Araştırma Makalesi
BibTex RIS Kaynak Göster

ACL Rüptüründe Ameliyat Öncesi Düzeltici Egzersiz Eğitimi: Ağrı, Stabilite ve Fonksiyonel Sonuçlar Üzerindeki Etkileri: Tek Kör, Randomize Kontrollü Bir Çalışma

Yıl 2025, Sayı: 26, 430 - 438, 31.08.2025
https://doi.org/10.38079/igusabder.1666167

Öz

Amaç: Bu çalışma, ön çapraz bağ (ACL) yırtığı olan hastalarda rutin egzersizlere ek olarak verilen düzeltici egzersiz eğitiminin etkisini araştırmayı amaçladı.
Yöntem: Çalışmaya 36 ÖÇB rüptürü olan katılımcı dahil edilmiştir. Hastalar rastgele egzersiz ve kontrol gruplarına ayrılmıştır. Egzersiz grubu (n=18), rutin egzersiz programına ek olarak haftada 5 gün, 8 hafta boyunca düzeltici egzersiz eğitimi almıştır. Kontrol grubu (n = 18) ise yalnızca rutin egzersiz programını uygulamıştır. Çalışmada demografik bilgiler, ağrı ve instabilite hissi için Görsel Analog Skalası, Tegner Aktivite Ölçeği, Lysholm Diz Skorlama Sistemi, Kujala Patellofemoral Skorlama Sistemi ve Fonksiyonel Hareket Tarama değerlendirmeleri yapılmıştır. Değerlendirmeler, egzersiz eğitimi öncesinde ve 8 haftalık program sonunda tekrarlanmıştır.
Bulgular: Katılımcıların ortalama yaşı egzersiz grubunda 26,5 yıl, kontrol grubunda ise 28,3 yıl olarak bulunmuştur. Gruplar arasında stabilite hissi ve FMS toplam puanı açısından istatistiksel olarak anlamlı bir fark tespit edilmiştir. Ancak, egzersiz sonrası ağrı parametreleri, Lysholm skoru ve Kujala skoru açısından gruplar arasında anlamlı bir fark bulunmamıştır (p<0.05). Grup içi karşılaştırmalarda hem egzersiz hem de kontrol grubunda stabilite hissi ve FMS toplam puanı açısından anlamlı gelişmeler gözlemlenmiştir. Bununla birlikte, egzersiz sonrası aynı parametrelerde gruplar arasında da belirgin bir fark saptanmıştır. Ağrı, Lysholm ve Kujala skorlarında anlamlı iyileşme yalnızca düzeltici egzersiz grubunda gözlenmiştir.
Sonuç: Ön çapraz bağ yaralanması olan hastalarda, ameliyat öncesi uygulanan FMS tabanlı düzeltici egzersiz tedavisi, ağrı, diz stabilitesi, fonksiyon ve eklem hareket açıklığında önemli iyileşmelere yol açmıştır.

