The atteration of the value of muscle forces in the programme of physiotherapy after the reconstruction of anterior cruciate ligaments

Andrzej Czamara

Andrzej Czamara – The atteration of the value of muscle forces in the programme of physiotherapy after the reconstruction of anterior cruciate ligaments. Fizjoterapia Polska 2002; 2(4); 263-272

Abstract
Introduction. The aim of this research was the analysis of the alteration of the value of forces of the extensors and flexors of knee joints in the 13th week and the 6th month of physiotherapy of the patients after the reconstruction of anterior cruciate ligaments. Material and method. The research involved 46 patients, 25 of whom were women. 39 patients, 19 of whom were women, who had undergone at least a six-month physiotherapy were qualified for the analysis of the alteration of the value of forces. The author offered a four-step physiotherapy programme. In the 13th week and then at the beginning of the 6th month the moment of forces was measured and the analysis of the balance of the moment of forces of the flexors to extensors of knee joints was made. Results. A statistically essential increase of the moment of forces of traumatic limbs, both in a group of men and women, was reached in the 6th month as compared to the 13th week of physiotherapy. No statistically important differences were noted in a men’s group at the beginning of the 6th month. The results in the traumatic limbs were comparable the value of the moment of forces of healthy limbs. At the same time a women’s group got, in the traumatic limbs, about 80-90% of the value of the moment of forces of the muscle groups of healthy limbs. Some essential statistic differences were noted. The value of the balance of the moments of forces of the operated limbs’ muscles altered approaching in the 6th month the values of healthy limbs. Conclusions. The increase of the mean value of the moment of forces in traumatic limbs was reached in the treated groups. The dynamics of the increase of the value of the moment of forces proved better in men. It appears that the analysis of the changes of balance of flexors to extensors may prove useful in the monitoring of the process of physiotherapy.

Key words:
Anterior Cruciate Ligament, physiotherapy, moment of forces

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The usefulness of kinesitherapy in the process of rehabilitation following surgical reconstruction of the anterior cruciate ligament: a comparative analysis of exercise methods in open and closed kinematic chains

Wojciech Hagner

Wojciech Hagner – The usefulness of kinesitherapy in the process of rehabilitation following surgical reconstruction of the anterior cruciate ligament: a comparative analysis of exercise methods in open and closed kinematic chains. Fizjoterapia Polska 2003; 3(1); 1-7

Abstract
Background. Damage to the ligamental and capsular apparatus of the knee, especially the anterior cruciate ligament (ACL), leads to instability of the knee, manifesting functionally as unsatisfactory joint coordination and slippage of the plateau of the tibia. The choice of treatment should be dictated by the extent of damage incurred by the knee and the patient’s age and degree of physical activity. Surgical reconstruction of the ACL restores joint coordination, but the final outcome is largely determined by post-surgical kinesitherapy. In planning the rehabilitation program after surgical reconstruction of the ACL, it is necessary to bear in mind the impact exercises will have on knee stability, as well as on the work and load of the passive and dynamic stabilizers of the knee.Material and methods. In this article the effects of exercises in systems based on open and closed kinematic chains are subjected to statistical analysis, as well as the impact of such exercises on the relative movements of the individual structural elements of the knee.Conclusions. The results of the present study showed that kinesitherapy in open and closed kinematic chains has a positive impact on rehabilitation outcome after ACL reconstruction, while the decisive factor is the skillful combination of exercises from both types of kinematic chain.

Key words:
Anterior Cruciate Ligament, kinesitherapy, open kinematic chain, closed kinematic chain

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Assessment of the effectiveness of selected physical therapy procedures in the early post-operative period fol łowing ACL surgery. Pilot study

Anna Polak, Ewa Grymel-Kulesza, Janusz Kubacki, Piotr Król

Anna Polak, Ewa Grymel-Kulesza, Janusz Kubacki, Piotr Król – Assessment of the effectiveness of selected physical therapy procedures in the early post-operative period fol łowing ACL surgery. Pilot study. Fizjoterapia Polska 2010; 10(1); 12-24

