukavina, Zavod za fizikalnu medicinu i rehabilitaciju ''Dr M. Zotović'' Banja Luka, RS, BiH

Specijalista fizikalne medicine i rehabilitacije, magistar medicinskih nauka

Siniša Nikolić, Zavod za fizikalnu medicinu i rehabilitaciju ''Dr M. Zotović'' Banja Luka, RS, BiH

diplomirani medicinar fizioterapije

References

1. Allum JH, Bloem BR, Carpenter MG, Hulliger M, Hadders-Algra M. Proprioceptive control of posture: a review of new concepts. Gait Posture 1998 Dec;8(3):214-42.
2. Sherrington CS. On the proprioceptive system, especially its reflex aspect. Brain 1907;29:467–82.
3. Dietz V. Proprioception and locomotor disorders. Nat Rev Neurosci 2002 Oct;3(10):781-90.
4. Ashton-Miller JA, Wojtys EM, Huston LJ, Fry-Welch D. Can proprioception really be improved by exercises? Knee Surg Sports Traumatol Arthrosc 2001 May;9(3):128-36.
5. Buckthorpe M, Della Villa F. Optimising the 'mid-stage' training and testing process after ACL reconstruction. Sports Med 2020 Apr;50(4):657-78.
6. Bączkowicz D, Skomudek A. Assessment of neuromuscular control in patients after anterior cruciate ligament reconstruction. Ortop Traumatol Rehabil 2013;15(3):205-14.
7. Dragičević-Cvjetkovic D, Bijeljac S, Palija S, Talić G, Nožica Radulović T, Kosanović Glogovac M, et al. Isokinetic testing in evaluation rehabilitation outcome after ACL reconstruction. Med Arch 2015;69(1):21-3.
8. Feiring CD, Ellenbecker ST, Derscheid LG. Test-retest reliability of the Biodex isokinetic dynamometer. J Orthop Sports Phys Ther 1990;11(7):298-300.
9. Czamara A, Tomaszewski W, Bober T, Lunarski B. The effect of physiotherapy on knee joint extensor and flexor muscle strength after anterior cruciate ligament reconstruction using hamstring tendon. Med Sci Monit 2011;17(1):33–41.
10. Briggs K, Lysholm J, Tegner Y, Rodkey W, Kocher M, Steadman R. The reliability, validity, and responsiveness of the Lysholm score and Tegner activity scale for anterior cruciate ligament injuries of the knee: 25 years later. Am J Sports Med 2009;37(5):890-7.
11. Rossignol S, Dubuc R, Gossard JP. Dynamic sensorimotor interactions in locomotion. Physiol Rev 2006 Jan;86(1):89-154.
12. Filbay SR, Ackerman IN, Russell TG, Crossley KM. Factors related to quality of life in people with knee pain, stiffness or activity limitations 5 to 20 years following anterior cruciate ligament reconstruction. Osteoarthritis Cartilage 2015;23(2):A279-80.
13. Hunnicutt J, McLeod M, Slone S, Gregory C. Quadriceps neuromuscular and physical function after anterior cruciate ligament reconstruction. J Athl Train 2020;55(3):238-45.

14. Liu-Ambrose T, Taunton JE, MacIntyre D, McConkey P, Khan KM. The effects of proprioceptive or strength training on the neuromuscular function of the ACL reconstructed knee: a randomized clinical trial. Scand J Med Sci Sports 2003 Apr;13(2):115-23..
15. Chouteau J, Testa R, Viste A, Moyen B. Knee rotational laxity and proprioceptive function 2 years after partial ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 2012;20(4):762-6.

16. Risberg MA, Holm I, Steen H, Beynnon BD. Sensitivity to changes over time for the IKDC form, the Lysholm score, and the Cincinnati knee score. A prospective study of 120 ACL reconstructed patients with a 2-year follow-up. Knee Surg Sports Traumatol Arthrosc 1999;7(3):152-9.
17. Arundale AJH, Cummer K, Capin JJ, Zarzycki R, Snyder-Mackler L. Report of the clinical and functional primary outcomes in men of the ACL-SPORTS Trial: Similar outcomes in men receiving secondary prevention with and without perturbation training 1 and 2 years after AVL reconstruction. Clin Orthop Relat Res 2017 Oct;475(10):2523-34.
18. Guney-Deniz H, Harput G, Kaya D, Nyland J, Doral MN. Quadriceps tendon autograft ACL reconstructed subjects overshoot target knee extension angle during active proprioception testing. Knee Surg Sports Traumatol Arthrosc 2020 Feb;28(2):645-52.
19. Johnson RJ, Eriksson E, Haggmark T, Pope MH. Five-to ten–year follow-up evaluation after reconstruction of the anterior cruciate ligament. Clin Orthop Relat Res 1984 Mar;(183):122-40.
20. Dubljanin-Raspopović E, Kadija M, Matanović D. [Evaluation of the intensive rehabilitation protocol after arthroscopically assisted anterior cruciate ligament reconstruction]. Srp Arh Celok Lek 2006 Nov-Dec;134(11-12):532-6. Serbian.
21. Risberg MA, Holm I, Myklebust G, Engebretsen L. Neuromuscular training versus strength training during first 6 months after anterior cruciate ligament reconstruction: a randomized clinical trial. Phys Ther 2007;87(6):737–50.
22. Tsaklis P, Abatzides G. ACL rehabilitation program using a combined isokinetic and isotonic strengthening protocol. Isokinet Exerc Sci 2002;10(4):211-9.
23. Lin DH, Lin YF, Chai HM, Han YC, Jan M. Comparison of proprioceptive functions between computerized proprioception facilitation exercise and closed kinetic chain exercise in patients with knee osteoarthritis. Clin Rheumatol 2007;26(4):520–8.
24. Ju YY, Wang CW, Cheng HY. Effects of active fatiguing movement versus passive repetitive movement on knee proprioception. Clin Biomech (Bristol, Avon) 2010 Aug;25(7):708-12.

Published
2021/12/31
Section
Original article