KNEE JOINT POSITION SENSE IN PHYSICALLY ACTIVE PATIENTS
AFTER ACL RECONSTRUCTION
Dawid Pawlak,
1, 2, A, B, DAleksandra Wysota,
1, 2, A, BMariusz Furmanek,
2, A, C, DKrzysztof Ficek,
3, A, D, EGrzegorz Juras
2, A, D, E1 *DOHQ2UWKRSDHGLF5HKDELOLWDWLRQ&HQWUH%LHUXĔ3RODQG
27KH-HU]\.XNXF]ND$FDGHP\RI3K\VLFDO(GXFDWLRQ'HSDUWPHQWRI+XPDQ0RWRU%HKDYLRXU.DWRZLFH3RODQG 3 Szczecin University, Faculty of Physical Culture and Health Promotion, Poland
A Study Design; B Data Collection; C Statistical Analysis; D0DQXVFULSW3UHSDUDWLRQ E Funds Collection
Address for correspondence:
Dawid Pawlak MSc.
*DOHQ2UWKRSDHGLFV5HKDELOLWDWLRQ&HQWUH -HU]HJR6W%LHUXQ3RODQG (PDLO GDZLGSDZ#JPDLOFRP
Abstract.
7KH WHUP ³SURSULRFHSWLRQ´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injury before the intervention or half a year later.Key words:
NQHHDQWHULRUFUXFLDWHOLJDPHQWMRLQWSRVLWLRQVHQVHUHFRQVWUXFWLRQIntroduction
7KHUHDUHYDULRXVZD\VLQZKLFKWKHVHQVRU\LQIRUPDWLRQPD\UHDFKWKH&HQWUDO1HUYRXV6\VWHP,WLVSDVVHG WKURXJKWKHVSHFLILFJURXSRIUHFHSWRUVFDOOHGSURSULRFHSWRUV7KHDIIHUHQWLQIRUPDWLRQGHULYHGIURPSURSULRFHSWRUV ZKLFKDUHGHSOR\HGLQSURSULRFHSWLYHVSRWVKDVDQLQIOXHQFHRQ FRQVFLRXVVHQVDWLRQV PXVFXODUVHQVH ERG\ SRVWXUH EDODQFH DQGWUDQVVHJPHQWDOVHQVH MRLQWVWDELOLW\ /HSKDUWHWDO 7KHLQWHUSUHWDWLRQRIWKHVH VLJQDOVRFFXUVLQWKHFHQWUDOQHUYRXVV\VWHP7KHLUDFWLYLW\PD\UHVXOWIURPSUHVVXUHFKDQJHRUFRQWUDFWLRQH[WHQVLRQ RIWLVVXHWKDWWDNHVSODFHGXULQJD FKDQJHRIMRLQWSRVLWLRQ3URSULRFHSWLRQLQWHJUDWHVWKHIXQFWLRQVRIVWDWLF FDSVXODU±OLJDPHQWFRPSOH[ DQGG\QDPLF JURXSRIPXVFOHVDFWLYHO\FRQQHFWHGZLWKD certain joint) joint stabilizers and SURWHFWVWKHMRLQWVDJDLQVWLQMXULHVGXULQJDFWLYLW\(DFKG\VIXQFWLRQRID OLJDPHQW±FDSVXODUDSSDUDWXVWKDWSHUWXUEV WKHOHYHORIQHXURPXVFXODUFRQWUROFRUUHVSRQGLQJO\SHUWXUEVWKHVWDWLFDQGG\QDPLFPHFKDQLVPV¶V\QFKURQL]DWLRQ and leads to joint dysfunction as well as to further damage and degeneration in subsequent stages. In recent \HDUV H[WHQVLYH UHVHDUFK KDV EHHQ FRQGXFWHG GHGLFDWHG WR WKH VHQVRU\ UROH RI WKH $&/ DQG WR WKH DQDO\VLV RI KRZ LWV GDPDJH LQIOXHQFHV NQHH MRLQW IXQFWLRQ $FFRUGLQJ WR )UHPHUH\ HW DO WKH PHFKDQRUHFHSWRUV UHVSRQVLEOH IRU EDWK\HVWKHVLD FRPSULVH IURP ± RI $&/ FDSDFLW\ ,Q PDMRULW\ FDVHV WKH LQMXU\ LV WKH UHVXOW of rotation forces acting on a NQHHMRLQWIL[HGLQWKHYDOJXVSRVLWLRQRUK\SHUH[WHQVLRQZLWKRXWFRQWDFWZLWKRWKHU SHRSOH7KLVPHFKDQLVPUHODWHVYHU\RIWHQWRDWKOHWHVDJHGEHWZHHQDQG\HDUV 9DQ*ULQVYHQHWDO 'DPDJHRIWKHSDVVLYHVWDELOL]HU±ZKLFKLVWKHOLJDPHQWLVRIWHQWKHFRQVHTXHQFHRID lack of dynamic stabilizer function (by dynamic stabilizers we mean muscles). Lacks of coordinated motion and/or incorrectly conducted motor WUDLQLQJLQFRPSHWLWLYHVSRUWVDUHRIWHQWKHUHDVRQVIRUNQHHMRLQWGLVRUGHUV$GGLWLRQDOO\ODFNLQJD FRPSHWHQW$&/ PD\H[SRVHWKHMRLQWWRUH±LQMXU\ZLWKWKHSRVVLELOLW\RIIXUWKHUDUWLFXODUPHQLVFXVRUDUWLFXODUFDUWLODJHGDPDJHWKDW PD\OHDGWRGHJHQHUDWLYHFKDQJHV,WFRQFHUQVQRWRQO\SURIHVVLRQDODWKOHWHVEXWDOVRDWKOHWHVDWDOOOHYHOV /HSKDUW HWDO
