Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
Turk J Med Sci. 2021 Aug 30;51(4):2036-2042. doi: 10.3906/sag-2004-110.
BACKGROUND/AIM: Anterior cruciate ligament (ACL) injuries cause mechanoreceptor loss in the joint; therefore, proprioceptive deficits are observed after injury. In particular, proprioceptive measurements made in the functional position give more accurate results, and this is an area that requires further studies. This study aimed to evaluate proprioception in patients who had undergone ACL reconstruction (ACLR) in functional positions used in daily life (closed kinetic chain position), according to joint angles where ACL injuries occur more frequently, in comparison with healthy controls.
Thirty-four participants who underwent ACLR using a hamstring tendon graft (aged 29.18 ± 8.16 years; body mass index (BMI), 26.58 ± 4.02 kg/cm2) and 31 healthy participants (aged 27.35 ± 5.74 years; BMI, 24.76 ± 2.98 kg/cm2) were included. Proprioception was assessed with an active angle repetition test, using an inclinometer in the closed kinetic chain position while standing. Participants were asked to perform single-leg squats until the angle at the knee joint was 30°. After the targeted angle was defined, the participants were asked to find the targeted angle. The difference between the targeted angle and the angle reached by the participants was calculated.
A statistically significant difference in the active joint position sense was found among the ACLR extremity, uninvolved extremity, and control extremity (p < 0.05). The proprioceptive sense between the two extremities in the ACLR group was similar, and the proprioceptive sense was worse than that of the control group.
To our knowledge, this is the first study to evaluate closed kinetic chain position in patients who underwent ACLR, and it showed that proprioceptive sense was still poor in patients with ACLR compared with the control group, even if an average of 24 months have elapsed since surgery.
背景/目的：前交叉韧带（ACL）损伤会导致关节内机械感受器丧失；因此，损伤后会出现本体感觉缺失。特别是，在功能位置进行的本体感觉测量会产生更准确的结果，这是一个需要进一步研究的领域。本研究旨在评估在日常生活中使用的功能位置（闭链运动位置）进行 ACL 重建（ACLR）的患者的本体感觉，根据更频繁发生 ACL 损伤的关节角度，与健康对照组进行比较。
纳入 34 名使用腘绳肌腱移植物进行 ACLR 的患者（年龄 29.18 ± 8.16 岁；体重指数（BMI）26.58 ± 4.02 kg/cm2）和 31 名健康参与者（年龄 27.35 ± 5.74 岁；BMI 24.76 ± 2.98 kg/cm2）。使用测斜仪在闭链运动位置站立时，通过主动角度重复测试评估本体感觉。要求参与者进行单腿深蹲，直到膝关节角度达到 30°。在确定目标角度后，要求参与者找到目标角度。参与者达到的角度与目标角度之间的差异被计算出来。
在 ACLR 肢体、未受累肢体和对照组之间，主动关节位置感存在统计学显著差异（p < 0.05）。ACLR 组两肢体之间的本体感觉相似，且本体感觉比对照组差。
据我们所知，这是第一项评估 ACLR 患者闭链运动位置的研究，结果表明，即使在手术后平均 24 个月，ACL 重建患者的本体感觉仍然较差，与对照组相比。
