No abstract

Interventional training programs with the SpeedCourt system seem to be advantageous in the late rehabilitation following ACL-knee surgery compared to current sensomotoric based concepts. We achieved improvements of anthropometric and functional parameters. Further studies with larger groups and longer periods of evaluation are necessary to support these data and to possibly establish a new innovative rehabilitation concept. Clinically, the demonstrated SpeedCourt system might help to determine the time "back/return to sports" for athletes more objectively and prospectively reduce the rate of ACL re-injuries.

There are currently no longitudinal data describing the pre- and postoperative postural regulation and stability of patients with anterior cruciate ligament (ACL) damage. Therefore, the aim of this study was to evaluate postural regulation and stability prior to and during rehabilitation following surgery of the ACL. Fifty-four physically active subjects (age: 30.5±10.9 years, 29 male subjects) were examined with the Interactive Balance System pre-, 6, and at 12 weeks following surgical reconstruction of the ACL using a hamstring tendon graft. The average period of time from injury to surgery was 27 days. Data were calculated with unifactorial and univariate analysis of variance. Significant effects were found for the somatosensory system (η2=0.115), stability indicator (η2=0.123), weight distribution index (η2=0.176), and synchronization (foot coordination) (η2=0.249). Involved side weight distribution (parameter: left) increased significantly (patients with left-sided/right-sided injury: η2=0.234/0.272). Load distribution to the heel remained stable during all three examination periods (η2=0.035 and η2=0.071), although a remarkable load at forefoot was observed. In seven out of 10 parameters partial effects were seen during the first 6 weeks after surgery. The results of this study indicated that injury of the ACL and subsequent surgical reconstructions result in postural regulation, with improvements in somatosensory system function, postural stability, weight distribution index, and foot coordination. Also, overloading of the injured side on the feet reduces significantly during rehabilitation. Thus, the initial phase of rehabilitation (weeks 1 to 6) seems to be more effective than the second period (weeks 6 to 12) postoperatively.

Our data revealed that training with fast responses at the SpeedCourt system clearly improved speed and speed strength performance of young soccer athletes, which is remarkable given the low intensity of influences (one TS per week). The increase in performance was accompanied by a significant reduction of the injury rate.

Knee osteoarthrosis (OA) is a widespread orthopedic problem and a high tibial osteotomy (HTO) is a common treatment to minimize degeneration of the affected compartment. The primary aim of this study was to evaluate the postural regulation and stability among patients who underwent HTO and rehabilitation. This prospective study included 32 patients (55.3 ± 5.57 years) diagnosed with medial tibiofemoral OA. Each subject completed postural regulation and stability testing (Interactive Balance System), as well as pain intensity (visual analogue scale) and quality of life questionnaires (SF-36) prior to HTO (exam 1), and at six weeks (exam 2), twelve weeks (exam 3) and six months (exam 4) post HTO. For postural comparison, all patients were matched (sex, age, height) with asymptomatic subjects. Significant time effects (exam 1 vs. exam 4) were found for weight distribution index (WDI; ηp2 = 0.152), mediolateral weight distribution ηp2 = 0.163) and anterior–posterior weight distribution ηp2 = 0.131). The largest difference (exam 3: ηp2 = 0.251) and the most significant differences to the matched sample were calculated for the stability indicator (exam 1: ηp2 = 0.237; exam 2: ηp2 = 0.215; exam 3: ηp2 = 0.251; exam 4: ηp2 = 0.229). Pain intensity showed a significant reduction (ηp2 = 0.438) from exam 1 (50.7 ± 20.0 mm) to exam 4 (19.3 ± 16.0 mm). Physical pain was the quality of life parameter with the largest improvement between exams 1 and 4 (ηp2 = 0.560). HTO allows patients to improve their mediolateral weight distribution, whereas postural stability is consistently lower than in asymptomatic subjects. This surgery leads to marked improvements in quality of life and pain.

ZusammenfassungIn den letzten Jahren wurden bedeutende Fortschritte in den chirurgischen Techniken, der postoperativen Rehabilitation und der Identifizierung von Risikofaktoren für eine zweite Verletzung des vorderen Kreuzbands (VKB) gemacht. Dies führte jedoch nicht zu einer Verringerung des sekundären VKB-Verletzungsrisikos. Die Wiederherstellung der anatomischen (operative Rekonstruktion) und anschließend insbesondere der trainingsbedingten funktionellen Stabilität sollte eine grundlegende Voraussetzung für die Rückkehr zu Pivot-Sportarten nach einer VKB-Verletzung sein. Das VKB hat eine bedeutende Rolle bei der Kniepropriozeption mit der Konsequenz einer eingeschränkten sensomotorischen Regulation im Verletzungsfall. Das Perturbationstraining stellt eine große Herausforderung in der spätrehabilitativen Phase nach VKB-Rekonstruktion dar. Die Diagnostik der Muskelaktivierung im Rehabilitationsverlauf nach VKB-Rekonstruktion hat deshalb eine enorme Bedeutung. Mit der entwickelten Software können Charakteristika der motorischen Einheiten knieführender Muskeln zeitnah objektiviert und somit eine mögliche Überlastung bei hochreaktivem Perturbationstraining im Rahmen der spätrehabilitativen Phase nach VKB-Rekonstruktion vermieden werden.

No abstract

Traumatic posterior locked shoulder dislocation is very rare. The dislocation is often combined with fractures of the humeral head or reversed Hill-Sachs deformities. This case report shows two different possibilities for treatment.