Rehabilitation of Patients with Arthrogenic Muscular Inhibition in Pathologies of Knee Using Virtual Reality

Flórez Fonnegra, Juan Pablo; Pino Prestan, Andrea Carolina; López, Lucelly López; Yepes, Juan C.; Pérez, Vera Z.

doi:10.3390/s23229114

Cited by 3 publications

(1 citation statement)

References 15 publications

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“…Virtual reality (VR) may create changes in cortical circuits. 36 These adaptations can be produced by different VR systems. The simplest of these systems provide sensory feedback, while more immersive systems facilitate learning by placing patients in a motivating environment or by allowing them to learn based on the observation of reality, action, and/or imitation in a modified environment.…”

Section: Rehabilitation Interventions ( Table 1 )mentioning

confidence: 99%

Quadriceps Activation After Anterior Cruciate Ligament Reconstruction: The Early Bird Gets the Worm!

MOIROUX--SAHRAOUI,

FORELLI,

MAZEAS

et al. 2024

International Journal of Sports Physical Therapy

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Arthrogenic Muscle Inhibition (AMI) is a phenomenon observed in individuals with joint injury or pathology, characterized by a reflexive inhibition of surrounding musculature, altered neuromuscular control, and compromised functional performance. After anterior cruciate ligament reconstruction (ACLR) one of the most obvious consequences of AMI is the lack of quadriceps activation and strength. Understanding the underlying mechanisms of AMI is crucial for developing effective therapeutic interventions. The surgical procedure needed to reconstruct the ACL has biochemical et physiological consequences such as inflammation, pain, and altered proprioception. These alterations contribute to the development of AMI. Therapeutic interventions aimed at addressing AMI encompass a multidimensional approach targeting pain reduction, inflammation management, proprioceptive training, and quadriceps activation. Early management focusing on pain modulation through modalities like ice, compression, and pharmacological agents help mitigate the inflammatory response and alleviate pain, thereby reducing the reflexive inhibition of quadriceps. Quadriceps activation techniques such as neuromuscular electrical stimulation (NMES) and biofeedback training aid in overcoming muscle inhibition and restoring muscle strength. NMES elicits muscle contractions through electrical stimulation, bypassing the inhibitory mechanisms associated with AMI, thus facilitating muscle activation and strength gains. Comprehensive rehabilitation programs tailored to individual needs and stage of recovery are essential for optimizing outcomes in AMI. The objective of this clinical viewpoint is to delineate the significance of adopting a multimodal approach for the effective management of AMI, emphasizing the integration of pain modulation, proprioceptive training, muscle activation techniques, and manual therapy interventions. Highlighting the critical role of early intervention and targeted rehabilitation programs, this article aims to underscore their importance in restoring optimal function and mitigating long-term complications associated with AMI.

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Section: Rehabilitation Interventions ( Table 1 )mentioning

confidence: 99%

Quadriceps Activation After Anterior Cruciate Ligament Reconstruction: The Early Bird Gets the Worm!

MOIROUX--SAHRAOUI,

FORELLI,

MAZEAS

et al. 2024

International Journal of Sports Physical Therapy

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Virtual reality‐based therapy after anterior cruciate ligament injury effectively reduces pain and improves knee function, movement patterns, and dynamic balance: A systematic review and meta‐analysis

Cortés‐Pérez,

Desdentado‐Guillem,

Camacho‐Delgado

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeVirtual reality‐based therapy (VRBT) may be an effective physical therapy complement employed in the rehabilitation of patients with anterior cruciate ligament (ACL) injury. This study aims to assess the effectiveness of VRBT in improving pain, knee function, strength, proprioception, flexion range of motion (ROM), and dynamic balance after ACL injury.MethodsWe conducted this systematic review with meta‐analysis following PRISMA criteria. Since inception to June 2024, we searched in PubMed Medline, WOS, SCOPUS, CINAHL and PEDro without publication date and language restrictions. Randomised controlled trials (RCTs), comprising only patients with ACL injury, that assess the effectiveness of VRBT compared to classical interventions on the outcomes of interest were included. PEDro scale was employed to analyze the methodological quality of the RCTs included. Cohen's standardised mean difference (SMD) and its 95% confidence interval (95% CI) was used to calculate the pooled effect in meta‐analyses.ResultsNine RCTs, providing data from 330 participants (26.96 ± 3.11 years, 85% males) were included. The RCTs included showed good methodological quality (PEDro scale = 6.88 points), being, performance and detection biases, the most common biases reported. Meta‐analyses showed that VRBT was more effective than classical interventions in reducing pain (SMD = −1.15; 95% CI −1.85 to −0.45; p = 0.001; I2 = 0%), and increasing knee function (SMD = 1.71; 95% CI 0.93 to 2.5; p < 0.001; I2 = 0%), strength (SMD = 0.82; 95% CI 0.4–1.23; p < 0.001; I2 = 0%) and flexion ROM (SMD = 0.7; 95% CI 0.37–1.01; p < 0.001; I2 = 0%). Additionally, VRBT improved postero‐medial (SMD = 0.46; 95% CI 0.01–0.9; p = 0.045; I2 = 15.1%) and postero‐lateral CoP excursion (SMD = 0.75; 95% CI 0.3–1.21; p = 0.001; I2 = 0%), being effective in improving dynamic balance.ConclusionVRBT is an effective physical therapy complement to be included in the ACL's rehabilitation programmes due to reduces pain and increases knee function, strength, ROM and dynamic balance after ACL injury.Level of evidenceLevel II evidence.

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Arthrogene Muskelinhibition (AMI)

Praetorius,

Schoepp

2024

Knie J.

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Rehabilitation of Patients with Arthrogenic Muscular Inhibition in Pathologies of Knee Using Virtual Reality

Cited by 3 publications

References 15 publications

Quadriceps Activation After Anterior Cruciate Ligament Reconstruction: The Early Bird Gets the Worm!

Quadriceps Activation After Anterior Cruciate Ligament Reconstruction: The Early Bird Gets the Worm!

Virtual reality‐based therapy after anterior cruciate ligament injury effectively reduces pain and improves knee function, movement patterns, and dynamic balance: A systematic review and meta‐analysis

Arthrogene Muskelinhibition (AMI)

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