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The injured anterior cruciate ligament and neuromuscular rehabilitation

Zätterström, Rose LU (1999)
Abstract (Swedish)
Popular Abstract in Swedish

Två studier av icke-operativa behandlingsmetoder på patienter med främre korsbandsskada, redovisade i sex artiklar : 26 patienter med icke-akuta skador ingick i den första studien. Före träningen hade patienterna symtom med vikningar av knäet, svaghet i knäets sträckmuskulatur , nedsatt fysisk aktivitet och försämrad balans vid test stående på ett ben. Patienterna slumpades till knämuskelstärkande rörelser (Q -träning) eller till funktionell träning(F-träning) bestående av funktionella belastade rörelser. Efter 3 månaders träning hade alla muskelvärden förbättrats signifikant i båda grupperna utan skillnad mellan grupperna utom statisk knästräckning som var signifikant bättre i Q-gruppen.... (More)
Popular Abstract in Swedish

Två studier av icke-operativa behandlingsmetoder på patienter med främre korsbandsskada, redovisade i sex artiklar : 26 patienter med icke-akuta skador ingick i den första studien. Före träningen hade patienterna symtom med vikningar av knäet, svaghet i knäets sträckmuskulatur , nedsatt fysisk aktivitet och försämrad balans vid test stående på ett ben. Patienterna slumpades till knämuskelstärkande rörelser (Q -träning) eller till funktionell träning(F-träning) bestående av funktionella belastade rörelser. Efter 3 månaders träning hade alla muskelvärden förbättrats signifikant i båda grupperna utan skillnad mellan grupperna utom statisk knästräckning som var signifikant bättre i Q-gruppen. Träningen fortsatte ytterligare 3 månader då alla tränade funktionellt. Balansen normaliserades i det friska benet efter 3 månader och i det skadade benet efter 12 månader och kvarstod efter 36 månader. Vid 12 och 36 månader undersöktes de statiska muskelvärdena och kvarstod i knästräckning vid 36 månader. I Lysholms knee-score hade 21 av de 22 patienterna som deltog vid 36 månaders uppföljnijngen > 83 vilket innebar good/excellent som resultat. I studie nummer två ingick 100 patienter med akut främre korsbandsskada som artroskoperades inom 10 dagar efter skadan. 18 patienter hade isolerade skador, 82 patienter hade komplexa skador. 53 av patienterna slumpades till övervakad, (SV) träning under ledning av sjukgymnast. 47 patienter slumpades till egenträning efter skrivet hemprogram (SM) träning. Uppföljning efter 6 veckor, 3 12 och 36 månader : Studerade variabler: Statisk och dynamisk knä-sträckning och-böjning i Cybex isokinetisk apparat, en-ben längdhopp, Lysholm knee-score och Tegner aktivitetsskala. SV träningen pågick under sjukgymnastisk ledning 2 gånger/ vecka under 5-8 månader. Efter 6 veckor ansågs 50% av de självtränande patienterna i behov av sjukgymnatisk träning och överfördes till SV träning. RESULTAT : Vid 36 månaders uppföljning deltog 85 patienter. Männen i den ursprungliga SV gruppen hade signifikant bättre muskelvärden och hoppvärden än männen som kvarstod i SM gruppen vid 36 månader. Mellan SV männen och de männen som överförts efter 6 veckor fanns inte längre någon skillnad i muskelvärdena. Mellan kvinnorna observerades ingen skillnad beroende på att de flesta kvinnorna överförts till SV träning efter 6 veckor. 8 patienter opererades under uppföljningstiden. Skadans omfattning påverkade muskelvärdena vid 6 veckor och 3 månader men inte senare. Lysholm knee score påverkade resultaten vid 6 veckor och 3 månader men inte senare. Tegner activitetsskala var signifikant lägre vid 36 månader hos de patienter som skadats genom bollidrotter. Hos övriga patienter fanns ingen skillnad mellan aktivitetsnivå före skadan och vid 36 månader. (Less)
Abstract
Two prospective, short-term and long-term consecutive randomized studies on non-surgical treated patients with an ACL injury were performed. None of the patients were athletes on a professional level. Outcome measures : isometric muscle strength and isokinetic musclefunction, one-leg hop test, single limb balance, Lysholm knee score and Tegner activity level. In study number one 26 patients with non-acute ACL injuries, with a late diagnosis of symptomatic anterior cruciate ligament lesion, were examined and randomized to open-chain or closed-chain training for a 3 month period. Short term effect after training: Knee extensors improved significantly in both groups, with significantly higher value in isometric extension in open-chain... (More)
