Proprioception and performance after anterior cruciate ligament rupture

Abstract

The aim of this study was to investigate the characteristics of proprioception in patients with an anaterior-cruciate-ligament (ACL)-injured knee and to determine whether there is a correlation between proprioception and performance. We studied 32 patients with unilateral isolated ACL ruptures. Proprioception of the knee was evaluated by examining the joint position sense. Functional performance was evaluated with the one-leg hop (OLH) and one-leg vertical jump (OLV) tests. The mean error angle of the joint position sense was 3.6±1.5°o n the intact side and 5.2±1.9°on the injured side. The joint position sense was thus clearly reduced on the injured side (p<0.05). The distance of jumping in the OLH test and the height of jumping in the OLV test was also clearly reduced on the injured side compared with that on the intact side (p<0.01) both with and without visual control. Moreover, we found a significant correlation between proprioception and performance in the ACL-injured knees, and this correlation was more distinct with visual deprivation. In conclusion, decreased proprioception in patients with ACL deficiency reduced their functional ability.Résumé Le but de cette étude était d'étudier les caractéristiques de proprioception chez les malades avec une lésion du LCA, et déterminer s'il y avait une corrélation entre proprioception et performance. Nous avons étudié 32 malades avec une rupture isolée unilatérale du LCA. La proprioception du genou a été évalué en examinant le sens des positions de l'articulation. La fonction a été évaluée avec le saut à cloche-pied (OLH) et saut vertical unipodal (OLV). L'angle moyen d'erreur de position était 3,6±1,5°sur le côté intact et 5,2±1,9°sur le côté blessé. Le sens de position était donc notablement réduit du côté blessé (p<0.05). La distance de saut dans l'épreuve OLH et la hauteur du saut dans l'épreuve OLV ont aussi été réduite du côté blessé comparé avec le côté intact (p<0.01) les deux avec et sans contrôle visuel. De plus, nous avons trouvé une corrélation certaine entre proprioception et performance dans les genoux avec lésion du LCA, et cette corrélation était encore plus nette avec privation visuelle. En conclusion, la diminution de la proprioception chez les malades avec une insuffisance du LCA à réduit leur capacité fonctionnelle.

Rehabilitation After Anterior Cruciate Ligament Reconstruction

“…The two groups were similar preoperatively, but after treatment the continuous active motion group had 2.2°greater improvement in joint position sense compared with the continuous passive motion group (p = 0.0001). The authors concluded that the 2.2°represented a clinically significant difference on the basis of previous work correlating improved proprioception and patient satisfaction 41,42 . Several issues in this study led to potential biases; >90% of patients were male, attrition was not mentioned, and there was no discussion of randomization or use of an independent examiner.…”

Motion Alterations After Anterior Cruciate Ligament Reconstruction: Comparison of the Injured and Uninjured Lower Limbs During a Single-Legged Jump

“…We also can suggest that this phenomenon could be related to the deficit in proprioception observed in the knee joint after ACL injury and surgery. 24,25 Katayama et al 25 described a correlation between reduced joint position sense and decreased jumping performance after ACL injury, whereas MacDonald et al 24 observed a higher threshold to detect passive motion of the knee joint in the IL than UL after ACL reconstruction. The reduced knee extension in the IL affects the ankle joint by limiting plantar flexion.…”

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

“…Several studies have shown that even after ACL r u p t u r e , p a t i e n t s d i s p l a y d e c r e a s e d proprioception 4,5,16) and to some extent this remains even after reconstruction 2,6,17) . It has also been shown that patient satisfaction does not correlate well with knee joint stability following ACL reconstruction, but rather with the residual level of proprioception.…”