Ankle sprains (AS) are common in the military population, with a prevalence 5 to 8 times higher than that for civilians. The aim of this study was to evaluate in patients with severe AS the impact of disuse on thigh muscle induced by unloading and immobilization due to care. This study focused on muscle trophicity and dynamometric strength. In this observational prospective study, assessments were repeated at 3 visits: close to injury, 15 and 30 days following the sprain. The injured limb was compared to the contralateral limb. A dynamometer assessment was used to monitor changes in strength and fatigue of the thigh muscles of both limbs. Isometric and isokinetic concentric evaluation of peak torque (PTiso and PTdyn), total work (Wt), and peak torque time integral (IPT) of thigh muscles. Full follow-up was obtained in 30 subjects. The injured limbs showed significant deficits in the mean (SD). The quadriceps PTiso and IPT deficits were −12.6% ± 1.9% ( P < .0001) and −13.27% ± 1.8% ( P < .0001), respectively. The quadriceps PTdyn showed a significant deficit since V2 (−12.2.5% ± 2.0). The quadriceps Wt presented a significant deficit of −4.2% ± 2.4 ( P < .0007) at 1 month. The hamstring PTdyn deficit presented a mean loss of −16.5% ± 2.4% ( P < .0001). The hamstring Wt deficit was −13.7% ± 2.3% ( P < .001). The analysis of variance showed that the grade of the sprain had a significant effect on the quadriceps PTq deficit ( P < .016) but not the type of discharge. Our study showed that disuse leads to a significant deficit in the strength of knee muscles within 1 month. It is noteworthy that the hamstrings are more affected than the quadriceps. The rehabilitation protocol to prevent the risk of iterative ankle injuries and secondary knee injuries should incorporate early training of both quadriceps and hamstrings.
Introduction: Surgery is the first-line treatment for athletes with anterior cruciate ligament tear and who want to regain their preinjury sport level. The main determinants of recovery are joint stability, muscle recovery, and restoration of functional skills. Joint stability is provided by surgery, but there is little information on muscle and functional recoveries. While different surgical techniques are now established and well documented, recovery of muscle properties is not well understood, and few explorations have been done. Currently there is no consensus on the time frame for resuming sports activities after anterior cruciate ligament reconstruction (ACLR), nor on the means of objectifying it. Nevertheless, at 9 month post-operatively there is a great disparity observed in the levels of muscle recovery or reinjury. Anticipating patient status evolution would allow more personalized and adapted rehabilitation. The aim of this study is to test the ability of preoperative and 3 months postoperative measurements to predict neuro-muscular recovery at 9 months postoperative. To that end, trophic (MRI), mechanical (peak torque, work) and neuromuscular (RMS and median frequency) measurements will be performed in sportive subjects followed-up from before surgery to 9 months post-ACLR. Methods and Analysis:This study is a prospective single-center study, with 3 repeated assessments at 0 (pre-operative), 3, and 9 months post-ACLR. 40 patients will be included. 40 healthy subjects will be also enrolled in a single visit as a control group. At each visit, thigh muscle properties will be explored through MRI imaging, isokinetic tests in isometry and dynamic conditions synchronized with surface electromyogram. Questionnaires (IKDC, ARPEGE), and a functional test (COFRAS) will be conducted. All will be crossed to neuromuscular adaptation, muscle strength and fatigue. Discussion:The combination of all these elements coupled with longitudinal monitoring aims to better understand neuromuscular evolution, provide objective criteria for the RTS and propose guidelines for rehabilitation. Depending on the evolution of patients at each stage, it would be interesting to propose a personalized re-athletization according to the patient profile.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.