$&/UHFRQVWUXFWLRQVDUHSHUIRUPHGLQRUGHUWRDYRLGWKHDERYHPHQWLRQHGFKDQJHV$&/UHFRQVWUXFWLRQLV the kind of surgery that requires the recreation of a OLJDPHQWLQLWVDQDWRPLFDOSRVLWLRQRUDVFORVHDVSRVVLEOH WRDQDWRPLFDOSRVLWLRQ,QRUGHUWRSHUIRUP$&/UHFRQVWUXFWLRQWKHJUDIWVWKDWDUHXVHGPRVWIUHTXHQWO\DUH PHGLDOSDWHOODUOLJDPHQW 3%7%±ERQH±SDWHOODUWHQGRQ±ERQHJUDIW VHPLWHQGLQRVXVWHQGRQRUWZRWHQGRQV RIVHPLWHQGLQRVXVPXVFOHRURIJUDFLOLVPXVFOH±LIWKHGLPHQVLRQVRIRQHWHQGRQDUHLQVXIILFLHQWWRSHUIRUPWKH TXDGUXSOH±EXQGOHJUDIW7KHJUDIWRULJLQDWHVHLWKHUIURPWKHSDWLHQW¶VWLVVXHV DXWRJHQRXVJUDIW RUIURPD donor DOORJHQLFJUDIW±DOORJUDIW 1DNDPXUDHWDO
Many researchers are trying to find newer and newerPHWKRGVDQGH[SODLQSURSULRFHSWLRQ¶VGHYLFHVLQRUGHU WRLGHQWLI\LWV³GHIHFWV´DQGWKHUHE\PDNHSRVVLEOHWKHHDUO\SUHYHQWLRQRIMRLQWLQVWDELOLW\DQGLQFRQVHTXHQFH ±LWVLQMXU\ )UHPHUH\HWDO -36H[DPLQDWLRQDOORZVXVWRHYDOXDWHWKHSURSULRFHSWLRQRID knee joint in a TXDQWLWDWLYH PDQQHU LQ ERWK DFWLYH DQG SDVVLYH PRWLRQ SUHVHQWHG LQ DQJXODU GHJUHHV 5HVHDUFK DERXW WKH HYDOXDWLRQRI-36DQGSURSULRFHSWLRQGLVRUGHUVLQ$&/LQMXU\DVGHVFULEHGLQWKHOLWHUDWXUHSURYLGHVFRQWUDGLFWRU\ UHVXOWV,QWKHLUUHVHDUFK )UHPHUH\HWDO DQG )LVFKHUDQG-HQVHQ SUHVHQWHGD significant disability RISURSULRFHSWLRQLQSDWLHQWVZLWK$&/LQMXU\%DUUHWWHWDO DQG%DUUDFNHWDO DOVRSUHVHQWHGGHILQLWH reduction of JPS ability in the knee with an injured ligament. According to this research, ACL injury – where ACL LVDOVRWKHPHFKDQLFDO VWDWLF NQHHMRLQWVWDELOL]HUFDXVHVWKH$&/SURSULRFHSWRUG\VIXQFWLRQDQGVHQVRU\GHILFLWV 7KH\H[SODLQWKDWZLWKWKHUHGXFWLRQLQQXPEHURISURSULRFHSWRUVPXVFOHIXQFWLRQFKDQJHVDQGFRQVHTXHQWO\MRLQW LQVWDELOLW\UHVXOWV -RKDQVVRQHWDO 5HKPHWDO 5HLGHUHWDO
As observed in the research, injured joint signal disorder may also cause the abnormities in movement SHUFHSWLRQDQGSRVLWLRQRIDQDORJLFDOMRLQWLQWKHKHDOWK\OLPE 2¶&RQQHOOHWDO *RRGHWDO GHPRQVWUDWHG DQWLWKHWLFDOUHVXOWVVXJJHVWLQJWKDW$&/LQMXU\GRHVQRWFDXVHDQ\FKDQJHLQSURSULRFHSWLRQ&RDQG&DQQRQ Beard et al. (1994), Harteret et al. (1992) and Skinner and Barrack (1991) in their research were also unable to find statistically significant differences between a healthy limb and the one with anterior knee instability among healthy FRQWUROVXEMHFWV0DF'RQDOGHWDO DFFRUGLQJWRWKHLUFRQFOXVLRQVDOVRSUHVHQWHG-36UHVXOWVZKLFKZHUH GLIILFXOWWRLQWHUSUHW
