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Z Orthop Ihre Grenzgeb 2001; 139(4): 359-365
DOI: 10.1055/s-2001-16924
REHABILITATION

Georg Thieme Verlag Stuttgart · New York

Seilzugisokinetik in der Knierehabilitation - erste Ergebnisse

Isokinetic Pulley System in Knee Rehabilitation - First ResultsM.  Thomas1 , C.  Kubaile2 , M.  Busse2
  • 1Orthopädische Klinik und Poliklinik der Universität Leipzig (Direktor: Prof. Dr. med. G. von Salis-Soglio)
  • 2Institut für Sportmedizin, Sportmedizinische Ambulanz und Rehabilitationszentrum Universität Leipzig (Direktor: Prof. Dr. med. M. W. Busse)
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Publication History

Publication Date:
04 September 2001 (online)

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Zusammenfassung.

Studienziel war die Evaluation der postoperativen rehabilitativen Therapie nach Knieoperationen mit einem isokinetischen Seilzuggerät (Moflex®, Recotec/Bernina, Schweiz). Methode: Im Rahmen einer prospektiven Studie nahmen insgesamt 73 Patienten an einem standardisierten Rehabilitationsprogramm teil (vordere Kreuzbandplastik, VKB: n = 51, davon Lig. Patellae-Plastik, VKB/P: n = 30 sowie Semitendinosus-Plastik, VKB/S: n = 21; arthroskopische Meniskusteilresektion: n = 22). Schwerpunkt des Programmes war ein Training mit einem isokinetischen Seilzuggerät, kombiniert mit einer linear arbeitenden Knieführungsschiene. Ergebnisse: Die Anwendung eines Monitor-feed-back-Systems ist zur Vermeidung von kritischen Belastungsspitzen erforderlich. Schmerzarm mögliche konzentrische Trainingskraft und -arbeit am Seilzug-Isokinetikgerät mit linear arbeitender Knieführungsschiene steigerten sich um ca. 130 % nach im Mittel 16 Rehabilitationstagen. Die konzentrische Maximalkraft am rotatorischen lsokinetiksystem (Cybex®, Kaphingst, Lahntal) stieg nach im Mittel 16 Tagen um ca. 69 % und lag gegenüber der gesunden Seite dann bei ca. 90 %. Schlussfolgerung: Diese ersten Ergebnisse zeigen eine überzeugende Effektivität der Seilzugisokinetik in der Rehabilitation nach den genannten Knieoperationen. Ein frühzeitiger postoperativer Einsatz ist grundsätzlich durch passiven oder aktiv-assistiven Modus möglich. Es werden erste Referenzwerte zu Steigerungsraten isokinetischer Seilzugbelastung im Rahmen der Knierehabilitation vorgestellt.

Aim: The purpose of this study was to evaluate the results of a knee rehabilitation program after knee surgery, based on an isokinetic pulley System (Moflex®, Recotec/Bernina, Switzerland). Method: In this prospective study, 73 patients participated in a standardized rehabilitation program (ACL reconstruction, ACL/all: n = ;51; patellar tendon, ACL/P: n = 30; semitendinosus tendon, ACL/S: n = 21; arthroscopic meniscus resection: n = 22). The major aspect of the program was an isokinetic pulley system with an implemented, linearly working knee device. Results: Isokinetic training with the used device affords strict monitor feed-back to avoid critical torque values. Concentric training strength and workload which were attained without relevant pain were increased by about 130 % within a mean of 16 rehabilitation days. At the end of the rehabilitation program, the maximum concentric strength of the affected knee measured by a rotating isokinetic system (Cybex®, Kaphingst, Lahntal) increased by about 69 % and amounted to about 90 % of that of the unaffected knee. Conclusion: These first results demonstrate the value of the isokinetic pulley system in the rehabilitation after knee surgery as described above. The equipment may be used already in an early postoperative stage by the use of a passive or active-assistive mode. First results of strength increases using an isokinetic pulley system in knee rehabilitation are presented.

