Improvement of posture stability by vibratory stimulation following anterior cruciate ligament reconstruction

Abstract

Surgical reconstruction of the anterior cruciate ligament (ACL) may reduce, but it does not always eliminate, knee and body instability because of a persisting proprioceptive deficit. In order to enhance body stability, a new protocol of treatment has been proposed consisting of mechanical vibration (100 Hz frequency and < 20 microm amplitude) of the quadriceps muscle in the leg that has undergone ACL reconstruction. In our trials, stimulation was performed when the quadriceps muscle was kept isometrically contracted. Treatment was started one month after surgery. Vibration was applied for short periods over three consecutive days. Nine months after treatment, postural stability was re-evaluated with the subjects standing on one leg with open and with closed eyes. The postural stability of the subjects having undergone vibration treatment, standing on the operated leg was significantly improved one day after treatment when evaluated as mean of speed and elliptic area of the center of pressure. The improvement persisted and increased during the following weeks. Peak torques of the operated leg extensor muscles also increased and reached values close to that of the leg, which had not been operated. Conversely, the balance of the untreated subjects standing on the operated leg did not improve and the restoration of the extensor muscle peak torque was poor. It is concluded that short lasting proprioceptive activation by vibration may lead to a faster and more complete equilibrium recovery probably by permanently changing the network controlling knee posture.

Rehabilitation After Anterior Cruciate Ligament Reconstruction

“…Brunetti et al performed a randomized, double-blind, placebo-controlled trial to evaluate whether vibratory stimulation could cause complex electrical and mechanical stimuli shown to improve proprioception 30 . Vibratory treatment consisted of mechanical vibration at a 100-Hz frequency and <20-mm amplitude applied for thirty minutes on three consecutive days to the distal aspect of the quadriceps muscle of the operatively treated leg one month after surgery.…”

Effects of local vibrations on skeletal muscle trophism in elderly people: mechanical, cellular, and molecular events

“…Brunetti and coworkers studied posture stability after vibratory stimulation following anterior cruciate ligament reconstruction. These authors concluded that vibration leads to a faster and more complete recovery of equilibrium, confirming a role for vibration in proprioceptive stimulation (19). In conclusion, it remains difficult to find a rationale that is logically used to design vibration treatment and to predict treatment outcomes.…”

Effect of Proprioceptive Rehabilitation on Postural Control Following Anterior Cruciate Ligament Reconstruction

“…Surgical reconstruction of the anterior cruciate ligament (ACL) may reduce, but it does not always eliminate knee and body instability because of a persisting proprioceptive deficit 24) . The main goal of our study was to evaluate changes in postural control and its effects on the functional status of patients who had undergone unilateral ACL reconstruction (ACLR).…”