Objective
7KHREMHFWLYHRIWKLVVWXG\ZDVWRHYDOXDWHNQHHMRLQWSRVLWLRQVHQVHLQSDWLHQWVEHIRUHWKHDUWKURVFRSLF$&/ reconstruction and a SHULRGRIPRQWKVDIWHUWKHLQWHUYHQWLRQ,WZDVDOVRPHDQWWRYHULI\WKHLQIOXHQFHRI$&/ UHFRQVWUXFWLRQZLWKDXWRJHQRXVVHPLWHQGLQRVXVPXVFOHWHQGRQDQGJUDFLOLVPXVFOHWHQGRQJUDIWRQSURSULRFHSWLYH NQHHMRLQWSRVLWLRQVHQVH
Methods
7KH UHVHDUFK SURMHFW ZDV DJUHHG WR E\ WKH %LRHWKLFDO &RPPLWWHH RI 6FLHQWLILF 5HVHDUFK DW $FDGHP\ RI Physical Education (resolution no. 6/12 of June 1st 7KHUHVHDUFKZDVFDUULHGRXWLQD JURXSRIVSHFLILFDOO\
VHOHFWHGPHQ PHDQDJH \HDUVPHDQZHLJKW NJPHDQKHLJKW FP $OORIWKH SDWLHQWVUHJXODUO\SUDFWLFHGDPDWHXUVSRUWVEHIRUHWKHLQMXU\DQGKDGWKHLU$&/LQMXUHGGXULQJD VSRUWLQJDFWLYLW\$OO WKHH[DPLQHGZHUHGLDJQRVHGZLWK$&/LQMXU\EDVHGRQWKHLUPHGLFDOKLVWRU\DQGDGGLWLRQDOLPDJLQJH[DPLQDWLRQV $OORIWKHPKDGEHHQSUHYLRXVO\TXDOLILHGIRUVXUJLFDOWUHDWPHQWGXHWRXQLODWHUDOSRVW±WUDXPDWLFDQWHULRUNQHH joint instability. ACL injury concerned only one of the limbs. The healthy limb was treated as internal control. The DUWKURVFRSLF$&/UHFRQVWUXFWLRQZDVFRQGXFWHGLQHDFKFDVHE\NHHSLQJWKHOLJDPHQW¶VRULJLQDOVWXPSVDQGXVLQJ autogenous semitendinosus and gracilis muscle tendons. Patients with articular cartilage damage of 3rd and 4th grade
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method and to make him accustomed to the given commands. Before each test, the device’s calibration was tested and a ZDUPXSRQWKHVWDWLRQDU\ELF\FOHZDVSHUIRUPHG7KHH[DPLQDWLRQSURFHGXUHFRQVLVWHGRIDFWLYHLQWHQWLRQDO UHSURGXFWLRQRINQHHMRLQWIOH[LRQLQWKHIROORZLQJDQJXODUSRVLWLRQV 7KHGHFLVLRQZDVPDGHWRFDUU\RXW WKHWHVWRIDFWLYHMRLQWUHSURGXFWLRQWRJLYHXVPRUHDIIHUHQWLQIRUPDWLRQDVFRPSDUHGZLWKD -36SDVVLYHWHVW 2OVVRQ HWDO DQGDVHYLGHQFHGE\WKHUHVHDUFKRI%H\QQRQHWDO VXFKD WHVW\LHOGVWKHODUJHVWUHSHDWDELOLW\ DQGVHQVLWLYLW\RIWKHWHVW)RUWKHSXUSRVHRIWKLVVWXG\WKHDEVROXWHPHDQHUURU WKHDYHUDJHHUURULQWKHWUHH trials ignoring the direction of the error), relative error (the average of errors in the three trials taking into account the direction of the error), and variable error (the standard deviation of the three relative error measurements) were FDOFXODWHG 2OVVRQHWDO
7KHPHDVXUHPHQWVRIDFWLYHUHSURGXFWLRQRINQHHMRLQWSRVLWLRQZHUHFRQGXFWHGXVLQJD functional evaluation GHYLFHHTXLSSHGZLWKHOHFWURQLFJRQLRPHWHU±%DOWLPRUH7KHUDSHXWLF(TXLSPHQW %7( 35,086567KHVXEMHFW ZDVSODFHGRQD chair, with his head and his back on a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Figure 1.