Kaynakça

  • 1. Murray MM. Current status and potential therapies to stimulate repair of the anterior cruciate ligament. J Orthop Res. 2009;27(4):515-521.
  • 2. Ardern CL, Webster KE, Taylor NF, Feller JA. Return to sport following anterior cruciate ligament reconstruction surgery: A systematic review and meta-analysis of the state of play. Br J Sports Med. 2011;45(7):596-606.
  • 3. Myer GD, Ford KR, Paterno MV, Nick TG, Hewett TE. The effects of generalized joint laxity on dynamic knee motion in ACL-injured girls. Clin J Sport Med. 2008;18(1):2-9.
  • 4. Risberg MA, Lewek M, Snyder-Mackler L. A systematic review of evidence for anterior cruciate ligament rehabilitation: How much and what type? Phys Ther Sport. 2004;5(3):125-145.
  • 5. Hewett TE, Myer GD, Ford KR. Anterior cruciate ligament injuries in female athletes: Part 1, mechanisms and risk factors. Am J Sports Med. 2013;34(2):299-311.
  • 6. Paterno MV, Rauh MJ, Schmitt LC, Ford KR, Hewett TE. Incidence of second ACL injuries 2 years after primary ACL reconstruction and return to sport. Am J Sports Med. 2010;38(7):1276-1283.
  • 7. Cook G, Burton L, Hoogenboom BJ, Voight M. Functional movement screening: The use of fundamental movements as an assessment of function-Part 1. Int J Sports Phys Ther. 2014;9(3):396-409.
  • 8. Kiesel K, Plisky PJ, Voight ML. Can serious injury in professional football be predicted by a preseason functional movement screen? N Am J Sports Phys Ther. 2007;2(3):147-158.
  • 9. Chorba RS, Chorba DJ, Bouillon LE, Overmyer CA, Landis JA. Use of a functional movement screening tool to determine injury risk in female collegiate athletes. N Am J Sports Phys Ther. 2010;5(2):47-54.
  • 10. Cook G, Burton L, Hoogenboom BJ, Voight M. Functional movement screening: The use of fundamental movements as an assessment of function-part 2. Int J Sports Phys Ther. 2014;9(4):549-63.
  • 11. Chao WC, Shih JC, Chen KC, Wu CL, Wu NY, Lo CS. The effect of functional movement training after anterior cruciate ligament reconstruction: A randomized controlled trial. J Sport Rehabil. 2018;27(6):541-545.
  • 12. Padua DA, Marshall SW, Boling MC, Thigpen CA, Garrett WE, Beutler AI. The landing error scoring system (LESS) is a valid and reliable clinical assessment tool of jump-landing biomechanics: The JUMP-ACL study. Am J Sports Med. 2012;37(10):1996-2002.
  • 13. Grooms DR, Myer GD, Paterno MV, Ford KR, Hewett TE. Neuroplasticity mechanisms associated with ACL injury prevention and rehabilitation. J Orthop Res. 2017;35(10):2266-2274.
  • 14. Sugimoto D, Myer GD, Barber Foss KD, Hewett TE. Specific exercise effects of preventive neuromuscular training intervention on anterior cruciate ligament injury risk reduction in young females: Meta-analysis and subgroup analysis. Br J Sports Med. 2015;49(5):282-289.
  • 15. Dingenen B, Gokeler A. Optimization of the return-to-sport paradigm after anterior cruciate ligament reconstruction: A critical review of the literature. Br J Sports Med. 2017;51(22):1323-1328.
  • 16. Chaudhari AM, Briant PL, Bevill SL, Koo S, Andriacchi TP. Knee kinematics change due to age and walking speed, but not gender. Gait Posture. 2011;31(1):17-22.
  • 17. Riemann BL, Lephart SM. The sensorimotor system, part I: The physiologic basis of functional joint stability. J Athl Train. 2002;37(1):71-79.
  • 18. Bodden JG, Needham RA, Chockalingam N. The effect of an intervention program on functional movement screen test scores in mixed martial arts athletes. J Strength Cond Res. 2015;29(1):219-225.
  • 19. Gross DL, Christopher GE, Faulk RT. Functional training program bridges rehabilitation and return to duty. J Spec Oper Med. 2009;9(2):29-48.
  • 20. Suzuki K, Akasaka K, Otsudo T, et al. Effects of functional movement screen training in high‑school baseball players: A randomized controlled clinical trial. Medicine (Baltimore). 2021;100(14):e25423.

Preoperative Corrective Exercise Training in ACL Rupture: Effects on Pain, Stability, and Functional Outcomes: A Single-Blind Randomized Controlled Trial

Yıl 2025, Sayı: 26, 430 - 438, 31.08.2025
https://doi.org/10.38079/igusabder.1666167

Öz

Aim: This study aimed to investigate the effect of corrective exercise training in addition to routine exercises on patients with anterior cruciate ligament (ACL) rupture.
Method: 36 ACL ruptured participants were included in the study. Patients were randomly divided into exercise and control groups. The exercise group (n=18) received corrective exercise training 5 days a week for 8 weeks in addition to the routine exercise program. The control group (n=18) received a routine exercise program. Demographic information, Visual Analog Scale for pain and instability feeling, Tegner Activity Scale, Lysholm Knee Scoring System, Kujala Patellofemoral Scoring System, and Functional Movement Screen evaluations were done. Evaluations were repeated before exercise training, at the end of the
Results: The average age of the participants was 26.5 years in the exercise group and 28.3 years in the control group. A statistically significant difference was found between the groups in the feeling of stability and FMS total score parameters. However, no difference was found between the groups in the pain parameters, Lysholm score, and Kujala score after exercise (p<0.05). In intra-group comparisons before and after exercise, a significant difference was observed in the feeling of stability and FMS total score values in both groups, and in the same parameter, a considerable difference was found between the two groups after exercise. A significant difference was observed in pain, Lysholm and Kujala scores only in the corrective exercise group.
Conclusion: Pre-operatively applied FMS-based corrective exercise therapy in patients with ACL injury led to significant improvements in pain, knee stability, function, and range of motion.

Etik Beyan

ETHICAL STATEMENT: This study was carried out with the approval of the Ethics Committee of University of Health Sciences Hamidiye Non-Interventional Research Ethics Committee, dated 25/01/2019 and numbered 19/03. A signed subject consent form in accordance with the Declaration of Helsinki was obtained from each participant.

