Effect of Perturbation Training on Postural Control in Patients Undergoing Anterior Cruciate Ligament Reconstruction

Document Type : Original article

Authors

1 MSc Student of Physiotherapy, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran

2 Department of Physiotherapy and Iranian Center of Excellence in Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

3 Department of Basic Rehabilitation Sciences, School of Rehabilitation, and Biomechanics Lab., Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Ira

Abstract

Background and Aim: After Anterior Cruciate Ligament Reconstruction (ACLR), postural control deficit remains due to sensory defect. Performing exercises based on neuromuscular training (perturbation training) may cause “postural control” and “functional level” improvement. The present study was carried out to evaluate the effect of perturbation training on postural control in patients with history of ACLR.
Materials and Methods: A total of 20 patients with history of ACLR who had followed routine rehabilitation protocol, and who returned to the previous level of activity, were included in two equal treatment and control groups. The mean time after surgery was 9.5+/-2.1 months. Force plate test was performed for evaluating the center of pressure parameters such as mean Velocity (Vm), Standard Seviation for distance (SDx), and Velocity (SDv) for each group. Also, cross hop functional test and subjective IKDC were performed for both groups. For treatment group only, 10 sessions of perturbation training were performed. Finally, these tests were repeated and compared between the two groups.
Results: A significant increase was observed in the score of IkDC in treatment group (P- value<0.005) . Also, the results of   functional test showed a decrease in the mean velocity and SDx in the involved limbs in the treatment group, but in the control group no obvious difference was noticed. The difference observed between treatment and control groups were statistically significant.
 
Conclusion: Perturbation training can induce decrease in the center of pressure parameters, which increases functional test and IKDS scores. According to the results of the present study, performing perturbation protocol in patients who have had ACLR is recommended.

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Main Subjects


  1. Johansson H, Sjölander P, Sojka P. A sensory role for the cruciate ligaments. ClinOrthopRelat Res. 1991;(268):161-178.##
  2. Zouita ben moussa A, Zouita S, Dziri C, Ben Salah FZ . Single –leg assessment of postural stability and knee functional outcome 2 years after anterior cruciate ligament reconstruction. Ann PhysRehabilMed 2009; 52:475-484. ##
  3. Brooke E, Howells C, Clare L. Is postural control restored following anterior cruciate ligament reconstruction? Asystematic review. Knee Surg Sport Arthrosc.2011##
  4. Mohammadi F, Salavati M, Akbari B, Mazaheri M. Static and dynamic postural control in competitive athletes after anterior cruciate ligament reconstruction and controls. Knee Surg Sports J.2011 Nov(10) : 456-461##
  5. Feizabadi N, Jamshidi AA. Effects of perturbation training on ground reaction force and  function in ACLD Patients  during step up and down].Master of Science Thesis, Iran University  of Medical Sciences , 2010##
  6. Negahban H, Hadian MR, Salavati M, Mazaheri M, Talebian S, Jafari AH, Parnianpour M . The effects of dual-tasking on postural control in people with unilateral anterior cruciate ligament injury. Gait Posture 2009;30:477-481. Master of Science Thesis, Iran University  of Medical Sciences , 2007##
  7. Mehdi Naserpour, Ali Ashraf Jamshidi, Ali Amiry, Mohammad Reza Kihany. The Effect of a Modified Perturbation Training on Muscle Activation Pattern and Function in ACL Deficient Patients. ##
  8. Abbasi L. Jamshidi AA.  The survey on  kinematics in patients with anterior cruciate ligament injury during walking.  Master of Science Thesis, Iran University  of Medical Sciences. ##
  9. Irrgang JJ, Anderson AF, Boland AL, HarnerCD,et al. Development and validation      of international knee documentation committee subjective the knee fovm. Ame J Sport Med 2001;29(5) ;600-613. ##
  10. Swanic CB, Harner CD, Lephrat SM, Neurophysiology of the knee In: Surgery of the knee. (Norman SW, InsallGN,et al.) 3rd ed. NewYork : Churchil , 2001;pp:176-189. ##
  11. Callanghan JJ, Rosenberg AG, Rubash HE. The adult knee. 3rd ed. . USA. Lippincott Williams and Wilkins, 2002; pp; 389-430. ##
  12. Moghadam M, HadiyanMR,et al. Effects of single vs dual task balance training on postural control performance in older adult. J Rehabilit 2010:8:345-349. ##
  13. Zouita ben moussa A, Zouita S, Dziri C, Ben Salah FZ . Single –leg assessment of postural stability and knee functional outcome 2 years after anterior cruciate ligament reconstruction. Ann PhysRehabilMed 2009; 52:475-484. ##
  14. Henriksson M, Ledin T, Good L . Postural control after anterior cruciate ligament reconstruction and functional rehabilitation. Am J Sport Med 2001;29:359-366. ##
  15. Bonfim TR, Paccola CA, Barela JA. Proprioceptive and behavior impairment in individuals with anterior cruciate ligament reconstructed knee.ArchPhys Med Rehabil  2003; 84:1217-1223. ##
  16. Riley PO, Benda BJ, Gill-Body KM, Krebs DE. Phase plane analysis of stability in quiet standing. J Rehabil Res Dev 1995;32(3):227–235. ##
  17. Ageberg E, Roberts D, FridenT.The effect of short-duration sub-maximal cycling on balance in single-limb stance in patients with anterior cruciate ligament injury:BMC.2004;10(4):231-237. ##
  18. Ageberg E, Za¨tterstro¨m R, Moritz U, Fride´n T. Influence ofsupervised and nonsupervised training on postural control afteran acute anterior cruciate ligament rupture: A 3-year longitudinalprospective study. J Orthop Sports PhysTher 2001;31(11):632–644##
  19. Shirashi M, Mizuta H, Kubota K,et al.Stabilometric assessment in the anterior cruciate ligament-reconstructed knee.1996,Clin J Sport Med:6:32-39. ##

Volume 6, Issue 3
September and October 2017
Pages 113-117
  • Receive Date: 15 April 2016
  • Revise Date: 09 September 2016
  • Accept Date: 03 October 2016
  • First Publish Date: 23 September 2017