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Principles of brain plasticity in improving sensorimotor function of the knee and leg in patients with anterior cruciate ligament injury: a double-blind randomized exploratory trial

Ageberg, Eva LU ; Björkman, Anders LU ; Rosén, Birgitta LU and Roos, Ewa M. (2012) In BMC Musculoskeletal Disorders 13(68).
Abstract
Background: Severe traumatic knee injury, including injury to the anterior cruciate ligament (ACL), leads to impaired sensorimotor function. Although improvements are achieved by training, impairment often persists. Because good sensorimotor function is associated with better patient-reported function and a potential lower risk of future joint problems, more effective treatment is warranted. Temporary cutaneous anesthesia of adjacent body parts was successfully used on the hand and foot to improve sensorimotor function. The aim of this study was to test whether this principle of brain plasticity could be used on the knee. The hypothesis was that temporary anesthesia of the skin area above and below the knee would improve sensorimotor... (More)
Background: Severe traumatic knee injury, including injury to the anterior cruciate ligament (ACL), leads to impaired sensorimotor function. Although improvements are achieved by training, impairment often persists. Because good sensorimotor function is associated with better patient-reported function and a potential lower risk of future joint problems, more effective treatment is warranted. Temporary cutaneous anesthesia of adjacent body parts was successfully used on the hand and foot to improve sensorimotor function. The aim of this study was to test whether this principle of brain plasticity could be used on the knee. The hypothesis was that temporary anesthesia of the skin area above and below the knee would improve sensorimotor function of the ipsilateral knee and leg in subjects with ACL injury. Methods: In this double-blind exploratory study, 39 subjects with ACL injury (mean age 24 years, SD 5.2, 49% women, mean 52 weeks after injury or reconstruction) and self-reported functional limitations and lack of trust in the knee were randomized to temporary local cutaneous application of anesthetic (EMLA (R)) (n = 20) or placebo cream (n = 19). Fifty grams of EMLA (R), or placebo, was applied on the leg 10 cm above and 10 cm below the center of patella, leaving the area around the knee without cream. Measures of sensory function (perception of touch, vibration sense, knee kinesthesia) and motor function (knee muscle strength, hop test) were assessed before and after 90 minutes of treatment with EMLA (R) or placebo. The paired t-test was used for comparisons within groups and analysis of variance between groups, except for ordinal data where the Wilcoxon signed rank test, or Mann-Whitney test, was used. The number of subjects needed was determined by an a priori sample size calculation. Results: No statistically significant or clinically relevant differences were seen over time (before vs. after) in the measures of sensory or motor functions in the EMLA (R) group or in the placebo group. There were no differences between the groups due to treatment effect (EMLA (R) vs. placebo). Conclusions: Temporary cutaneous anesthesia of adjacent body parts had no effect in improving sensorimotor function of the knee and leg in subjects with severe traumatic knee ligament injury. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Musculoskeletal Disorders
volume
13
issue
68
publisher
BioMed Central
external identifiers
  • wos:000309070600001
  • scopus:84860653654
ISSN
1471-2474
DOI
10.1186/1471-2474-13-68
language
English
LU publication?
yes
id
e0ca0f29-af7c-4938-bb78-d60e8a416ee5 (old id 3191611)
date added to LUP
2012-12-03 07:13:13
date last changed
2017-01-01 05:54:48
@article{e0ca0f29-af7c-4938-bb78-d60e8a416ee5,
  abstract     = {Background: Severe traumatic knee injury, including injury to the anterior cruciate ligament (ACL), leads to impaired sensorimotor function. Although improvements are achieved by training, impairment often persists. Because good sensorimotor function is associated with better patient-reported function and a potential lower risk of future joint problems, more effective treatment is warranted. Temporary cutaneous anesthesia of adjacent body parts was successfully used on the hand and foot to improve sensorimotor function. The aim of this study was to test whether this principle of brain plasticity could be used on the knee. The hypothesis was that temporary anesthesia of the skin area above and below the knee would improve sensorimotor function of the ipsilateral knee and leg in subjects with ACL injury. Methods: In this double-blind exploratory study, 39 subjects with ACL injury (mean age 24 years, SD 5.2, 49% women, mean 52 weeks after injury or reconstruction) and self-reported functional limitations and lack of trust in the knee were randomized to temporary local cutaneous application of anesthetic (EMLA (R)) (n = 20) or placebo cream (n = 19). Fifty grams of EMLA (R), or placebo, was applied on the leg 10 cm above and 10 cm below the center of patella, leaving the area around the knee without cream. Measures of sensory function (perception of touch, vibration sense, knee kinesthesia) and motor function (knee muscle strength, hop test) were assessed before and after 90 minutes of treatment with EMLA (R) or placebo. The paired t-test was used for comparisons within groups and analysis of variance between groups, except for ordinal data where the Wilcoxon signed rank test, or Mann-Whitney test, was used. The number of subjects needed was determined by an a priori sample size calculation. Results: No statistically significant or clinically relevant differences were seen over time (before vs. after) in the measures of sensory or motor functions in the EMLA (R) group or in the placebo group. There were no differences between the groups due to treatment effect (EMLA (R) vs. placebo). Conclusions: Temporary cutaneous anesthesia of adjacent body parts had no effect in improving sensorimotor function of the knee and leg in subjects with severe traumatic knee ligament injury.},
  author       = {Ageberg, Eva and Björkman, Anders and Rosén, Birgitta and Roos, Ewa M.},
  issn         = {1471-2474},
  language     = {eng},
  number       = {68},
  publisher    = {BioMed Central},
  series       = {BMC Musculoskeletal Disorders},
  title        = {Principles of brain plasticity in improving sensorimotor function of the knee and leg in patients with anterior cruciate ligament injury: a double-blind randomized exploratory trial},
  url          = {http://dx.doi.org/10.1186/1471-2474-13-68},
  volume       = {13},
  year         = {2012},
}