الفهرس 
Accelerated Rehabilitation for ACL Reconstruction (Shelbourne and Nitz, 1990)
Functional Anatomy of Knee Flexors and Extensors Flexors of the knee jointOnly 14 pages are availabe for public view
 |  | from | 142 |  |  |
| | | from | 142 | | |
Abstract
Evaluation of Neuromuscular Changes Following Anterior Cruciate Ligament Reconstruction/ Sobhy Mahmoud Abdel-Wahed Aly; Supervisors: Prof. Dr. Alaaddin Abdel-Hakim Balbaa, Professor of Physical Therapy, Department of Physical Therapy for Musculoskeletal Disorders; Faculty of Physical Therapy, Cairo University; Prof. Dr. Ahmed Abdel-Aziz, Professor of Orthopedic Surgery, Faculty of Medicine, Cairo University; Dr. Nagui Sobhi Nassif, Lecturer of Biomechanics, Department of Biomechanics, Faculty of Physical Therapy, Cairo University; Dr. Ahmed Yousry Radwan, Lecturer of Biomechanics, Department of Biomechanics, Faculty of Physical Therapy, Cairo University; Thesis: Ph.D.; Biomechanics, 2011.
Abstract
The purpose of this study was to investigate the effect of ACL reconstruction on neuromuscular performance of the knee muscles six months following reconstruction. Isokinetic peak torque, time to peak torque, and myoelectric activities of knee flexors and extensors were compared between the operated side and the non-operated side in patients following ACL reconstruction with age and activity matched control group. Twenty patients with ACL reconstruction using semitendinosus and gracilis autograft (mean age 21 ± 2.8 years, weight 73 ± 8.6 kg, and height of 171.9 ± 4.2 cm) were compared with twenty healthy male subjects (mean age 21.4 ± 1.8 years, weight 75.1 ± 7.1 kg, and height of 174.3 ± 5.2 cm). Biodex Isokinetic dynamometer (system 3) was used in synchronization with the Noraxon 1400A EMG apparatus to record the isokinetic and EMG data at angular velocities of 60º/s and 180º/s. Contraction mode was set at concentric extensors/concentric flexors and eccentric flexors/eccentric extensors. Results showed that the operated limb improved when compared with the non-operated one but when compared with control group significance differences appeared. Knee flexors were affected more than knee extensors and the eccentric deficits were larger than concentric deficits. The significant weakness of the knee extensors is most apparent under eccentric mode at 180º/s; and the significant weakness of knee flexors is most apparent under eccentric mode at both 60º/s and 180º/s. For myoelectric activities, the Hamstring (H) and Vastus Lateralis (VL) appeared to be the most affected muscles. In addition, there was a significant difference between the non-operated side and the control group. Conclusion: ACL reconstruction has significant effect on neuromuscular performance of knee extensors and flexors that persisted six months following reconstruction. Alteration in neuromuscular performance was not limited to the operated side only but extended to the contralateral side. Contralateral limb strength should not be used as end goal of rehabilitation. Specificity of velocity and contraction mode should be considered in evaluation. Based on the outcomes of the current accelerated rehabilitation program, it can be concluded that six months following ACL reconstruction is not the safe time to return to full sport activities.
Key words: ACL reconstruction, Knee joint, Isokinetic, EMG, Neuromuscular performance.