scholarly journals Early Superimposed NMES Training is Effective to Improve Strength and Function Following ACL Reconstruction with Hamstring Graft regardless of Tendon Regeneration

2022 ◽  
pp. 91-103
Author(s):  
Luciana Labanca ◽  
Jacopo E. Rocchi ◽  
Silvana Giannini ◽  
Emanuele R. Faloni ◽  
Giulio Montanari ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Cruciate Ligament ◽  
Neuromuscular Electrical Stimulation ◽  
Knee Function ◽  
Control Group ◽  
Hamstring Graft ◽  
Countermovement Jump ◽  
Tendon Regeneration ◽  
Sit To Stand ◽  
Thigh Muscles

The study aimed at investigating the effects of neuromuscular electrical stimulation superimposed on functional exercises (NMES+) early after anterior cruciate ligament reconstruction (ACLr) with hamstring graft, on muscle strength, knee function, and morphology of thigh muscles and harvested tendons. Thirty-four participants were randomly allocated to either NMES+ group, who received standard rehabilitation with additional NMES of knee flexor and extensor muscles, superimposed on functional movements, or to a control group, who received no additional training (NAT) to traditional rehabilitation. Participants were assessed 15 (T1), 30 (T2), 60 (T3), 90 (T4) and at a mean of 380 days (T5) after ACLr. Knee strength of flexors and extensors was measured at T3, T4 and T5. Lower limb loading asymmetry was measured during a sit-to-stand-to-sit movement at T1, T2, T3, T4 and T5, and a countermovement-jump at T4 and T5. An MRI was performed at T5 to assess morphology of thigh muscles and regeneration of the harvested tendons. NMES+ showed higher muscle strength for the hamstrings (T4, T5) and the quadriceps (T3, T4, T5), higher loading symmetry during stand-to-sit (T2, T3, T4, T5), sit-to-stand (T3, T4) and countermovement-jump (T5) than NAT. No differences were found between-groups for morphology of muscles and tendons, nor in regeneration of harvested tendons. NMES+ early after ACLr with hamstring graft improves muscle strength and knee function in the short- and long-term after surgery, regardless of tendon regeneration.

scholarly journals Effects of lower limb resistance exercise on muscle strength, physical fitness, and metabolism in pre-frail elderly patients: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoxing Lai ◽  
Lin Bo ◽  
Hongwei Zhu ◽  
Baoyu Chen ◽  
Zhao Wu ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Resistance Exercise ◽  
Frail Elderly ◽  
Lower Limb ◽  
Intervention Group ◽  
Control Group ◽  
Walking Test ◽  
Sit To Stand ◽  
Femoris Muscle ◽  
Activity Energy

Abstract Background Few studies examined interventions in frail elderly in China, while the awareness of applying interventions to prevent frailty in pre-frail elderly is still lacking. This study aimed to explore the effects of lower limb resistance exercise in pre-frail elderly in China. Methods This was a randomized controlled trial of patients with pre-frailty. The control group received routine care, while the exercise group received a 12-week lower limb resistance exercise based on routine care. The muscle strength in the lower limbs, physical fitness, and energy metabolism of the patients was evaluated at admission and after 12 weeks of intervention. Results A total of 60 pre-frail elderly were included in this study. The patients were divided into the exercise group (n = 30) and control group (n = 30) by random grouping. There were 17 men and 13 women aged 65.3 ± 13.4 in the exercise group, and 15 men and 15 women aged 67.6 ± 11.9 years in the control groups. The Barthel index was 80.3 ± 10.6 and 85.1 ± 11.6, respectively. The characteristics of the two groups were not significantly different before intervention (all p > 0.05). The results of repeated measurement ANOVA showed that there was statistically significant in crossover effect of group * time (all p < 0.05), that is, the differences of quadriceps femoris muscle strength, 6-min walking test, 30-s sit-to-stand test, 8-ft “up & go” test, daily activity energy expenditure and metabolic equivalent between the intervention group and the control group changed with time, and the variation ranges were different. The main effects of time were statistically significant (all p < 0.05), namely, femoris muscle strength, 6-min walking test, 30-s sit-to-stand test, 8-ft “up & go” test, daily activity energy expenditure and metabolic equivalent of the intervention group and the control group were significantly different before and after intervention. The main effects of groups were statistically significant (p < 0.05), namely, femoris muscle strength, 6-min walking test, 30-s sit-to-stand test, daily activity energy expenditure and metabolic equivalent before and after intervention were significantly different between the intervention group and the control group, while there was no significant differences in 8-ft “up & go” test between groups. Conclusion Lower limb resistance exercise used for the frailty intervention could improve muscle strength, physical fitness, and metabolism in pre-frail elderly. Trial registration ChiCTR, ChiCTR2000031099. Registered 22 March 2020, http://www.chictr.org.cn/edit.aspx?pid=51221&htm=4