Abstract
Background. The study aimed to assess the effectiveness ofa therapeutic regimen combining kinesiotherapy, cryotherapy and electrical stimulation in patients with a surgically treated anterior cruciate ligament (ACL). Materials and methods. Twenty-four patients with reconstructed ACL participated in the study. The patients were randomly divided into Groups A and B, each group containing 12 indMduals. Both groups received kinesiotherapy and cryotherapy according to the same programme, but Group B additionally received electrical stimulation. A therapeutic cycle comprised kinesiotherapy, cryotherapy and electrical stimulation procedures, ten of each kind. Sessions took place three times a week. The progress of healing in the patients was followed by assessing passive and active flexion at the knee, measuring the knee-joint circumference and load-testing of the limb.Results. After the treatment, both groups showed statistically significant improvements in flexion of the knee joint and reduced swelling of the joint. The leg-loading test performed after the treatment provided statistically significant improvement compared to pre-treatment data in both groups. No statistically significant differences were found between the two groups regarding treatment effectiveness.Conclusions. A combination of kinesiotherapy and cryotherapy is an effective adjunct to the treatment of patients with a surgically treated anterior cruciate ligament. The introduction of electrical stimulation did not offer additional therapeutic benefits.
Słowa kluczowe
anterior cruciate ligament, ACL, kinesiotherapy, cryotherapy, electrical stimulation
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Sensibility disorders after ACL reconstruction with BTB graft

Dariusz Grela, Anna Morawik

Dariusz Grela, Anna Morawik – Sensibility disorders after ACL reconstruction with BTB graft. Fizjoterapia Polska 2010; 10(4); 299-306

Abstract
Background. The purpose of the research was to analyse data concerning superficial sensibility disorders on the lateral side of knee joint occurring after reconstruction of anterior cruciate ligament (ACL) with bone-tendon-bone (BTB) graft.
The research was mainly to find out the span of time after which ailments of this type subsided.
Material and methods. The research was carried out among 137 patients who underwent ACL reconstruction with BTB. They were asked to fill in question naires after 3, 4, 5, 6, 12, 18 and 24 months after the surgery. Questions were to find out information about the region of sensibility disorders, current quality of the disorders and the time span after which the disorders sustained.
Results. Patients after anterior cruciate ligament reconstruction with a graft taken from patellar tendon report sensibility disorders on the lateral side of the knee joint below the patella on the level of the scar. Most often these ailments subside after 12-18 months after the surgery. Superficial sensibility was back after 4 months at the earliest.
Conclusions. In case of most patients, superficial sensibility in the discussed region was fully restored. This allows to state that the examined disorders are temporary. Before a patient regains normal sensibility, many procedures in physiotherapy of the region we are discussing should be applied very carefully.
Key words:
sensation disorders, nerve regeneration, anterior cruciate ligament
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Charakterystyka więzadła przedniobocznego stawu kolanowego oraz jego korelacja z urazami więzadła krzyżowego przedniego u sportowców

Patrycja Szkutnik, Marcin Domżalski

P. Szkutnik, M. Domżalski: Characteristic of the anterolateral ligament of the knee and its correlation with trauma of the anterior cruciate ligament in athletes. FP 2015; 15(4); 74-81

Streszczenie
Urazy więzadła krzyżowego przedniego (ACL) są najczęstszymi urazami stawu kolanowego u sportowców. Diagnozujemy je specyficznymi testami klinicznymi – test Lachmana, szuflady przedniej, pivot-shift oraz dodatkowymi badaniami obrazowymi. Formą leczenia jest rekonstrukcja więzadła z pobranego przeszczepu mięśniowego. Po leczeniu wciąż pojawia się problem z niestabilnością rotacyjną. Tylko 60% sportowców wraca do formy sprzed urazu. Ma to związek z więzadłem przedniobocznym stawu kolanowego (ALL). Jest to więzadło występujące u ok. 95% populacji. Znajduje się na przedniobocznej stronie stawu kolanowego łącząc kość udową z kością piszczelową. Odpowiada za stabilność rotacyjną kolana, szczególnie przy zgiętym kolanie (30-90o), wspomaga funkcję więzadła ACL. Uszkodzenia ALL, które mogą być bezobjawowe, mogą prognozować następowe zerwanie ACL. Natomiast przy zerwaniach więzadła ACL prawie zawsze jest uszkodzone więzadło ALL. Zerwania i uszkodzenia więzadła ALL wykazują związek ze złamaniami Segonda. Niewykryte uszkodzenia ALL powodują niepowodzenia leczenia urazów więzadła krzyżowego przedniego. Należy zastanowić się czy przy współistniejących urazach ACL i ALL wystarczyłoby leczenie zachowawcze uszkodzonego więzadła ALL, aby leczenie i rehabilitacja zakończyły się sukcesem, czy konieczna jest również rekonstrukcja więzadła ALL. Celem publikacji jest zwrócenie uwagi na powszechny problem urazów stawu kolanowego u sportowców i sposób ich leczenia, które doprowadzą do pełnego wyzdrowienia zawodnika oraz jego szybszy powrót do gry.

Słowa kluczowe:
staw kolanowy, więzadło przednioboczne kolana, więzadło krzyżowe przednie, charakterystyka, uraz

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