virtuelle Fachbibliothek Sportwissenschaft
Dissertation: Lothar Thorwesten
Abstract Variances in selected gait parameters during rehabilitation of ACL reconstructed patients
Within this study 50 patients (33 men with an average age of 27.7 years as well as 17 women with an average age of 26.4 years) were tested at 8, 12 and 24 weeks after ACL reconstruction. The number of patients reduced to 35 patients in the 2nd Test after 12 weeks and/or 19 patients in the 3rd test after 24 weeks. A group of 19 volunteers (14 men with an average age of 30.6 years as well as 5 women with an average age of 26.2 years) served as a control group.
The motion analysis was performed on a treadmill at standardized speeds of 3 km/h and 4 km/h. An automatic electrooptical motion analysis system with passive retroflecting markers was used to measure kinemetric data. Ground reaction forces were calculated using force plates.
The results of the kinemetric data showed a significant reduction of the contact time of the injured leg during gait cycle, as well as a reduced step length in 1st and 2nd test at 8 and 12 weeks after ACL reconstruction respectively. Furthermore the kinemetric data of the knee joint revealed a persisting deficit of knee extension during heel contact phase as well as an existing Flexion-Extension deficit during stance phase. The measured data of the ankle joint suggested an adaptation of the maximum joint angle during stance phase for both sides. The hip angle of the uninjured side demonstrated a higher hip extension at the end of the stance phase. The altered joint positions during gait cycle were accompanied by changes in movement velocities.
The data of the force plates showed significant side-differences regarding anterior/posterior force parameters in the 3rd test at 24 weeks after surgical reconstruction. This can also be demonstrated for the second peak of vertical force parameters.
The reduced development of vertical torque on the ACL reconstructed side is most likely related to changes in movement patterns with reduced interior and external rotation of the injured leg. 24 weeks after surgical reconstruction of the ACL significant differences in numerous gait parameters can be measured.
These results are most likely explained by modified sonsorimotor feedback depending on loss of propriocetive afferences as well as the aditional trauma caused by surgical treatment.
Finally this study underlines the importance of objective therapy control and accentuates the relevance of special propriocetive training in ACL-patients as well as a special gait training in the context of the rehabilitation.
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