Arthroscopic Imaging Treatment and Clinical Rehabilitation of Knee Sports Injuries

2021 ◽  
Vol 11 (6) ◽  
pp. 1780-1788
Author(s):  
Habaxi Kaken ◽  
Shanshan Wang ◽  
Wei Zhao ◽  
Baoerjiang Asihaer ◽  
Li Wang
Keyword(s):  
Muscle Strength ◽  
Knee Joint ◽  
Sports Injuries ◽  
Cruciate Ligament ◽  
Quadriceps Muscle ◽  
Lower Limbs ◽  
Continuous Passive Motion ◽  
Control Group ◽  
Pressure Therapy ◽  
Quick Recovery

This article studies the effects of arthroscopic imaging treatment and clinical rehabilitation of knee sports injuries. Arthroscopy was used to perform meniscus trimming and resection for 40 patients with knee sports injuries. The ages of the patients ranged from 20 to 60 years old. All patients received routine rehabilitation training such as continuous passive motion of the knee joint, biofeedback of the lower limbs, and air pressure therapy of the lower limbs. In addition, the control group was given muscle strength training, and the training began after the patients received the quadriceps muscle strength test. The removal of the joint cavity and the joint debridement has achieved satisfactory treatment results. In the experiment, the test cases were divided into two groups, and the sensor test platform was used for signal collection. Normal activities can be resumed 2 weeks after the operation. After a follow-up of 6 to 24 months, the knee joint pain disappeared, the joint was free of swelling, and the knee function was normal up to 93%. Arthroscopic reconstruction of the anterior and posterior cruciate ligament joint repair/reconstruction of the medial and posterolateral ligament knots is safe and feasible for the treatment of multiple ligament injuries of the knee joint. It has the advantages of less trauma and quick recovery. Early postoperative systemic and standardized rehabilitation exercises can obtain good knee joint function.

scholarly journals Physiotherapy and Electrical Stimulation Effects on Strength of M. Quadriceps, Knee Range of Motion and Pain in Patients Following Anterior Cruciate Ligament Operation

2019 ◽  
Vol 1 (16) ◽  
Author(s):  
Justina Marčiulionytė ◽  
Justinas Škikas ◽  
Saulė Sipavičienė
Keyword(s):  
Anterior Cruciate Ligament ◽  
Electrical Stimulation ◽  
Muscle Strength ◽  
Range Of Motion ◽  
Cruciate Ligament ◽  
Quadriceps Muscle ◽  
Control Group ◽  
Study Group ◽  
Quadriceps Muscle Strength ◽  
Anterior Cruciate

Background. Research aim was to analyze the quadriceps muscle strength recovery after anterior cruciate ligament reconstruction using electrical stimulation and physical therapy. Methods. There were two randomly selected groups, with eight people in each group. The selection criteria were that the subjects had to have anterior cruciate ligament operation six weeks prior and were very active physically. One group was for research (study group), the other one for reference (control group). The study group had electrical stimulation combined with physical therapy exercises two times a week, for 45 minutes. The control group had exercises to strengthen the quadriceps muscle also two times a week, for 45 minutes. Both groups were tested before and after the research. The things evaluated during the test were – visual pain scale (VAS) scores, quadriceps muscle strength during extension and flexion using (R. Lovett) scoring system and goniometry showing degrees of extension and flexion. Results. Comparing both study and control groups, there was statistically signifcant improvement (p < 0.05), however the study group recovered faster and had statistically greater benefts. Conclusions. After 6 weeks of physiotherapy, the range of motion, quadriceps muscle strength increased and pain decreased in the operated leg. 1. After 6 weeks of physiotherapy and electrical stimulation, the range of motion, quadriceps muscle strength increased and pain decreased in the operated leg. 2. After 6 weeks of physiotherapy and electrical stimulation, the range of motion, quadriceps muscle strength, pain in the operated leg changed more in the study group than in subjects who received only physical therapy.Keywords: anterior cruciate ligament, electrical stimulation, quadriceps muscle, ligament reconstruction, muscle strength.

scholarly journals Impact of Exercise Modalities on Peripheral and Central Components of Cardiorespiratory Capacity in Heart Transplantation Patients: A Systematic Review and Meta-Analysis

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 32
Author(s):  
Natália Turri-Silva ◽  
Francisco Valdez Santos ◽  
Wanessa Camilly Caldas Rodrigues ◽  
Josuelir Silva Freire ◽  
Lawrence C. Cahalin ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Meta Analysis ◽  
Interval Training ◽  
Control Group ◽  
Stand Test ◽  
Combined Training ◽  
Sit To Stand ◽  
High Intensity Interval ◽  
Training Modalities ◽  
The Impact

Background and Objectives: To analyze the effects of aerobic, resistance, and combined training on peripheral and central components related to cardiorespiratory capacity after HTx. Materials and Methods: No time restriction was applied for study inclusion. MEDLINE/PubMed; EMBASE, CENTRAL, and PEDro databases were investigated. Studies reporting heart transplanted patients older than 19 years following aerobic, resistance, and combined training according. The outcomes included: V′O2 peak, VE/V’CO2 slope, heart rate (HR peak), systolic and diastolic blood pressure (SBP and DBP peak), maximum repetition test(1RM), sit-to-stand test, and flow-mediated dilation (FMD). The studies were selected by consensus. Four hundred ninety-two studies initially met the selection criteria. Cochrane handbook was used for abstracting data and assessing data quality and validity. Independent extraction by two observers was applied. Results: Isolated aerobic training leads to a greater increase in V′O2 peak than combined training compared to the control group (p < 0.001, I2 = 0%). However, no significant differences were found in the subgroup comparison (p = 0.19, I2 = 42.1%). HR peak increased similarly after aerobic and combined training. High-intensity interval training (HIIT) was better than moderate continuous intensity to increase the V′O2 after long term in HTx. Still, there is scarce evidence of HIIT on muscle strength and FMD. No change on VE/V’CO2 slope, FMD, and SBP, DBP peak. 1RM and the sit-to-stand test increased after resistance training (p < 0.001, I2 = 70%) and CT (p < 0.001, I2 = 0%) when compared to control. Conclusions: Aerobic and combined training effectively improve VO2 peak and muscle strength, respectively. HIIT seems the better choice for cardiorespiratory capacity improvements. More studies are needed to examine the impact of training modalities on VE/V’CO2 slope and FMD.

scholarly journals Quadriceps Muscle Strength Recovery With the Use of High Tone Power Therapy After ACL Reconstruction: a Randomized Controlled Trial

2020 ◽  
Author(s):  
Katarzyna Ogrodzka-Ciechanowicz ◽  
Grzegorz Głąb ◽  
Jakub Ślusarski ◽  
Artur Gądek
Keyword(s):  
Muscle Strength ◽  
Acl Reconstruction ◽  
Controlled Trial ◽  
Cruciate Ligament ◽  
Quadriceps Muscle ◽  
Knee Extensors ◽  
Control Group ◽  
High Tone ◽  
Randomized Controlled ◽  
Stimulation Of

Abstract BackgroundA relatively new method of electrotherapy is High Tone Power Therapy. It directly affects cell metabolism, improving metabolic processes in tissues, and pain relief. It can also be used to obtain stimulating effects of the current, in this case also for electro stimulation of the quadriceps. The aim was to assess the effectiveness of electro stimulation of the quadriceps muscle in patients after ACL reconstruction, with the use of High Tone Power Therapy.MethodsIn pre post treatment randomized controlled trial took part thirty-five patients after anterior cruciate ligament reconstruction. The tests were carried prior to and 6 months following the ACL reconstruction. After the surgery, the patients were randomly divided into two research groups – experimental group (17 patients) had the High Tone Power Therapy included in rehabilitation, while the control group (18 patients) was without the High Tone Power Therapy. All patients were subjected to 6-month rehabilitation. Research tools included the measurement of muscle strength torque, ROM, knee and thigh circumference measurements, the Lysholm and the VAS scale ResultsThe analysis showed that there were no statistically significant differences in the measurement of maximum muscle torque of knee extensors between groups and measurements. The analysis did not show any statistically significant differences in other analyzed variables.ConclusionsHigh Tone Power Therapy used in the rehabilitation of patients after ACL reconstruction does not significantly affect the strength of the quadriceps muscle and the function of the knee joint.Trail Registration This study was registered retrospectively in the Australian New Zealand Clinical Trials Registry (ANZCTR). Registration number: ACTRN12616001416482.

