Hajouj Elie, Hadian Mohammad Reza, Mir Seyed Mohsen, Talebian Saeed, Ghazi Salah
Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Brain and Spinal Cord Injury Research Center, Institute of Neuroscience, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Arch Bone Jt Surg. 2021 Sep;9(5):519-526. doi: 10.22038/abjs.2020.50106.2485.
Proprioceptive training in the aquatic environment is more beneficial owing to water properties. The primary goal of the present study was to investigate the effectiveness of the incorporation of innovative aquatic proprioceptive training into conventional accelerated land-based rehabilitation protocol in knee function and joint position sense in male athletes after anterior cruciate ligament reconstruction (ACLR).
A total of 38 athlete male athletes with ACLR were randomly assigned to two rehabilitation groups. The conventional therapy group (CT) (n=19) received conventional rehabilitation for 6 weeks, while the hydrotherapy group (HT) (n=19) received the same conventional rehabilitation, in addition to 12 sessions of innovative aquatic proprioceptive training. The outcomes included the joint position sense (JPS) errors, visual analog scale (VAS), and international knee documentation committee (IKDC). Repeated measures analysis of variance (ANOVA) was used to compare the means between the two groups. Cohen's d from an independent t-test was used to calculate the effect sizes for all variables after the intervention for both groups.
Base on the results, there were a significant difference in absolute errors (AE) (F=56.231, ) and variable errors (VE) (F=60.245, ) between the two groups. No significant differences were detected in constant error (CE), VAS, and IKDC between the two groups (). Both groups displayed a significant difference in terms of AE, VE, VAS, and IKDC after the intervention (). Percent changes after the intervention for AE(69.19%), VE (68.20%), CE (65.20%), VAS37.50%, and IKDC (38.61%) were greater in the HT group, compared to the CT group.
As evidenced by the obtained results, innovative aquatic proprioceptive training incorporate into the conventional rehabilitation accelerated protocol offers the improvement of proprioception efficiency for individuals with ACL reconstruction. Therefore, it could be useful to clinicians when designing rehabilitation protocol to ensure the optimal engagement of proprioception.
由于水的特性，在水环境中进行本体感觉训练更有益。本研究的主要目的是探讨将创新的水上本体感觉训练纳入传统的加速陆地康复方案对男性运动员前交叉韧带重建（ACLR）后膝关节功能和关节位置觉的有效性。
总共38名ACLR男性运动员被随机分配到两个康复组。传统治疗组（CT）（n = 19）接受6周的传统康复治疗，而水疗组（HT）（n = 19）除了接受相同的传统康复治疗外，还接受12次创新的水上本体感觉训练。结果包括关节位置觉（JPS）误差、视觉模拟量表（VAS）和国际膝关节文献委员会（IKDC）评分。采用重复测量方差分析（ANOVA）比较两组之间的均值。使用独立t检验的Cohen's d来计算两组干预后所有变量的效应大小。
基于结果，两组之间的绝对误差（AE）（F = 56.231， ）和可变误差（VE）（F = 60.245， ）存在显著差异。两组之间在恒定误差（CE）、VAS和IKDC方面未检测到显著差异（ ）。两组在干预后AE、VE、VAS和IKDC方面均显示出显著差异（ ）。与CT组相比，HT组干预后AE（69.19%）、VE（68.20%）、CE（65.20%）、VAS（37.50%）和IKDC（38.61%）的百分比变化更大。
所得结果表明，将创新的水上本体感觉训练纳入传统康复加速方案可提高ACL重建个体本体感觉效率。因此，临床医生在设计康复方案时确保本体感觉的最佳参与可能会有所帮助。