Kaynakça

  • 1. Murray MM. Current status and potential therapies to stimulate repair of the anterior cruciate ligament. J Orthop Res. 2009;27(4):515-521.
  • 2. Ardern CL, Webster KE, Taylor NF, Feller JA. Return to sport following anterior cruciate ligament reconstruction surgery: A systematic review and meta-analysis of the state of play. Br J Sports Med. 2011;45(7):596-606.
  • 3. Myer GD, Ford KR, Paterno MV, Nick TG, Hewett TE. The effects of generalized joint laxity on dynamic knee motion in ACL-injured girls. Clin J Sport Med. 2008;18(1):2-9.
  • 4. Risberg MA, Lewek M, Snyder-Mackler L. A systematic review of evidence for anterior cruciate ligament rehabilitation: How much and what type? Phys Ther Sport. 2004;5(3):125-145.
  • 5. Hewett TE, Myer GD, Ford KR. Anterior cruciate ligament injuries in female athletes: Part 1, mechanisms and risk factors. Am J Sports Med. 2013;34(2):299-311.
  • 6. Paterno MV, Rauh MJ, Schmitt LC, Ford KR, Hewett TE. Incidence of second ACL injuries 2 years after primary ACL reconstruction and return to sport. Am J Sports Med. 2010;38(7):1276-1283.
  • 7. Cook G, Burton L, Hoogenboom BJ, Voight M. Functional movement screening: The use of fundamental movements as an assessment of function-Part 1. Int J Sports Phys Ther. 2014;9(3):396-409.
  • 8. Kiesel K, Plisky PJ, Voight ML. Can serious injury in professional football be predicted by a preseason functional movement screen? N Am J Sports Phys Ther. 2007;2(3):147-158.
  • 9. Chorba RS, Chorba DJ, Bouillon LE, Overmyer CA, Landis JA. Use of a functional movement screening tool to determine injury risk in female collegiate athletes. N Am J Sports Phys Ther. 2010;5(2):47-54.
  • 10. Cook G, Burton L, Hoogenboom BJ, Voight M. Functional movement screening: The use of fundamental movements as an assessment of function-part 2. Int J Sports Phys Ther. 2014;9(4):549-63.
  • 11. Chao WC, Shih JC, Chen KC, Wu CL, Wu NY, Lo CS. The effect of functional movement training after anterior cruciate ligament reconstruction: A randomized controlled trial. J Sport Rehabil. 2018;27(6):541-545.
  • 12. Padua DA, Marshall SW, Boling MC, Thigpen CA, Garrett WE, Beutler AI. The landing error scoring system (LESS) is a valid and reliable clinical assessment tool of jump-landing biomechanics: The JUMP-ACL study. Am J Sports Med. 2012;37(10):1996-2002.
  • 13. Grooms DR, Myer GD, Paterno MV, Ford KR, Hewett TE. Neuroplasticity mechanisms associated with ACL injury prevention and rehabilitation. J Orthop Res. 2017;35(10):2266-2274.
  • 14. Sugimoto D, Myer GD, Barber Foss KD, Hewett TE. Specific exercise effects of preventive neuromuscular training intervention on anterior cruciate ligament injury risk reduction in young females: Meta-analysis and subgroup analysis. Br J Sports Med. 2015;49(5):282-289.
  • 15. Dingenen B, Gokeler A. Optimization of the return-to-sport paradigm after anterior cruciate ligament reconstruction: A critical review of the literature. Br J Sports Med. 2017;51(22):1323-1328.
  • 16. Chaudhari AM, Briant PL, Bevill SL, Koo S, Andriacchi TP. Knee kinematics change due to age and walking speed, but not gender. Gait Posture. 2011;31(1):17-22.
  • 17. Riemann BL, Lephart SM. The sensorimotor system, part I: The physiologic basis of functional joint stability. J Athl Train. 2002;37(1):71-79.
  • 18. Bodden JG, Needham RA, Chockalingam N. The effect of an intervention program on functional movement screen test scores in mixed martial arts athletes. J Strength Cond Res. 2015;29(1):219-225.
  • 19. Gross DL, Christopher GE, Faulk RT. Functional training program bridges rehabilitation and return to duty. J Spec Oper Med. 2009;9(2):29-48.
  • 20. Suzuki K, Akasaka K, Otsudo T, et al. Effects of functional movement screen training in high‑school baseball players: A randomized controlled clinical trial. Medicine (Baltimore). 2021;100(14):e25423.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Ortopedi, Rehabilitasyon
Bölüm Makaleler
Yazarlar

Emre Serdar Atalay 0000-0002-8249-8628

Fatmagül Varol 0000-0003-2808-9732

Hasan Bombacı 0000-0002-8181-9805

Erken Görünüm Tarihi 30 Ağustos 2025
Yayımlanma Tarihi 31 Ağustos 2025
Gönderilme Tarihi 26 Mart 2025
Kabul Tarihi 7 Temmuz 2025
Yayımlandığı Sayı Yıl 2025 Sayı: 26

Kaynak Göster

JAMA Atalay ES, Varol F, Bombacı H. Preoperative Corrective Exercise Training in ACL Rupture: Effects on Pain, Stability, and Functional Outcomes: A Single-Blind Randomized Controlled Trial. IGUSABDER. 2025;:430–438.

 Alıntı-Gayriticari-Türetilemez 4.0 Uluslararası (CC BY-NC-ND 4.0)