Der Effekt von Action Observation Therapy auf die Extension nach einer vorderen Kreuzbandplastik: eine randomisierte kontrollierte Pilotstudie

Zusammenfassung

Eine bekannte Komplikation nach einer Plastik des vorderen Kreuzbandes (VKB) ist das Extensionsdefizit (ED). Ziel dieser Studie war, zu erforschen, ob eine zusätzlich zu den klassischen Streckübungen eingesetzte einmalige Anwendung der „Action Observation Therapy“ (AOT) die Extension des Kniegelenks nach einer VKB-Plastik deutlicher verbessert als eine Therapiesitzung ohne AOT.

13 Proband(inn)en mit ED nach einer VKB-Plastik wurden in eine AOT-Gruppe (n = 8) und eine Kontrollgruppe (n = 5) randomisiert. Jede Gruppe erhielt eine Therapiesitzung. Die Therapie bestand aus dem Betrachten eines Videos, gefolgt von aktiven Extensionsübungen, wobei das Video der AOT-Gruppe Extensionsübungen und das der Kontrollgruppe Landschaftsaufnahmen zeigte. Primäres Outcome war das Bewegungsausmaß der aktiven Extension, als sekundäre Outcomes wurden das Bewegungsausmaß der passiven Extension und die Heel-Height Difference (HHD) gemessen. Die Messungen erfolgten direkt vor und nach der Behandlung.

Die aktive Extension verbesserte sich sowohl in der AOT-Gruppe (von ∅ –2,0° (± 6,3) auf ∅ 0,8° (± 3,9), p = 0,036) als auch in der Kontrollgruppe (von ∅ –8,2° (± 5,5) auf ∅ –5,6° (± 4,7), p = 0,049). Die aktive Extension war in der AOT-Gruppe nach der Intervention signifikant besser als in der Kontrollgruppe (p = 0,023). Für die passive Extension und die HHD gab es keine signifikanten Unterschiede zwischen beiden Gruppen.

Bei Patient(inn)en nach einer VKB-Plastik zeigte sich in der Gruppe mit AOT eine bessere aktive Knieextension als in der Kontrollgruppe ohne AOT. Weitere Arbeiten mit einer größeren Stichprobe und einer längeren Verlaufskontrolle sind notwendig, um diese Ergebnisse zu bestätigen.

Abstract

A frequent complication after the reconstruction of the anterior cruciate ligament (ACL) is an extension deficit (ED). It was the aim of this study to research whether a one-time application of Action Observation Therapy (AOT) in addition to classic extension exercises significantly improved extension of the knee joint after ACL reconstruction, relative to a therapeutic session without AOT.

13 subjects with ED after ACL reconstruction were randomly assigned to an AOT group (n = 8) and a control group (n = 5). Each group received one therapy session. Therapy consisted of watching a video, followed by active extension exercises. The video for the AOT group contained extension exercises, while the one shown to the control group contained landscape shots. Primary outcome measure was the ROM of active extension. Secondary outcome measures were the ROM of passive extension as well as heel height difference (HHD). The measurements were taken immediately before and directly after the intervention.

Active extension improved in the AOT group (from ∅ –2.0° (± 6.3) to ∅ 0.8° (± 3.9), p = 0.036) as well as in the control group (from ∅ –8.2° (± 5.5) to ∅ –5.6° (± 4.7), p = 0.049). However, after the intervention, active extension in the AOT group was significantly better than in the control group (p = 0.023). With regard to passive extension and HHD, there were no significant differences between the two groups.

For patients after an ACL reconstruction, the group that received AOT showed better active knee extension than the control group that did not receive AOT. Further studies with larger samples and longer follow-up periods are required to confirm these results.

Schlüsselwörter

VKB-Plastik - vorderes Kreuzband - Video-Therapie - Action Observation Therapy - Knieextension

Key words

ACL reconstruction - anterior cruciate ligament - video therapy - Action Observation Therapy - knee extension

Publication History

Received: 24 February 2021

Accepted: 26 March 2021

Article published online:
14 December 2021

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