Ön çapraz bağ rekonstrüksiyonu sonrası verilen dirençli egzersiz eğitiminin sıçrama performansı üzerine etkisi

Öz

Amaç: İzokinetik kas kuvveti ve tek bacak sıçrama testi diz cerrahileri sonrasında spora veya günlük yaşama dönüşte bireyleri değerlendirmek için sıklıkla kullanılan ölçümlerdir. Bu çalışmanın amacı verilen izokinetik eğitimin, hamstring ve quadriceps kas kuvveti üzerindeki etkinliğini tek bacak sıçrama testi kullanarak değerlendirmek idi. Yöntem: Ön Çapraz Bağ Rekonstrüksiyonu geçiren 20 erkek hasta çalışmaya dahil edildi. 16. ve 24. haftalarda izokinetik kas kuvveti ve tek bacak sıçrama testleri yapıldı ve bu haftalar arasında bireylere izokinetik eğitim verildi. Zirve tork quadriceps/vücut ağırlığı, zirve tork hamstring/vücut ağırlığı, hamstring/quadriceps oranı değerleri çalışmaya dahil edildi. İkili karşılaştırmada Wilcoxon testi, korelasyon analizinde Pearson korelasyon katsayısı kullanıldı. Bulgular: Opere dizde 16. haftasında, ekstansiyon zirve tork değeri ile tek bacak sıçrama testi arasında orta derecede ilişki görülürken (r=0,622, p=0,023), sağlam dizde, ekstansiyon zirve tork değeri ile tek bacak sıçrama testi arasında bir ilişki görülmedi (r=0,147, p=0,631). 24.haftada, opere ve sağlam dizdeki ekstansiyon zirve tork değeri ve tek bacak sıçrama testi arasındaki ilişki orta derece bulundu (r=0,595, p=0,032), (r= 0,591, p=0,033). 16. haftada hamstring/quadriceps oranı ile tek bacak sıçrama testi arasındaki ilişki yüksek bulundu (r=0,725, p=0,005). Sonuç: Çalışmanın sonucunda, ön çapraz bağ rekonstrüksiyonu sonrası verilen dirençli izokinetik eğitimin, tek bacak sıçrama performansını orta derecede etkilediği bulundu.

Anahtar Kelimeler

• Ön çapraz bağ
• Kas kuvvet dinamometre
• Fiziksel uygunluk testi
• Quadriceps kası

Effect of resistive exercise training on jumping performance after anterior cruciate ligament reconstruction

Öz

Purpose: Isokinetic muscle strength and single leg jump test are frequently used measurements to evaluate individuals returning to sports or daily life after knee surgeries. The aim of this study was to evaluate the effectiveness of isokinetic training on hamstring and quadriceps muscle strength using the single leg jump test. Methods: Twenty male patients who underwent Anterior Cruciate Ligament Reconstruction were included in the study. Isokinetic muscle strength and single leg jump tests were performed at 16 and 24 weeks, and isokinetic training was given to the individuals between these weeks. Peak torque quadriceps/body weight, peak torque hamstring/body weight, peak torque hamstring/quadriceps ratio values were evaluated. Intra-group comparisons were analyzed with the Wilcoxon test, the correlation analysis was used Pearson’s correlation coefficient. Results: While there was a moderate correlation between the peak extension torque value and the single leg jump test in the operated knee at week 16 (r=0.62, p=0.023), there was no correlation between the extension peak torque value and the single leg jump test in the non-operated knee (r=0,14, p=0,63). The relationship between the peak extension torque value in the operated and non-operated knee and the single leg jump test was found to be moderate at 24 weeks (r=0,595, p=0,032), (r= 0,591, p=0,033). At 16 weeks, the relationship between hamstring/quadriceps ratio and single leg jump test was high (r=0.72, p=0.05). Conclusion: As a result of the study, it was found that resistive isokinetic exercise training given after anterior cruciate ligament reconstruction, moderately affected single leg jump performance.