Two prospective, short-term and long-term consecutive randomized studies on non-surgical treated patients with an ACL injury were performed. None of the patients were athletes on a professional level. Outcome measures : isometric muscle strength and isokinetic musclefunction, one-leg hop test, single limb balance, Lysholm knee score and Tegner activity level. In study number one 26 patients with non-acute ACL injuries, with a late diagnosis of symptomatic anterior cruciate ligament lesion, were examined and randomized to open-chain or closed-chain training for a 3 month period. Short term effect after training: Knee extensors improved significantly in both groups, with significantly higher value in isometric extension in open-chain training group,the remaining values with minor differences only. At 3 months standing balance was normalized on the uninjured, but not on the injured side, despite restoration of thigh muscle strength. At 12 months, standing balance was normalized in both legs and persisted at 36 month follow-up. Lysholm knee-score increased significantly during initial 3 months. After 36 months the score was excellent (>83) in 21 out of the 22 remaining patients. Isometric muscle strength values persisted at 36 months. Recreational sports were resumed after training by most patients. 100 patients with acute ACL injury revealed associate lesions in 82% of the cases. Need of supervision in training or not was evaluated, the patients were randomized to supervised or self-monitored training. A transferral of 50% of the SM patients to SV was indicated after 6 weeks, the majority were women. At 36 months isometric muscle strengths and isokinetic work capacity were significantly higher in male patients of original SV group, than in men remaining in the SM group.In transferred male patients recovery was seen with delay in time. In females no differences were observed between groups. Further studies on muscle function after ACL injuries in female patients are required. 85 patients completed the follow-up after 36 months. As part of a joint-protection strategy, restriction of hyperextension was preserved in the majority of cases during the period of follow-up and giving-way events occurred in 5-10% only of the patients during the follow-up. (Less)
Please use this url to cite or link to this publication:
author
opponent
  • Professor Ljunggren, Elisabeth, Bergen University, Bergen; Norway
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Surgery, long-term follow-up, short-term, non-surgical treatment, ACL injury, associated lesions, orthopaedics, traumatology, Kirurgi, ortopedi, traumatologi
pages
124 pages
publisher
PH Lingsväg 11, 224 65 Lund, Sweden,
defense location
University Hospital, the Aula
defense date
1999-05-11 10:15
external identifiers
  • Other:ISRN: LUMEDW/MEPT--1012--SE
ISBN
91-628-3538-6
language
English
LU publication?
yes
id
de6efeab-15bf-48f8-b313-46abe20c2a93 (old id 39653)
date added to LUP
2007-07-31 13:15:49
date last changed
2016-09-19 08:45:10
@misc{de6efeab-15bf-48f8-b313-46abe20c2a93,
  abstract     = {Two prospective, short-term and long-term consecutive randomized studies on non-surgical treated patients with an ACL injury were performed. None of the patients were athletes on a professional level. Outcome measures : isometric muscle strength and isokinetic musclefunction, one-leg hop test, single limb balance, Lysholm knee score and Tegner activity level. In study number one 26 patients with non-acute ACL injuries, with a late diagnosis of symptomatic anterior cruciate ligament lesion, were examined and randomized to open-chain or closed-chain training for a 3 month period. Short term effect after training: Knee extensors improved significantly in both groups, with significantly higher value in isometric extension in open-chain training group,the remaining values with minor differences only. At 3 months standing balance was normalized on the uninjured, but not on the injured side, despite restoration of thigh muscle strength. At 12 months, standing balance was normalized in both legs and persisted at 36 month follow-up. Lysholm knee-score increased significantly during initial 3 months. After 36 months the score was excellent (>83) in 21 out of the 22 remaining patients. Isometric muscle strength values persisted at 36 months. Recreational sports were resumed after training by most patients. 100 patients with acute ACL injury revealed associate lesions in 82% of the cases. Need of supervision in training or not was evaluated, the patients were randomized to supervised or self-monitored training. A transferral of 50% of the SM patients to SV was indicated after 6 weeks, the majority were women. At 36 months isometric muscle strengths and isokinetic work capacity were significantly higher in male patients of original SV group, than in men remaining in the SM group.In transferred male patients recovery was seen with delay in time. In females no differences were observed between groups. Further studies on muscle function after ACL injuries in female patients are required. 85 patients completed the follow-up after 36 months. As part of a joint-protection strategy, restriction of hyperextension was preserved in the majority of cases during the period of follow-up and giving-way events occurred in 5-10% only of the patients during the follow-up.},
  author       = {Zätterström, Rose},
  isbn         = {91-628-3538-6},
  keyword      = {Surgery,long-term follow-up,short-term,non-surgical treatment,ACL injury,associated lesions,orthopaedics,traumatology,Kirurgi,ortopedi,traumatologi},
  language     = {eng},
  pages        = {124},
  publisher    = {ARRAY(0xb50e2f0)},
  title        = {The injured anterior cruciate ligament and neuromuscular rehabilitation},
  year         = {1999},
}