Wpływ stopniowanego treningu chodzenia tyłem na bieżni na siłę i masę mięśnia czworogłowego uda oraz jakość życia po rekonstrukcji więzadła krzyżowego przedniego: randomizowane badanie kontrolowane

Diker Dev Joshi, Vikram Shetty, Pravin Aaron, Dhanesh Kumar KU

Diker Dev Joshi, Vikram Shetty, Pravin Aaron, Dhanesh Kumar KU – Effects of graded backward treadmill training on quadriceps strength, quadriceps muscle mass, and quality of life after anterior cruciate ligament reconstruction: a randomized controlled trial –  Fizjoterapia Polska 2025; 25(5); 18-25

DOI: https://doi.org/10.56984/8ZGA431Z4K7

Streszczenie
Wprowadzenie. Rekonstrukcja więzadła krzyżowego przedniego (ACL) często wiąże się z utrzymującym się osłabieniem mięśnia czworogłowego uda oraz obniżeniem jakości życia. Stopniowany trening chodzenia tyłem na bieżni mechanicznej jest postrzegany jako obiecująca interwencja wspomagająca rehabilitację nerwowo-mięśniową.
Cel. Ocena wpływu stopniowanego treningu chodzenia tyłem na bieżni na siłę mięśnia czworogłowego uda, jego masę mięśniową oraz jakość życia u osób po rekonstrukcji ACL.
Materiał i metody. W badaniu uczestniczyło 60 osób (w wieku 18–45 lat) po rekonstrukcji ACL z wykorzystaniem przeszczepu z mięśnia półścięgnistego, które losowo przydzielono do pięciu grup (A–E; n = 12 w każdej grupie). Grupy A–D realizowały trening chodzenia tyłem na bieżni przy nachyleniu odpowiednio 0°, 5°, 10° i 15°. Grupa E stanowiła grupę kontrolną i uczestniczyła w standardowym programie rehabilitacji. Trening prowadzono przez 20 minut na sesję, trzy razy w tygodniu, przez cztery tygodnie. Oceniano siłę mięśnia czworogłowego (za pomocą dynamometru), masę mięśniową (badanie ultrasonograficzne) oraz jakość życia (kwestionariusze IKDC i ACL-QOL). Analizę statystyczną przeprowadzono z wykorzystaniem analizy wariancji (ANOVA) oraz testów nieparametrycznych.
Wyniki. We wszystkich grupach odnotowano poprawę siły mięśnia czworogłowego, jego masy oraz jakości życia po zakończeniu interwencji. Największy średni przyrost siły mięśniowej zaobserwowano w grupie B, natomiast grupa D wykazała największe zwiększenie masy mięśniowej oraz najwyższą poprawę wyników jakości życia. Istotne różnice między grupami stwierdzono na etapie badania wyjściowego w zakresie siły mięśniowej (p < 0,001) oraz w badaniu końcowym w odniesieniu do masy mięśniowej ocenianej ultrasonograficznie (p = 0,010), wyników IKDC (p = 0,033) oraz ACL-QOL (p = 0,016).
Dyskusja. Wyniki badania wskazują, że trening chodzenia tyłem na bieżni prowadzi do poprawy siły i masy mięśnia czworogłowego uda oraz jakości życia niezależnie od zastosowanego nachylenia. Największe przyrosty siły w grupie B sugerują, że umiarkowane nachylenie może być optymalne dla zwiększania zdolności generowania siły mięśniowej, natomiast wyraźniejsze zmiany masy mięśniowej i jakości życia w grupie D wskazują, że większe nachylenia mogą sprzyjać hipertrofii mięśniowej oraz poprawie funkcjonowania psychospołecznego.
Wnioski. Stopniowany trening chodzenia tyłem na bieżni po rekonstrukcji ACL istotnie poprawia masę mięśnia czworogłowego uda oraz jakość życia, przy czym większe nachylenia wykazują silniejsze działanie. Konieczne są dalsze badania w celu oceny długoterminowych efektów oraz określenia optymalnych parametrów treningu.
Słowa kluczowe
więzadło krzyżowe przednie, chodzenie tyłem na bieżni, rehabilitacja, siła mięśnia czworogłowego uda, jakość życia
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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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使用Lysholm量表评估前后手术期物理治疗对前交叉韧带重建患者功能恢复的影响

Sebastian Zduński, Witold Rongies

S. Zduński, W. Rongies – Evaluation of pre and post operative physiotherapy using the Lysholm scale on functional Outcomes in Patients undergoing Anterior Cruciate Ligament Reconstruction. Fizjoterapia Polska 2020; 20(1); 130-143

DOI: https://doi.org/10.56984/8ZG078S84

摘要

背景。 大多数前交叉韧带(ACL)损伤需要手术和物理治疗。决定物理治疗成功的一个重要因素是患者在ACL重建手术前就已达到最佳功能状态。

材料与方法。 研究共纳入72名随机入组的患者,他们均被诊断为前交叉韧带完全断裂并被确定适合手术重建。实验组包括37名患者,年龄在18至60岁之间(平均年龄37 ±10.3岁)。所有实验组患者在手术前的4周内接受了一套基于既定康复实践的物理治疗方案。对照组包括35名患者,年龄在18至60岁之间(平均年龄34 ±10.0岁),他们未接受任何术前物理治疗。

结果。 在第二次评估时,与基线相比,实验组和对照组的Lysholm评分均有显著提高(p < 0.05)。实验组的Lysholm-Gillquist评分优于对照组。在手术后第6周和第12周,实验组和对照组在Lysholm功能性膝关节评分上存在统计学显著差异(p < 0.05)。

结论。

  1. 在前交叉韧带完全断裂的患者中,术前物理治疗是一个重要且有益的因素,有助于在ACL重建前改善膝关节功能。
  2. 手术后,两组患者的Lysholm评分(用于评估功能性膝关节)均证实了手术和物理治疗方案的有效性。

关键词:
膝关节, 前交叉韧带, Lysholm-Gillquist量表

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Characteristic of the anterolateral ligament of the knee and its correlation with trauma of the anterior cruciate ligament in athletes

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

Abstract

Traumas of the anterior cruciate ligament (ACL) are the most common injuries of a knee joint in athletes. We diagnose them by specific clinical tests – Lachman test, anterior drawer test, pivot-shift test and additional imaging studies. Form of the treatment is to reconstruct the ligament with a graft taken muscle. After treatment, there is still a problem with the rotational instability. Only 60% of the athletes returned to pre-injury form. This is due to anterolateral ligament (ALL) of knee. It is a ligament that occurs in approximately 95% of the population. It’s located on the anterolateral side of the knee joint which connects the femur with the tibia bone, it is responsible for rotational stability of the knee, especially when bent knee (30-90 deg) and it`s supports the function of the ACL. ALL trauma that may be asymptomatic, they can imply subsequently breaking of the ACL. However, when ACL is ruptured, almost always the ALL is damaged too. Ruptures and damages of ALL have a connection with Segond fractures. Undetected damage of ALL causes treatment failure of the anterior cruciate ligament injuries. It should be taken into consideration that with concomitant ACL and ALL injuries conservative treatment of damaged ALL is enough for treatment and rehabilitation success or if reconstruction of the ALL also necessary. The aim of the study is to highlight the widespread problem of knee injuries in athletes and how they should be treated so it will lead to full recovery of the competitor and his/her faster return to the game.

Key words:
knee joint, anterolateral ligament of the knee, anterior cruciate ligament, characteristic, trauma

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