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Does the number and frequency of supervised physiotherapy effect the biomechanical function of the knee joint after ACLR
Author(s):
Czamara A. (Poland)
,
Czamara A. (Poland)
Affiliations:
Krzeminska Katarzyna
,
Krzeminska Katarzyna
Affiliations:
Szuba L.
,
Szuba L.
Affiliations:
Krolikowska Aleksandra
,
Krolikowska Aleksandra
Affiliations:
Reichert P.
Reichert P.
Affiliations:
ESSKA Academy. Czamara A. 05/09/18; 209405; P05-1920 Topic: Sports Related Injuries
Assoc. Prof. Andrzej Czamara
Assoc. Prof. Andrzej Czamara
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Abstract
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Objectives: So far, there is no evidence of the influence of the frequency of supervised physiotherapy visits on the biomechanical parameters of the knee joint muscles in patients after anterior cruciate ligament reconstruction (ACLR). The study aimed to compare the effect of six months postoperative physiotherapy of high-frequency versus low-frequency physiotherapy visits regime in ACLR patients.

Methods: Group I comprised male patients after ACLR (n=20), who underwent postoperative high-frequency supervised physiotherapeutic procedure (x=74.1 appointments). Group II comprised male patients after ACLR (n=20), who underwent postoperative low-frequency and supervised physiotherapeutic procedure (x=31.7 appointments). The time of one visit with the physiotherapist lasted two hours. Group III, controls, comprised males (n=20) without knee injuries. The orthopedic examinaton, the range of movement measurement and pain assessment were carried out. In groups I and II, measurements of maximum torque (N*m) under isometric conditions of knee flexors and knee extensors at 13 and 24 weeks after ACLR and under isokinetic conditions at 18 and 24 weeks since the ACLR (60/s, and 180/s) were carried out. In the Group III, biomechanical measurements were performed once. Relative values of isometric (RIT) and isokinetic (RPT) torque were calculated by dividing the torques by body mass and analyzed. The values of total work (TW) expressed in (J), and power (P) given in (W) and their relative values (RW) and (RP) were also analyzed. The results were statistically analyzed.

Results: The first assessment demonstrated in both ACLR groups statistically significantly lower RIT and RPT, RW, and RP values of the extensors and flexors muscles of operated side compared to the unoperated side (p=0.003 to p=0.001). After 24 weeks, significant increases of RIT, RPT, RW, and RP in both groups were observed, and there was no pain and range of movement difference. However, in Group II compared to Group I, there was a statistically significantly lower value of biomechanical parameters on the operated side vs. the unoperated side for both examined muscle groups (p=0.008 to p=0.001). Post hoc analysis showed significantly lower RPT's of the knee extensors and RIT of the flexors compared to control group (p=0.040, p=0.047).

Conclusions: Performing 6 months of supervised physiotherapy with more regular visits improved the RIT and RPT values and other biomechanical parameters of knee flexors and extensors in isokinetic and isometric tests compared to fewer and less regular physiotherapy visits in ACLR patients.

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