Research background and hypothesis. Proprioception is important in the prevention of injuries as reduced proprioception is one of the factors contributing to injury in the knee joint, particularly the ACL. Therefore, proprioception appears not only important for the prevention of ACL injuries, but also for regaining full function after ACL reconstruction.Research aim. The aim of this study was to understand how proprioception is recovered four and five months after anterior cruciate ligament (ACL) reconstruction.Research methods. The study included 15 male subjects (age – 33.7 ± 2.49 years) who had undergone unilateral ACL reconstruction with a semitendinosus/gracilis (STG) graft in Kaunas Clinical Hospital. For proprioceptive assessment, joint position sense (JPS) was measured on both legs using an isokinetic dynamometer (Biodex), at knee flexion of 60° and 70°, and at different knee angular velocities of 2°/s and 10°/s. The patients were assessed preoperatively and after 4 and 5 months, postoperatively.Research results. Our study has shown that the JPS’s (joint position sense) error scores to a controlled active movement is significantly higher in injured ACL-deficient knee than in the contralateral knee (normal knee) before surgery and after four and five months of rehabilitation. After 4 and 5 months of rehabilitation we found significantly lower values in injured knees compared to the preoperative data. Our study has shown that in injured knee active angle reproduction errors after 4 and 5 months of rehabilitation were higher compared with the ones of the uninjured knee. Proprioceptive ability on the both legs was independent of all differences angles for target and starting position for movement. The knee joint position sense on both legs depends upon the rate of two different angular velocities and the mean active angle reproduction errors at the test of angular velocity slow speed was the highest compared with the fast angular velocity. Discussion and conclusions. In conclusion, our study shows that there was improvement in mean JPS 4 and 5 months after ACL reconstruction, but it did not return to normal indices.
Santykiškai didesnis raumenų susitraukimo jėgos sumažėjimas stimuliuojant raumenį mažais nei dideliais dažniais vadinamas mažų dažnių nuovargiu (MDN). Galimos šios MDN priežastys: raumeninės skaidulos sarkomerų ir elas-tinių komponentų irimas bei sumažėjęs iš sarkoplazminio tinklo išmetamų Ca 2+ kiekis. Nėra vienodos nuomonės dėl įvairių metabolitų poveikio raumenų susitraukimo funkcijai.Tyrimo tikslas — nustatyti adenozintrifosfato (ATP), fosfokreatino (PCr) ir neorganinio fosfato (P i ) poveikį priekinio blauzdos raumens mažų dažnių nuovargiui išemijos sąlygomis.Eksperimento metu buvo tiriami sveiki nesportuojantys 24—32 metų amžiaus vyrai (n = 10). Tiriamųjų raumuo iš-eminėmis sąlygomis vieną minutę buvo stimuliuojamas elektra (ES) tokiu dažniu, kuris sukelia 50% maksimaliosios raumens susitraukimo jėgos dydį. Registruoti rodikliai: priekinio blauzdos raumens susitraukimo jėga, sukelta 1, 15, 50 ir 100 Hz dažnio elektros stimuliavimu, bei ATP, PCr, P i koncentracija, nustatyta naudojant spektrometrą (Vi-vospec, Otsuka Elektronics, Fort Collins, Co) ir superlaidų horizontalų branduolių magnetinio rezonanso magnetą. Magneto galingumas — 2,9 T, cilindro skersmuo — 31 cm. Iš P i ir PCr koncentracijos pokyčių skirtumo nustatytas raumenų pH. Pagal 15 / 50 Hz stimuliavimo raumens susitraukimo jėgos santykio pokytį buvo vertinamas mažų dažnių nuovargis. Tyrimo rezultatai parodė, kad metabolinio nuovargio metu mažėjo visais (1—100 Hz) stimuliavimo dažniais sukelta priekinio blauzdos raumens susitraukimo jėga (p < 0,05). MDN tuoj po ES buvo mažas, tačiau reikšmingai padi-dėjo praėjus 24 valandoms po stimuliavimo (p < 0,05), kai tuo tarpu metaboliniai pokyčiai išnyko per 30 minučių po stimuliavimo. ATP koncentracija eksperimento metu nepakito. Išvada: po 1 minutės priekinio blauzdos raumens stimuliavimo išeminėmis sąlygomis PCr ir P i koncentracijos pokyčiai tiesioginio poveikio mažų dažnių nuovargiui neturėjo.