Schlüsselwörter:

Kniegelenk - Rehabilitation - Isokinetik - Kraftmessung

Key words:

Knee joint - rehabilitation - isokinetic - strength measurement

Literatur

  • 01 Pässler  H H, Shelbourne  K D. Biologische, biomechanische und klinische Konzepte zur Nachbehandlung nach Bandeingriffen am Knie.  Orthopäde. 1993;  22 421-435
    Google Scholar
  • 02 Dahners  L E, Torke  M, Gilbert  J. The effect of motion on collagen synthesis and fibre orientation during ligament healing.  Trans Orthop Res Soc. 1989;  14 299
    Google Scholar
  • 03 Muneta  T, Lewis  J, Stewart  N. Effects of controlled load on graft healing: autograft vs allograft.  Trans Orthop Res Soc. 1993;  18 4
    Google Scholar
  • 04 Muneta  T, Yamamoto  H, Takakuda  K, Sakai  H, Sakai  H, Furuya  K. Effects of postoperative immobilization on the reconstructed anterior cruciate ligament.  Am J Sports Med. 1993;  21 305-313
    Google Scholar
  • 05 Burroughs  P, Dahners  L E. The effect of enforced exercise on the healing of ligament injuries.  Am J Sports Med. 1990;  18 376-378
    Google Scholar
  • 06 Gamble  J G, Edwards  C C, Max  S R. Enzymatic adaptation in ligaments during immobilization.  Am J Sports Med. 1984;  12 221-228
    Google Scholar
  • 07 Schaberg  J W, Dahners  L E, DeMasi  R R, Lester  G E. Collagen alignment in healing ligaments: effects of stress and immobilization.  Trans Orthop Res Soc. 1992;  17 101
    Google Scholar
  • 08 Bosch  U, Kasperczyk  W, Marx  M, Reinert  C, Oestern  H, Tscherne  H. Healing of graft fixation site under functional conditions in posterior cruciate ligament reconstruction.  Arch Orthop Trauma Surg. 1989;  108 154-158
    Google Scholar
  • 09 Kasperczyk  W J, Bosch  U, Oestern  H-J, Tscherne  H. Influence of immobilization on autograft healing in the knee joint.  Arch Orthop Trauma Surg. 1991;  110 158-161
    Google Scholar
  • 10 Laros  G S, Tipton  C M, Cooper  R R. Influence of physical acitivity on ligament insertions in the knees of dogs.  J Bone Joint Surg. 1971;  53-A 275-286
    PubMedGoogle Scholar
  • 11 Pässler  H H, Deneke  J, Dahners  I E. Augmentated repair and early mobilization of acute anterior cruciate ligament injuries.  Am J Sports Med. 1992;  20 6
    PubMedGoogle Scholar
  • 12 Dahners  L E, Padett  I. The effect of joint motion on collagen-organization in healing ligaments.  Trans Orthop Res Soc. 1990;  14 299
    PubMedGoogle Scholar
  • 13 Baratta  R, Solomonow  M, Zhou  B H, Letson  D, Chuinard  R, D'Ambrosia  R. Muscular coactivation.  Am J Sports Med. 1988;  16 113-122
    PubMedGoogle Scholar
  • 14 Brotzman  S B, Head  P. The knee.  In: S. B. Brotzman (Ed) Clinical orthopedic rehabiliation. Mosby, St. Louis; 1996: 183-243
    Google Scholar
  • 15 Arms  S W, Pope  M H, Johnson  R J, Fischer  R A, Arvidsson  I, Eriksson  E. The biomechanics of anterior cruciate ligament rehabilitation and reconstruction.  Am J Sports Med. 1984;  12 8-18
    PubMedGoogle Scholar
  • 16 Beynnon  B D, Howe  J G, Pope  M H, Johnson  R J, Fleming  B C. The measurement of anterior cruciate ligament strain in vivo.  Intern Orthop (SICOT). 1992;  16 1-12