scholarly journals Study of proprioception and muscle strength following arthroscopic anterior cruciate ligament reconstruction

2021 ◽  
Vol 7 (3) ◽  
pp. 502
Author(s):  
Shankarlinga S. ◽  
Basavaraj S. Kyavater ◽  
Manik Rana
Keyword(s):  
Anterior Cruciate Ligament ◽  
Muscle Strength ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Hamstring Graft ◽  
Cruciate Ligament Reconstruction ◽  
Knee Mechanics ◽  
Anterior Cruciate

<p><strong>Background:</strong> Mechanoreceptors plays a vital role in knee mechanics. Since there are controversies surrounding the overall recovery time of proprioception following surgery, it is necessary to define the factors affecting proprioceptive recovery after anterior cruciate ligament reconstruction and to investigate the relationship between proprioception and muscle strength following surgery.</p><p><strong>Methods: </strong>Current study is combined prospective and retrospective study done at K. S. hospital Koppal, spanning for a period of one year (December 2019 to December 2020). All patients presented with isolated anterior cruciate ligament (ACL) tear were included in the study. Patients were treated by arthroscopic ACL reconstruction with hamstring graft only and followed up for a period of year. Outcome measures include centre of mass proprioception in AP and medio-lateral direction and muscular strength through force gauze in Newton.</p><p><strong>Results:</strong> 26 patients (mean age 33) were included in the study, all ACL tears were treated by arthroscopic ACL reconstruction with hamstring graft and they underwent varying period of rehabilitation.</p><p><strong>Conclusions:</strong> This study shows that our understanding of biomechanics of ACL reconstructed knees is still evolving, and proprioception is found to be a key factor in determining post-op recovery. ACL remnant preservation intra-op along with proper mechanical positioning of the graft may help in better proprioception and functional outcome following the reconstruction.</p>

scholarly journals Radiological outcome of hamstring graft after anterior cruciate ligament reconstruction with augmentation of bone marrow aspirate concentrate

2021 ◽  
Vol 7 (2) ◽  
pp. 376
Author(s):  
D. S. Bhamare ◽  
Girish Nathani ◽  
Ishan Shevate ◽  
Clevio Desouza ◽  
Amol Patil
Keyword(s):  
Bone Marrow ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Bone Marrow Aspirate ◽  
Cruciate Ligament ◽  
Control Group ◽  
Hamstring Graft ◽  
Bone Marrow Aspirate Concentrate ◽  
Graft Healing ◽  
Anterior Cruciate

<p class="abstract"><strong>Background:</strong> Anterior cruciate ligament (ACL) tears are common injuries in the athletic population. Surgical intervention is required for ACL tears as it restores the knee function and it prevents early osteoarthritis. In the recent research there is increasing use of bone marrow aspirate concentrate in orthopaedics. Bone marrow aspirate concentrate (BMAC) provides mesenchymal stem cells progenitor cells and growth factors which has potential benefits in hamstring graft healing after ACL reconstruction.</p><p class="abstract"><strong>Methods:</strong> This was a prospective randomized case control study carried out between May 2017 and June 2020. 30 patients between age group of 18 to 40 years with complete ACL tear were divided into two groups which consisted of the control group in which only ACL reconstruction was done and second group in which ACL reconstruction was done augmenting it with bone marrow aspirate concentrate. For the BMAC group, 3 ml of BMAC was obtained in the operation theatre itself and was injected into femoral tunnel and the tibia tunnel just before portal suturing. MRI was obtained post operatively at 6 months and at 1 year. Graft healing was seen as the time taken for the graft to reach ligamentization phase when the graft became hyper intense or was visualized similar to PCL or the remnant which was preserved during reconstruction in all cases.<strong></strong></p><p class="abstract"><strong>Results:</strong> Most of the patients in which augmentation (86%) was done healed at 6 month as compared to those who were not augmented (13%).</p><p class="abstract"><strong>Conclusions:</strong> BMAC showed faster and better healing of the graft in ACL reconstruction.</p>

Subsequent Surgery for Loss of Motion After Anterior Cruciate Ligament Reconstruction Does Not Influence Function at 2 Years: A Matched Case-Control Analysis