Kuris iš fenomenų — raumenų nuovargis ar postaktyvacinė potenciacija (PAP) — bus vyraujantis, priklauso nuo fi zinio krūvio tipo, intensyvumo, trukmės ir poilsio laiko tarp stimulų trukmės. Žinoma, kad PAP silpnėja mažėjant fi zinio krūvio intensyvumui, tačiau kaip PAP ir nuovargis veikia griaučių raumenų savybes atliekant skirtingo intensyvumo, bet tokios pačios apimties darbą, nėra aišku. Todėl svarbu nustatyti PAP ir nuovargio poreiškį atlikus 30 s maksimalųjį ir 60 s submaksimalųjį, bet tokios pačios apimties nenutrūkstamą krūvį.Buvo tiriami sveiki aktyviai nesportuojantys vyrai (amžius 23—27 m., svoris — 83,5 ± 5,4 kg) (n = 11). Tiriamieji atliko 30 s maksimalųjį (MVC-30 s) ir 60 s submaksimalųjį krūvį, t. y. naudodami 50% pastangų (50% MVC-60 s) koją tiesė per kelio sąnarį. Darytina prielaida, kad abiejų krūvių metu atlikto darbo apimtis buvo vienoda. Krūviai atlikti atsitiktine tvarka. Keturgalvio šlaunies raumens susitraukimo jėga, sukelta 1 (P 1), 10 (P 10), 20 (P 20) ir 50 (P 50) Hz stimuliavimo dažniu, raumens susitraukimo (CT) ir atsipalaidavimo iki pusės jėgos P 1 (½ RT) trukmė ir EMG rms buvo registruojami iš karto atlikus krūvį (0 min) ir praėjus 1, 2 ir 3 min po jo. P 1 jėga užregistruota iš karto po (0 min) ir praėjus 1 min po MVC-30 s krūvio buvo didesnė, lyginant su reikšmėmis po 50% MVC-60 s krūvio (p < 0,05). P 1 susitraukimo laikas (CT) nepakito per 3 min atsigavimo laikotarpį, tačiau P 1 atsipalaidavimo iki pusės jėgos (1/2 RT) trukmė labiau pailgėjo iš karto po 50% MVC-60 s nei po MVC-30 s krūvio (p < 0,05). Iškart po MVC-30 s krūvio (0 min) ir praėjus 1 min P 10 jėga po buvo reikšmingai didesnė (p < 0,05), palyginti su 50% MVC-60 s. Jokio skirtumo tarp MVC-30 s ir 50% MVC-60 s krūvių nenustatyta stimuliuojant raumenis dideliais stimuliavimo dažniams, testuojant MVJ ir EMG rms atsigavimo metu. Postaktyvacinės potenciacijos ir nuovargio sąveika atliekant tokios pačios apimties fizinį krūvį, priklauso nuo krūvių intensyvumo. Kuo intensyviau atliekamas fi zinis krūvis, tuo labiau potenciacija paslepia nuovargį iškart atlikus krūvį. Atlikus submaksimalų fi zinį krūvį potenciacija labiau išryškėja per atsigavimo laikotarpį.
There is a lack of equipment and methods for the reliable and valid measurements of human neuromuscular control. To overcome this limitation, an analyzer of dynamic parameters (DPA-1) of human hand and leg movements was constructed by Kaunas University of Technology and "Katra" engineers in collaboration with the Lithuanian Academy of Physical Education. The aim of the study was to determine the reliability and validity of the tests performed on the DPA-1 in healthy and injured subjects after the anterior cruciate ligament (ACL) reconstruction surgery.Material and Methods. The men who had undergone a unilateral ACL reconstruction (n=17, on the average 3.8 months [SD, 2.1] after the surgery) and healthy untrained men (n=17) performed the research protocol twice within 24 hours in between. Average reaction time, mean and maximal movement speed, time to reach maximal speed, and movement distance of the right and left feet for the patients and of the dominant foot for the healthy subjects using the DPA-1 as well as the scores of isokinetic muscle strength and self-assessment tests were registered.Results. There was a significantly reduced concentric peak torque on the injured knee compared with the uninjured knee during knee extension, and the mean score of the Lysholm scale for the injured knee was 69.1 (SD, 13.7) (P<0.05, compared between legs). The test-retest reliability for all the DPA-1 tests varied from 0.68 to 0.94 (P<0.05). However, there were no significant differences in most variables measured by the DPA-1 between injured knee, uninjured knee, and control knee.Conclusions. The results revealed low validity of the DPA-1 tests for the evaluation of patients following ACL surgery, despite the reliability of these tests varied from moderate to very high.Correspondence to S. Kamandulis, Sports and Movement Science Centre, Lithuanian Academy of Physical Education, Sporto 6,
Research background and hypothesis. The Anterior cruciate ligament (ACL) is the most commonly injured ligament of the knee and its injuries result in significant functional impairment. Injury to the ACL is associated with altered knee joint loading and impaired neuromuscular control, which defined as the ability to produce well controlled movements and dynamic balance.Research aim. The aim of this study was to evaluate motor coordination and functional capacity of patients who received rehabilitation program following ACL reconstruction.Research methods. The study included 15 males aged 33.7 ± 2.49 years who had undergone unilateral ACL reconstruction with a semitendinosus/gracilis (STG) graft in Kaunas Clinical hospital. For objective functional testing, we used figure-of-eight movement coordination test. The Lysholm questionnaire was included as a disability outcome measure following ACL injury and reconstruction. The patients were assessed preoperatively and after 5 and 21weeks postoperatively.Research results. The results of this study indicated that motor coordination timescale showed significant differences (p < 0.05) between the injured and the healthy legs before surgery and after 5 and 21 weeks. The movement coordination test data showed that there the timescale significantly longer on the injured knee compared with the noninjured knee. After 21 weeks of rehabilitation we found significantly lower (p < 0.05) values in injured knees compared with the preoperative data. In injured knee the timescale after 21 weeks of rehabilitation was significantly (p < 0.05) longer compared with noninjured knee.The Lysholm questionnaire scale indicated that there was a significant difference in the results for values (p < 0.05) before surgery and after 21 weeks of rehabilitation. The questionnaire scale data showed that after 21 weeks of rehabilitation results for values was significantly (p < 0.05) highest compared with before surgery and after 5 weeks.Discussion and conclusions. There was improvement in the injured leg in mean motor coordination timescale 21 weeks after ACL reconstruction, but the timescale was higher than in the uninjured leg. After 21 weeks of ACL reconstruction knee functional status in most patients was good or excellent.
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