Abstract
Dynamic stability of the knee and weakness of the extensor muscles are considered to be the most important functional limitations after anterior cruciate ligament (ACL) injury, probably due to changes at the central (cortical and corticospinal) level of motor control rather than at the peripheral level. Despite general technological advances, fewer contraindicative surgical procedures, and extensive postoperative rehabilitation, up to 65% of patients fail to return to their preinjury level of sports, and only half were able to return to competitive sport. Later, it becomes clear that current rehabilitation after knee surgery is not sufficient to address the functional limitations after ACL reconstruction even years after surgery. