Izokinetički profil osoba sa rupturom prednjeg ukrštenog ligamenta

  • Miodrag P Drapšin Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
  • Damir Lukač Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
  • Predrag Rašović Clinic for Orthopaedic Surgery and Traumatology, Clinical Center of Vojvodina, Novi Sad, Serbia
  • Patrik Drid Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
  • Aleksandar Klašnja Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
  • Ivan Lalić Clinic for Orthopaedic Surgery and Traumatology, Clinical Center of Vojvodina, Novi Sad, Serbia
DOI: https://doi.org/10.2298/VSP141128067D
Ključne reči: knee injuries||, ||koleno, povrede, anterior cruciate ligament||, ||ligament, prednji ukršteni, muscle, sceletal||, ||mišići, skeletni, muscle strenght||, snaga,

Sažetak


Uvod/Cilj. Promene u zglobu kolena koje nastupaju nakon lezije prednjeg ukrštenog ligamenta (ligamentum cruciatum anterius – LCA) dovode do poteškoća u hodanju, trčanju i skakanju, pogotovo prilikom nagle promene pravca kretanja. Ovakva pojava u značajnoj meri umanjuje kvalitet života kod takve osobe i dovodi do umanjenja nivoa fizičke aktivnosti. Povrede kolenog zgloba čine 5% ukupnog broja najtežih akutnih sportskih povreda. Cilj ovog istraživanja bio je da se utvrdi snaga mišića natkolenice kod osoba sa jednostranom rupturom LCA, kao i razlika snage mišića između zdrave i povređene noge. Metode. U istraživanje je bilo uključeno 114 muškaraca, aktivnih sportista, različitih sportskih disciplina, sa kliničkom dijagnozom rupture LCA. Kod svakog ispitanika postojala je ruptura LCA na jednom kolenu, tako da je zdrava noga predstavljala kontrolnu grupu u ovom istraživanju. Pomoću izokinetičkog aparata merili smo snagu mišića natkolenice i to za dve test brzine, 60º/s and 180º/s. Rezultati. Utvrđena je statistički značajna razlika (p < 0,01) između zdrave i povređene noge i to za merene parametre: maksimalni obrtni moment za bedrene ekstenzore (Ptrq_E), maksimalni iznos ugla ekstenzije (Ang_E), snaga ekstenzije (Pow_E) i rad tokom ekstenzije (Work_E). Za odnos mišići zadnje lože/kvadriceps (H/Q) utvrdili smo da postoji izražen disbalans u mišićnoj snazi kod povređene noge. Zaključak. Postoji visok stepen vrednosti izokinetičke dinamometrije kao metode za određivanje snage mišića natkolenice. Ovu oblast potrebno je dodatno istraživati u cilju unapređenja kako dijagnostike, tako i rehabilitacionih programa kod osoba sa insuficijencijom LCA.

Reference

Bahr R, Mæhlum S. Clinical Guide to Sport Injuries. Champaign, IL: Human Kinetics; 2004.

Bellabarba C, Bush-Joseph CA, Bach BR. Patterns of meniscal injury in the anterior cruciate-deficient knee: a review of the literature. Am J Orthop (Belle Mead NJ) 1997; 26(1): 18−23.

Serpas F, Yanagawa T, Pandy M. Forward-dynamics simulation of anterior cruciate ligament forces developed during isokinetic dynamometry. Comput Methods Biomech Biomed Engin 2002; 5(1): 33−43.

Dvir Z. Isokinetics. Muscle testing, Interpretations and Clinical applications, 2nd ed. Edinburgh: Churchill Livingstone; 2004.

Hendrich V. Diagnosis of fresh combined injuries of the knee ligaments (clinical and technical diagnosis). Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir 1989: 415−9. (German)

Noesberger B. Diagnosis of acute tears of the anterior cruciate ligament, and the clinical features of chronic anterior instability. In: Jacob RP, Staubli H, editors. The knee and the cruciate ligaments. Berlin, Heidelberg, New York, London, Paris: Springer − Verlag; 1992. p. 143−56.

Falchook FS, Tigges S, Carpenter WA, Branch TP, Stiles RG. Accuracy of direct signs of tears of the anterior cruciate ligament. Can Assoc Radiol J 1996; 47(2): 114−20.

Sanchis-Alfonso V, Martinez-Sanjuan V, Gastaldi-Orquin E. The value of MRI in the evaluation of the ACL deficient knee and in the post-operative evaluation after ACL reconstruction. Eur J Radiol 1993; 16(2): 126−30.

Andrade MS, Cohen M, Piçarro IC, Silva AC. Knee performance after anterior cruciate ligament reconstruction. Isokinet Exerc Sci 2002; 10(2): 81–6.

Cardone C, Menegassi Z, Emygdio R. Isokinetic assessment of muscle strength following anterior cruciate ligament reconstruction. Isokinet Exerc Sci 2004; 12(3): 173−7.

Porter GK, Kaminski TW. Knee angle does not affect ankle eversion to inversion peak torque ratios derived from an isokinetic dynamometer. Isokinet Exerc Sci 2004; 12(2): 99−104.

Sykaras E, Mylonas A, Malliaropoulos N, Zakas A, Papacostas E. Manual massage effect in knee extensors peak torque during short - term intense continuous concentric - eccentric isokinetic exercise in female elite athletes. Isokinet Exerc Sci 2003;11(3): 153−7.

Lund H, Søndergaard K, Zachariassen T, Christensen R, Bülow P, Henriksen M, et al. Learning effect of isokinetic measurements in healthy subjects, and reliability and comparability of Biodex and Lido dynamometers. Clin Physiol Funct Imag 2005; 25(2): 75−82.

Johnson D. Controlling anterior shear during isokinetic knee extension exercise. J Orthop Sports Phys Ther 1982; 4(1): 23–31.

Strauss GR, Bozikovic AJ, Jones GL, Neale GC, Spittles MR, Boyle JJ. Knee extensor strength 12 and 18 weeks post anterior cruciate ligament reconstruction. Isokinet Exerc Sci 1998; 7(1): 19−26.

Beynnon BD, Johnson RJ, Abate JA, Fleming BC, Nichols CE. Treatment of anterior cruciate ligament injuries. Part I. Am J Sports Med 2005; 33(10): 1579−602.

Andersen LL, Magnusson S, Nielsen M, Haleem J, Poulsen K, Aa-gaard P. Neuromuscular activation in conventional therapeutic exercises and heavy resistance exercises: implications for reha-bilitation. Phys Ther 2006; 86(5): 683−97.

Burkett LN, Alvar B, Irvin J. Determining the optimal knee angle for testing maximal isometric hamstring peak torque on an isokinetic dynamometer. Int Sports J 2001; 6: 171−5.

Calmels P, van den Borne I, Nellen M, Domenach M, Minaire P, Drost M. A pilot study of knee isokinetic strength in young, highly trained, female gymnasts. Isokinet Exerc Sci 1995; 5(1): 69−74.

Capranica L, Cama G, Fanton F, Tessitore A, Figura F. Force and power of preferred and nonpreferred leg in young soccer players. J Sports Med Phys Fitness 1992; 32(4): 358−63.

Brady EC, O'Regan M, Mccormak B. Isokinetic assessment of uninjured soccer players. In: Reilly T, Clarys J, Stibbe A, editors. StibbeScience and football. London: Spon; 1993.

Caine DJ, Caine CG, Lindner KJ. Epidemiology of sport injuries. Champaign, IL: Human Kinetics; 1996.

Heitkamp HC, Fleck M, Mayer F, Horstmann T, Dickhuth HH. Balance training in male and female judokas: Gain in strength. Isokinet Exerc Sci 2002; 10(1): 64−73.

Imamura RT, Hreljac A, Escamilla RF, Edwards WB. A three-dimensional analysis of the center of mass for three different judo throwing techniques. J Sports Sci Med 2006; 5(CSSI): 122−31.

Almosnino S, Brandon SC, Day AG, Stevenson JM, Dvir Z, Bardana DD. Principal component modeling of isokinetic moment curves for discriminating between the injured and healthy knees of unilateral ACL deficient patients. J Electromyogr Kinesiol 2014; 24(1): 134−43.

Grace TG, Sweetser ER, Nelson MA, Ydens LR, Skipper BJ. Isokinetic muscle imbalance and knee joint injuries. A perspective blind study. J Bone Joint Surg Am 1984; 66(5): 734−40.

de Jong SN, van Caspel DR, van Haeff MJ, Saris DB. Functional assessment and muscle strength before and after reconstruction of chronic anterior cruciate ligament lesions. Arthroscopy 2007; 23(1): 21−8.

Dvir Z, Eger G, Halperin N, Shklar A. Thigh muscle activity and anterior cruciate ligament insufficiency. Clin Biomech 1989; 4(2): 87−91.

Bonamo JJ, Fay C, Firestone T. The conservative treatment of the anterior cruciate deficient knee. Am I Sports Med 1990; 168(6): 618–23.

Akima H, Takahashi H, Kuno S, Katsuta S. Coactivation pattern in human quadriceps during isokinetic knee-extension by muscle functional MRI. Eur J Appl Physiol 2004; 91(1): 7−14.

Sbriccoli P, Solomonow M, Zhou B, Lu Y, Sellards R. Neuromuscular response to cyclic loading of the anterior cruciate ligament. Am J Sports Med 2005; 33(4): 543−51.

Zemach L, Almoznino S, Barak Y, Dvir Z. Quadriceps insufficiency in patients with knee compromise: How many velocities should an isokinetic test protocol consist of? Isokinet Exerc Sci 2009; 17(2): 129−33.

Tsuda E, Okamura Y, Otsuka H, Komatsu T, Tokuya S. Direct evidence of the anterior cruciate ligament-hamstring reflex arc in humans. Am J Sports Med 2001; 29(1): 83−7.

Olmo J, Castilla N. Explosive strength - related isokinetic parameters in high - level sprinters and long - distance runners: The relative power index. Isokinet Exerc Sci 2005; 13(4): 243-9.

Scoville CR, Arciero RA, Taylor DC, Stoneman PD. End Range Eccentric Antagonist/Concentric Agonist Strength Ratios: A New Perspective in Shoulder Strength Assessment. J Orthop Sports Phys Ther 1997; 25(3): 203−7.

Aagaard P, Simonsen EB, Magnusson SP, Larsson B, Dyhre-Poulsen P. A new concept for isokinetic hamstring: quadriceps muscle strength ratio. Am J Sports Med 1998; 26(2): 231−7.

Ikeda H, Kurosawa H, Kim S. Quadriceps torque curve pattern in patients with anterior cruciate ligament injury. Int Orthop 2002; 26(6): 374−6.

Almosnino S, Stevenson JM, Day AG, Bardana DD, Diaconescu ED, Dvir Z. Differentiating between types and levels of isokinetic knee musculature efforts. J Electromyogr Kinesiol 2011; 21(6): 974−81.

Objavljeno
2017/03/20
Broj časopisa
Vol. 73 Br. 7 (2016)
Rubrika
Originalni članak