    PubMedGoogle Scholar
  • 17 Henning  C E, Lynch  M A, Glick  K R. An in vivo strain gage study of elongation of the anterior cruciate ligament.  Am J Sports Med. 1985;  13 22-26
    PubMedGoogle Scholar
  • 18 Fleming  B C, Beynnon  B D, Renström  P A, Johnson  R J, Nichols  C E, Peura  G D, Uh  B S. The strain behaviour of the anterior cruciate ligament during stair climbing: an in vivo study.  Arthroscopy. 1999;  15 185-191
    PubMedGoogle Scholar
  • 19 Lutz  G E, Palmitier  R A, Chao  E YS. Comparison of tibiofemoral joint forces during open kinetic chain and closed kinetie chain exercises.  J Bone Joint Surg. 1993;  75-A, 5 275-286
    PubMedGoogle Scholar
  • 20 Mangine  R E, Eifert-Mangine  M. Isokinetik approach to selected knee pathologies.  In: G. J. Davies (Ed) A compendium of isokinetics in clinical usage. S & S Publishers, Onalaska; 1992: 285-305
    Google Scholar
  • 21 Andrews  J R, Wilk  K E (Eds). The athlet's shoulder. Churchill Livingstone, New York, Edinburgh, London, Madrid, Melbourne, Tokyo; 1994
    Google Scholar
  • 22 Rabin  S I, Post  M. A comparative study of clinical muscle testing and cybex evaluation after shoulder operations.  Clin Orthop. 1990;  258 147-156
    PubMedGoogle Scholar
  • 23 Porcellini  G, Baccarani  G, Campi  F, Galassi  R. Isokinetie testing to evaluate patients submitted to surgery for the treatment of surgical lesion of the rotator cuff.  Chir Organi Mov. 1996;  8 295-302
    PubMedGoogle Scholar
  • 24 Thomas  M, Grünert  J, Standtke  S, Busse  M. Seilzugisokinetik in der Schulterrehabilitationerste Ergebnisse.  Z Orthop. 2001;  139 80-86
    PubMedGoogle Scholar
  • 25 Palmitier  R A, An  K N, Scott  S G, Chao  E Y. Kinetic chain exercise in knee rehabilitation.  Sports Med. 1991;  11 402-413
    PubMedGoogle Scholar
  • 26 Hollmann  W, Hettinger  T. lsokinetisches Training.  In: W. Hollman, T. Hettinger (Eds) Sportmedizin. Schattauer, Stuttgart, New York; 2000: 214-216
    Google Scholar
  • 27 Kinast  C, Schmeitzky  C. Tibiale Translation in der Rehabilitation nach Ersatz des vorderen Kreuzbandes.  Orthopäd Mitt. 1993;  23 167
    PubMedGoogle Scholar
  • 28 Paulos  L, Noyes  F R, Grood  E, Butler  D L. Knee rehabilitation after anterior cruciate ligament reconstruction and repair.  Am J Sports Med. 1981;  9 140-149
    PubMedGoogle Scholar
  • 29 Davies  G (Ed). A compendium of isokinetics in clinical usage and rehabilitation techniques.  S & S Publishers, Onalaska/Wiskonsin; 1992
    Google Scholar
  • 30 DeCarlo  M S, Shelbourne  K D, McCaroll  J R, Rettig  R C. Traditional versus accelerated rehabilitation following ACL reconstruction: A one-year follow-up.  JOSPT. 1992;  15 309-316
    PubMedGoogle Scholar
  • 31 Grimby  G, Gustafsson  E, Peterson  L, Renström  P. Quadriceps function and training after knee ligament surgery.  Med Sci Sport Exerc. 1980;  12 70-75
    PubMedGoogle Scholar

Dr. M. Thomas

Orthopädische Klinik und Poliklinik der Universität Leipzig

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