Subject during the JPS trialStatistical analysis
7KH -36 H[DPLQDWLRQ UHVXOW IRU HDFK DQJXODU VHWWLQJ ZDV SUHVHQWHG E\ WKH DYHUDJH YDOXH obtained from three measurements for each of the given angular settings. The means of each, obtained in that ZD\ZHUHFRPSDUHGE\WKHDQDO\VLVRIYDULDQFHIRUWKHUHSHDWHGPHDVXUHPHQWV$129$IRUHYHU\GHSHQGHQW variable: JPS absolute error, JPS relative error, and JPS variable error, which characterize the accuracy and SUHFLVLRQRIPHDVXUHPHQW %ULQGOHHWDO 2OVVRQHWDO 7KHREWDLQHGUHVXOWVZHUHHODERUDWHGEDVHGRQ WKHFRPPRQO\XVHGVWDWLVWLFDODQDO\VLVPHWKRGE\PHDQVRI67$7,67,&$VRIWZDUHSDFNDJHYHUVLRQ 6WDW6RIW ,QF 4XDQWLWDWLYHPDUNVZHUHGHVFULEHGE\XVLQJWKHDULWKPHWLFDYHUDJHVWDQGDUGGHYLDWLRQ 6' VNHZQHVV DQGNXUWRVLV7KHVWDWLVWLFDOO\VLJQLILFDQWGLIIHUHQFHVEHWZHHQWKHYDULDEOHVIRUERWKOLPEVZHUHH[DPLQHG:LWK WKHSXUSRVHRIGHWHUPLQLQJWKHVWDWLVWLFDOGLIIHUHQFHVVLJQLILFDQFHOHYHORIWKHSRVW±KRFDQDO\VLVZDVFDUULHGRXW %RQIHUURQLPXOWLSOHFRPSDULVRQZDVFKRVHQWRFDUU\RXWWKHDQDO\VLV7KHVLJQLILFDQFHOHYHOLQDOOWKHVWDWLVWLFDOWHVWV ZDVS
Results
$QDO\VLVRIYDULDQFHIRUWKHUHSHDWHGPHDVXUHPHQWVRIWKHYDULDEOH DEVROXWHUHODWLYHDQGYDULDEOHHUURU 3 î$129$ DQJOH GLGQRWGHPRQVWUDWHD statistically significant JPS variability in either of the limbs, HLWKHUEHIRUHRUILYHPRQWKVDIWHUWKHDUWKURVFRSLF$&/UHFRQVWUXFWLRQ3RVWKRFDQDO\VLV %RQIHUURQLWHVW GLGQRW UHYHDODQ\VLJQLILFDQWGLIIHUHQFHVEHWZHHQWKHH[DPLQHGDQJXODUSRVLWLRQV DQG 7KHELJJHVWGLIIHUHQFH RIWKHDFWLYHUHSURGXFWLRQRINQHHMRLQWSRVLWLRQZDVQRWLFHGLQWKHYDULDEOHHUURUVFRUHVIRUWKHDQJOHRI
Figure 2.