Anahtar Kelimeler

• Anterior cruciate ligament
• Muscle strength dynamometer
• Physical fitness testing
• Quadriceps muscle

Kaynakça

1. 1. Ageberg E, Roos HP, Silbernagel K., et al., Knee extension and flexion muscle power after anterior cruciate ligament reconstruction with patellar tendon graft or hamstring tendons graft: a cross-sectional comparison 3 years post surgery. Knee Surg Sports Traumatol Arthrosc, 2009;17:162-169. 2. Beynnon BD, Johnson RJ, Abate JA, et al, Treatment of anterior cruciate ligament injuries, part I. Am J Sports Med, 2005;33:1579-1602. 3. Ithurburn MP, Paterno MV, Ford KR, et al, Young athletes with quadriceps femoris strength asymmetry at return to sport after anterior cruciate ligament reconstruction demonstrate asymmetric single-leg drop-landing mechanics. Am J Sports Med, 2015;43:2727-2737. 4. Harput G, Kılınç HE, Özer H, et al. Quadriceps and hamstring strength recovery during early neuromuscular rehabilitation after ACL hamstring-tendon autograft reconstruction. J Sport Rehabil, 2015;24:398-404. 5. Žargi TG, Drobnic M, Vauhnik R, et al. Factors predicting quadriceps femoris muscle atrophy during the first 12 weeks following anterior cruciate ligament reconstruction. Knee, 2017;24:319-328. 6. Wilk, KE, Arrigo CA. Rehabilitation principles of the anterior cruciate ligament reconstructed knee: twelve steps for successful progression and return to play. Clin Sports Med, 2017;36: 189-232.
2. 7. Wernbom M, Augustsson J, Thomeé R. The influence of frequency, intensity, volume and mode of strength training on whole muscle cross-sectional area in humans. Sports Med, 2007;37:225-264.
3. 8. Kannus P. Isokinetic evaluation of muscular performance: implications for muscle testing and rehabilitation. Int J Sports Med, 1994;15 Suppl 1:S11-18.
4. 9. Caffrey E, Docherty CL, Schrader J, et al., The ability of 4 single-limb hopping tests to detect functional performance deficits in individuals with functional ankle instability. J Orthop Sports Phys Ther, 2009;39:799-806.
5. 10. Van Melick E, Van Cingel REH, et al., Assessment of functional performance after anterior cruciate ligament reconstruction: a systematic review of measurement procedures. Knee Surg Sports Traumatol Arthrosc, 2013;21:869-879.
6. 11. Dingenen, B, Truijen J, Bellemons J, et al., Test–retest reliability and discriminative ability of forward, medial and rotational single-leg hop tests. Knee. 2019;26:978-987.
7. 12. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum; 1988.
8. 13. Aizawa, J, Hirohata K, Ohji, S. et al. Correlations between isokinetic knee torques and single-leg hop distances in three directions in patients after ACL reconstruction. BMC Sports Sci Med Rehabil 2021;13:38.

9. 14. Baltaci G, Yilmaz G, Atay AO. The outcomes of anterior cruciate ligament reconstructed and rehabilitated knees versus healthy knees: a functional comparison. Acta Orthop Traumatol Turc. 2012;46:186-195.
10. 15. Reid A, Birmingham TB, Stratford PW, et al, Hop testing provides a reliable and valid outcome measure during rehabilitation after anterior cruciate ligament reconstruction. Phys Ther. 2007; 87:337-349.
11. 16. Ardern CL, Webster KE, Taylor NF, et al. 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; 45:596-606.
12. 17. Ageberg E, Thomeé R, Neeter C, et al., Muscle strength and functional performance in patients with anterior cruciate ligament injury treated with training and surgical reconstruction or training only: a two to five-year followup. Arthritis Rheum. 2008 Dec 15;59:1773-1779.
13. 18. Sueyoshi T, Nakahata A. Emota G, et al. Single-leg hop test performance and isokinetic knee strength after anterior cruciate ligament reconstruction in athletes. Orthop J Sports Med. 2017;5(11): doi:10.1177/2325967117739811.
14. 19. Lautamies R, Harilainen A, Kettunen J, et al., Isokinetic quadriceps and hamstring muscle strength and knee function 5 years after anterior cruciate ligament reconstruction: comparison between bone-patellar tendon-bone and hamstring tendon autografts. Knee Surg Sports Traumatol Arthrosc. 2008;16:1009-1016.