Učinki predoperativne ishemične vadbe z lahkim bremenom na zmogljivost in funkcijo stegenskih mišic pri pacientih s poškodbo sprednje križne vezi

Petrič, Maja (author), Kacin, Alan (mentor), Grapar Žargi, Tina (comentor)

Uvod: Poškodba sprednje križne vezi (ACL) spada med najpogostejše poškodbe kolenskega sklepa, zaradi katere je pogosto potrebna tudi artroskopska rekonstrukcija ACL. Fizioterapija po poškodbi in rekonstrukciji ACL je dolgotrajna in z vidika zmogljivosti in funkcije stegenskih mišic, pogosto ni popolnoma uspešna. Ishemična vadba z lahkim bremenom se je pri zdravih osebah izkazala za učinkovito metodo krepitve mišic in bi lahko bila primerna tudi za uporabo pri osebah s poškodbo ACL. Namen: Namen raziskave je bil ovrednotiti učinkovitost programa ishemične vadbe za izboljšanje zmogljivosti in funkcije stegenskih mišic pri osebah s poškodbo ACL. Metode dela: V raziskavo je bilo vključenih 13 oseb s pretrgano ACL (starost 37,5 ± 6,5 let). Preiskovanci so bili razvrščeni v dve skupini: ishemično skupino (IS), ki je izvajala ishemično vadbo z lahkim bremenom za krepitev stegenskih mišic poškodovanega spodnjega uda, ali placebo-ishemično skupino (PIS), ki je enako vadbo izvajala z navidezno oviranim pretokom krvi. Pred in po zaključenem vadbenem programu je bilo opravljeno testiranje funkcije (enonožni skok v daljino) in zmogljivosti stegenskih mišic (dinamometrične meritve in EMG aktivnost mišice quadriceps femoris). Rezultati: Preiskovanci IS so v času vadbenega programa dosegli statistično pomembno večje izboljšanje izokinetične zmogljivosti fleksorjev kolena (p60°/s < 0,05; p120°/s < 0,01) in ekstenzorjev kolena (p120°/s < 0,05) ter večjo vzdržljivost ekstenzorjev kolena (p60°/s < 0,05) kot preiskovanci PIS. Funkcija stegenskih mišic se je pomembno izboljšala v obeh skupinah (p < 0,001), brez pomembne razlike med skupinama. Izboljšala se je amplituda EMG mišice quadriceps femoris, in sicer vastus medialis (p < 0,05) ter vastus lateralis (p < 0,05). Razprava in sklep: S programom ishemične vadbe z lahkim bremenom lahko pacienti s pretrgano ACL učinkoviteje okrepijo stegenske mišice, še posebej fleksorje kolena, kot to dosežejo z enako količino in intenzivnostjo vadbe brez oviranega pretoka krvi skozi aktivne mišice. Učinkovitejša je tudi pri izboljšanju vzdržljivosti ekstenzorjev kolena.

• Language: Slovenian
• Keywords: vadba z oviranim pretokom krvi, quadriceps femoris, fleksorji kolena, poškodba ACL
• Work type: Master's thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2017
• PID: 20.500.12556/RUL-91523
• COBISS.SI-ID: 5242987
• Publication date in RUL: 19.04.2017

Secondary language

• Language: English
• Title: The effects of preoperative low-load ischemic training on performance and function of thigh muscles in patients with ACL injury

Abstract

Introduction: Anterior cruciate ligament (ACL) injury is one of the most common injuries of the knee joint, which also often requires arthroscopic ACL reconstruction. Physiotherapy after ACL injury and reconstruction is a long-lasting and often not completely successful in terms of performance and function of thigh muscles. Low-load ischemic training proved to be an effective method of strengthening the muscles in healthy subjects and it may be appropriate also for use in patients with ACL injury. Purpose: The purpose of this study was to evaluate the effectiveness of the preoperative low-load ischemic training program to improve capacity in the thigh muscle function in subjects with ACL injury. Methods: 13 patients (age 37.5 ± 6.5 years) with an ACL rupture participated in the study. Subjects were assigned into two groups: ischemic group (IS), which performed the low-load ischemic exercise to strengthen the thigh muscles of the injured leg, or placebo-ischemic group (PIS), which performed the same training program but without blood flow restriction of thigh muscles. Before and after completed training program testing of thigh muscles function (Single leg hop test) and performance (dynamometric testing and the EMG measures of the quadriceps femoris muscle activation) was carried out. Results: Subjects in IS achieved a statistically significant major improvement in isokinetic muscle performance of the knee flexors (p60°/s < 0.05; p120°/s < 0.01) and knee extensors (p60°/s < 0.05) and greater knee extensors muscle endurance (p60°/s < 0.05) by comparison with group PIS. The function of thigh muscles improved significantly in both groups (p < 0.001), with no significant differences between groups. As well there was an improvement in the EMG amplitude of the quadriceps femoris muscle activation, namely vastus medialis (p < 0.05) and vastus lateralis muscle (p < 0.05). Discussion and conclusion: The program of low-load ischemic exercise is more effective for patients with ACL injury to strengthen the thigh muscles, especially knee flexors, than the same amount and intensity of the exercise without blood flow restriction of the active muscles. It is also more effective in improving the knee extensors endurance.

• Keywords: blood flow restriction training, quadriceps femoris muscle, knee flexors, ACL injury