'LIIHUHQFHVEHWZHHQLQMXUHG$&/DQGQRQLQMXUHG$&/NQHHLQDYHUDJHYDULDEOHHUURURI-36LQth, 8th, 12th, 16thDQGth weekDiscussion
5HVHDUFKFRQFHUQLQJ-36HYDOXDWLRQRIWKHNQHHDQGSURSULRFHSWLRQGLVRUGHUVLQSDWLHQWVZLWK$&/LQMXU\KDV contradictory results. )UHPHUH\HWDO LQWKHLUUHVHDUFKRINQHHMRLQWSURSULRFHSWLRQZHUHWU\LQJWRHYDOXDWHWKHEDW\HVWKHVLD LQWKHSUH±DQGSRVW±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lack of significant GLIIHUHQFHVLQNQHH-36H[DPLQDWLRQZKLFKLVH[SODLQHGE\WKHPXVFOHDFWLYDWLRQ QHXURPXVFXODUFRQQHFWLRQV LQ WKHVWDJHRIUHSURGXFLQJD JLYHQMRLQWSRVLWLRQIRUFLQJWKHVLJQDOSDVVDJHLQDQRSHQIHHGEDFNORRS$VWKH\FODLP WKHPXVFOHLQYROYHPHQWLQWKHSURFHVVRIUHSURGXFLQJD MRLQWSRVLWLRQOLPLWVWKHSRVVLELOLW\RILVRODWHGHYDOXDWLRQRI WKHLPSDFWWKDWWKHOLJDPHQWGDPDJHPD\KDYHRQ-362QWKHRWKHUKDQGWKHVDPHPXVFOHLQYROYHPHQWOHWVXV HYDOXDWHWKHLPSDFWWKDWWKHGDPDJHKDVRQWKHIXQFWLRQDOG\QDPLFMRLQWVWDELOL]DWLRQYLD-36WHVWLQWKHDFWLYH movement with the joint’s natural loads.
In our study, we were unable to find any statistically significant value differences of active error score for knee MRLQWSRVLWLRQUHSURGXFWLRQLQDQ\RIWKHWHVWHGSRVLWLRQV
Conclusions
7KHUHVXOWVRIWKHFRQGXFWHGH[DPLQDWLRQGLGQRWGHPRQVWUDWHDQ\VLJQLILFDQW-36GLYHUVLW\EHWZHHQLQGLYLGXDO limbs. JPS evaluation did not allow the limb with ACL injury to be distinguished from the healthy one in the tested DQJXODUIOH[LRQUDQJH :HFDQFRQFOXGHWKDW$&/UHFRQVWUXFWLRQZLWKDXWRJHQRXVVHPLWHQGLQRVXVDQG JUDFLOLVPXVFOHWHQGRQVKDVOHVVLPSDFWRQSURSULRFHSWLYH-36UHVWLWXWLRQLQWKHIROORZLQJDQJXODUUDQJH DQG ,WZDVQRWLFHGLQWKHDQDO\VLVRI-36WHVWUHVXOWVWKDWGHSHQGLQJRQWKHILQDOHIIHFW±WKHV\VWHPDWLFVSRUW DFWLYLW\SHUIRUPHGE\WKHH[DPLQHGSDWLHQWVEHIRUHWKHVXUJHU\PLJKWSRVVLEO\LQIOXHQFHWKHILQDOUHVXOW:HPD\ FRQFOXGHWKDWWKHSK\VLFDODFWLYLW\HIIHFWVWKHLPSURYHPHQWRIWKHSURSULRFHSWLYHVHQVHPHFKDQLVPVWKHUHVXOWRI ZKLFKPD\EHWKHUHFRYHU\RIFRQVFLRXV³MRLQWVHQVH´DQGG\QDPLFMRLQWVWDELOL]DWLRQDFKLHYHPHQW,QRXUVWXGLHV we were restricted by a VPDOOQXPEHURISDWLHQWVDQGWKHIDFWWKDWRQO\WKH-36KDGEHHQHYDOXDWHGDPRQJD wide UDQJHRIRWKHUVFLHQWLILFPHWKRGVRINQHHMRLQWSURSULRFHSWLRQH[DPLQDWLRQHJHYDOXDWLRQRIGLIIHUHQWLDWLRQIRUJLYHQ OHYHORIPXVFXODUVWUHQJWKDFWLYHUHSURGXFWLRQRIWKHMRLQWSRVLWLRQIRUWKHRSSRVLWHOLPE
References
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Nakamura N., Horibe S., Sasaki S., Kitaguchi T., Tagami M., Mitsuoka T., Toritsuka Y., Hamada M., Shino K. Evaluation of active knee IOH[LRQDQGKDPVWULQJVWUHQJWKDIWHUDQWHULRUFUXFLDWHOLJDPHQWUHFRQVWUXFWLRQXVLQJKDPVWULQJWHQGRQV$UWKURVFRS\ ±
O’Connell M., George K., Stock D. Postural sway and balance testing: a FRPSDULVRQRIQRUPDODQGDQWHULRUFUXFLDWHOLJDPHQWGHILFLHQW knees. Gaite Posture. 1998; 8: 136–142.
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