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Ocena propriocepcije kolena po rekonstrukciji sprednje križne vezi
Avtor: Borut Pompe, Klemen Stražar
Mentor: doc. dr. Vane Antolic, dr.med.
Somentor: prof. dr. Vinko Pavlovcic, dr.med., dr. Uroš Stanic
IZHODIŠCA: V sprednji križni vezi kolena se nahajajo mehanoreceptorji, ki imajo funkcijo propriocepcije. Pri strgani vezi je prekinjena povezava med proprioceptorji in centralnim živcnim sistemom. Proprioceptivni signali iz sprednje križne vezi manjkajo, zato predvidevamo, da je moten obcutek o položaju poškodovanega kolena.
NAMEN: V nalogi skušamo oceniti kakovost propriocepcije v obdobju 6 do12 mesecev po rekonstrukciji sprednje križne vezi pri 12 zdravih ljudeh.
METODA: Metodo smo izvajali s trodimenzionalnim opticnim sistemom za analizo gibanja-ELITE. Propriocepcijo kolena smo ocenjevali z merjenjem sposobnosti ponovitve kota skrcenja kolena. Ocenjevali smo jo tudi z gibanjem opticnih markerjev pri doskoku na eno nogo z 20 cm visokega podstavka, kjer smo merili najvecji pojemek markerja pritrjenega na koleno, cas od stika s tlemi do najvecjega pojemka, kot skrcitve kolena pri najvecjem pojemku in najvecje dosežene kote skrcitve kolena.
REZULTATI: Povprecni pogreški kotov pri ponovitvi skrcenja noge v kolenu se pri skupini poškodovanih statisticno znacilno niso razlikovali med zdravo in poškodovano nogo, vendar pa je bila razlika poprecnih pogreškov kotov med kontrolno skupino in skupino poškodovanih statisticno znacilna. Poprecja najvecjih pojemkov opticnih markerjev pri doskoku in casov od stika s tlemi do najvecjega pojemka se pri poškodovancih in kontrolni skupini statisticno niso razlikovali. Ugotovili smo statisticno znacilno razliko med skupino poškodovanih in kontrolno skupino pri merjenju povprecij najvecjih kotov skrcenja kolena ter kotov pri najvecjem pojemku pri doskoku.
ZAKLJUCKI: Metoda pri kateri merimo sposobnost ponovitve kota sklepa, je uporabna za oceno propriocepcije kolena. Propriocepcijo je možno ocenjevati tudi z metodo pri kateri merimo kote pri doskoku. Manjši doseženi koti med doskokom so verjetno posledica mehanizmov, ki jih po poškodbi organizem aktivira, da bi preprecil ponovno poškodbo.
[Abstract / English version]
Impaired proprioception after anterior cruciate ligament reconstruction
Author: Borut Pompe, Klemen Stražar
Mentor: doc. dr. Vane Antolic, dr.med.
Co-mentor: prof. dr. Vinko Pavlovcic, dr.med., dr. Uroš Stanic
INTRODUCTION: In anterior cruciate ligament mechanoreceptors with proprioceptive function were found. In anterior cruciate ligament deficient knee the proprioception of the knee is diminished.
AIM: The aim of our study was to evaluate the proprioception of the knee and its influence on the jump. Proprioception of the knee was tested in 13 patients 6-12 months after the reconstruction of anterior cruciate ligament and in 12 age-matched healthy individuals.
METHODS: The proprioception was measured by detecting the ability to reproduce the flexion angles of the knee with 3 dimensional optical motion analysis system ELITE. The patients were also asked to jump on one foot from the height of 20 cm. During the landing phase of the jump maximal deceleration during the landing phase of the jump. the time between touching the ground and maximal deceleration, the angle in time of maximal deceleration and maximal angle reached during the jump were detected by the ELITE system.
RESULTS: The error of the angle reproducement was significantly higher on both legs in patients with reconstructed anterior cruciate ligament compared to the healthy individuals. No difference was found in the ability reproducing the angles between injured and non-injured leg in patients with reconstructed anterior cruciate ligament. Maximal deceleration during the landing phase of the jump and the time between touching the ground and maximal deceleration did not differ significantly when the two tested groups were compared. Maximal angle reached during the jump and the angle in time of maximal deceleration were significantly lower in patients with reconstructed anterior cruciate ligament.
CONCLUSIONS: The ability to reproduce the position of the limb was found to be useful but subjective test to detect the proprioceptive function of the knee. Measuring the angles during the jump is found to be a useful test for estimation of the proprioception. Lower reached angles in anterior cruciate ligament reconstructed patients during the landing phase of the jump could indicate the involvement of protective mechanism.