segunda-feira, 23 de março de 2009

ARTIGO DO MÊS (13/2009)

Correlation between proprioception, muscle strength, knee laxity, and dynamic standing balance in patients with chronic anterior cruciate ligament deficiency


Lee, H. M.; Cheng, C. K.; Liau, J. J.
The Knee (2009), Feb 22


ABSTRACT

Proprioception and muscle strength are both reported to influence single-limb stance balance in patients with chronic anterior cruciate ligament (ACL) injuries. However, the effects of these parameters on dynamic stance balance in such patients are currently unknown.


This study was undertaken to ascertain whether proprioception, muscle strength, and knee laxity are correlated with dynamic standing balance in patients with ACL deficiency.

Ten young men with unilateral ACL deficiency participated in this study. The mean time interval from the injury to the study was 12.8 months. Knee laxity measurements, passive re-positioning (PRP) and threshold for detection of passive motion (TTDPM) proprioception tests, quadriceps and hamstring muscle strength tests, and dynamic single-limb balance tests were performed for both injured and uninjured limbs. Significant differences between the injured and uninjured sides were observed for all test parameters.

As independent variables, knee laxity, PRP proprioception, and muscle strength did not correlate with dynamic standing balance for the injured limb. However, a significant positive correlation (P<0.05)>.

KEY-IDEA: To improve dynamic single-limb stance balance in patients with ACL injuries, training in TTDPM proprioceptive ability is recommended as the most important initial approach for such patients.

Snyder-Mackler et al. (1997) found no correlation between the magnitude of passive knee laxity after ACL injury and functional outcome. Knee joint laxity is therefore not likely to serve as a good predictor for balance control and functional outcome.

Rehabilitation programs that improve TTDPM proprioceptive ability, therefore, represent the most important approaches to improving dynamic single-limb stance balance in patients with chronic ACL injuries.

A ESTABILIDADE DINÂMICA FUNCIONAL RESULTA da INTERACÇÃO ENTRE FACTORES NEUROMUSCULARES e FACTORES BIOMECÂNICOS operacionalizada em PADRÕES MOTORES EFICIENTES E SEGUROS.
É MUITO MAIS DO QUE APENAS A ESTABILIDADE ARTICULAR PASSIVA e não deve SER REDUZIDA A ESTA.

Esta é uma ideia chave que em todos os momentos da reeducação funcional um Fisioterapeuta deve aplicar.
Raul Oliveira, Fisioterapeuta
R`Equilibriu_us, Gabinete de Fisioterapia
Av. D. João I, nº 8, Oeiras
309 984 508 / 917231718
Faculdade de Motricidade Humana

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