2010, Volume 6, Issue 2

Evaluation of physiotherapeutic procedures after ACL reconstruction in males



Andrzej Czamara1

1College of Physiotherapy in Wroclaw, Wroclaw, Poland


Full text

Abstract

Background and Study Aim: Evaluation of the four-stage physiotherapy program following ACL reconstruction.
Material and Methods: The sample comprised 108 males divided into two groups. Group I included physically active patients (n = 54) after endoscopic ACL reconstruction using semitendinosus and gracilis muscle graft, as well as Regidfix stabilising. Group II included physically active males with no injuries of the knee joint ( n= 54 ). The subjects were examined by the physician and referred to four stages of physiotherapy. The range of movement was measured for flexion and extension of the knee joints (0) and the knee joint circumference was measured (cm) during the first and twelfth week following the reconstruction. The values of gait kinematics parameters including gait speed (m/s), step length, step frequency (step/s) and stance/swing ratio ( %) were measured during the second and tenth week following the reconstruction. Based on the measurement of torque (Nm) for flexor and extensor muscles of the involved and uninvolved knee joints, performed during the thirteenth and twenty first week following the reconstruction, relative torque ( Nm/ kg ) value was calculated. Fitness test was performed to assess the running speed during the run with maximal speed and envelope run ( s ). The evaluation was performed only once in the control group. The results obtained for the involved limbs were compared to those obtained for the uninvolved limbs and then, subjected to statistic analysis.
Results: During the second examination a significant improvement was noted in the mean values obtained for the range of movements, knee joint circumference and most of the measured gait kinematics parameters and relative torque of the involved knee muscles compared to the first examination results, the values obtained for the uninvolved knees and the control group results.The time of run with maximal speed and envelope run, obtained in patients during the twenty fourth week of physiotherapy was similar to the time obtained for the control group.
Conclusions: The first two stages of physiotherapy (three months following ACL reconstruction) restored full range of movements, knee circumferences and most of the gait kinematics parameters, which were then similar to the values obtained for the control group. The restored torque values for extensor and flexor muscles of the operated knees and the time of runs: with maximal speed and envelope run required four stages of physiotherapy (6 – 8 month following the reconstruction).


Key words: gait kinematics, medical rehabilitation, muscle torque, physiotherapy after acl reconstruction, special test