2019 ◽  
Vol 47 (11) ◽  
pp. 2550-2556 ◽  
Author(s):  
Jacob Worsham ◽  
Walter R. Lowe ◽  
Dorcas Copa ◽  
Shelby Williams ◽  
Jacquelyn Kleihege ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Surgical Treatment ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Knee Function ◽  
Quality Data ◽  
Control Group ◽  
Manipulation Under Anesthesia ◽  
Anterior Cruciate ◽  
Loss Of Motion

Background: Loss of motion (LOM) remains a common complication after anterior cruciate ligament (ACL) reconstruction and can be detrimental to patient outcomes after surgery. LOM is multifactorial, but nonsurgical and surgical solutions to this complex problem are available. A paucity of quality data exists evaluating clinical outcomes after the surgical treatment of patients with LOM after ACL reconstruction. Hypothesis: Patients undergoing surgical lysis of adhesions and manipulation under anesthesia for LOM after ACL reconstruction will exhibit decreased function, lower outcome scores, and delayed time of release to play when compared with matched controls without LOM. Study Design: Cohort study; Level of evidence, 3 Methods: A database of 1572 patients undergoing ACL reconstruction was sampled from 2013 to 2017 to identify a total of 58 patients (LOM group [n = 29] vs matched control group [n = 29]). Group comparisons were examined for patients requiring a second surgical procedure for LOM versus matched controls after ACL reconstruction for differences in surgical timing, self-reported International Knee Disability Committee scores, objective function at release to play, and subjective knee function at 2 years with the Single Assessment Numeric Evaluation. The risk of a type I error was set at α = .05 for all statistical analyses. Results: Patients who underwent lysis of adhesions and manipulation under anesthesia for LOM after ACL reconstruction exhibited no differences in Single Assessment Numeric Evaluation knee function at 2 years when compared with matched controls (85.8 ± 14.9 vs 88.0 ± 10.8, P = .606). All patients met release-to-play criteria. Only International Knee Disability Committee scores ( P = .046) and single-legged hop testing ( P = .050) reached statistically significant differences, with higher scores in the control group. There was no difference in the time to release to play ( P = .034) or level of participation ( P = .180) between the control and surgical groups. Subjective function scores at 2 years were not significantly different between groups. Tourniquet time during the index ACL reconstruction was shorter in the control group ( P = .034). Conclusion: The findings of this study suggest that patients who undergo surgical treatment for LOM after ACL reconstruction can release to play at similar times but display relative deficits in single-legged-hop symmetry and lower self-reported function when compared with matched controls. Longer surgical times may increase the risk for LOM after ACL reconstruction. Registration: NCT03704376 (ClinicalTrials.gov identifier)

scholarly journals Isokinetic profile of subjects with the ruptured anterior cruciated ligament

2016 ◽  
Vol 73 (7) ◽  
pp. 631-635 ◽  
Author(s):  
Miodrag Drapsin ◽  
Damir Lukac ◽  
Predrag Rasovic ◽  
Patrik Drid ◽  
Aleksandar Klasnja ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Peak Torque ◽  
Acl Rupture ◽  
Thigh Muscle ◽  
Thigh Muscles ◽  
Significant Difference ◽  
Bilateral Differences ◽  
High Level

Background/Aim. All changes in the knee that appear after anterior cruciate ligament (ACL) lesion lead to difficulties in walking, running, jumping especially during sudden changes of the line of movement. This significantly impairs quality of life of these subjects and leads to decrease in physical activity. Knee injuries make 5% of all most severe acute sport injuries. The aim of the study was to determine strength of the thigh muscles in persons with unilateral rupture of the ACL and to evaluate potential bilateral differences between healthy and injured leg. Methods. This study involved 114 male athletes of different sport specialities with the clinical diagnosis of ACL rupture. Each subject had unilateral ACL rupture and the other leg was actually the control for this research. An isokinetic device was used to evaluate the muscle strength of thigh muscles. Testing was performed for two testing speeds, 60?/s and 180?/s. Results. Data analysis showed a statistically significant difference (p < 0.01) between the ACL and the healthy leg in the following parameters: peak torque for thigh extensors (Ptrq_E), angle to peak torque during extension (Ang_E), power of extension (Pow_E) and work during extension (Work_E). Analysing hamstrings to quadriceps (H/Q) ratio we found the unilateral disbalance of thigh muscle strength in ACL leg. Conclusion. A high level of validity makes isokinetic dynamometry the method for evaluation of thigh muscles strength and leaves this field of research open for new studies in order to improve both diagnostic and rehabilitation of patients with the insufficient ACL.

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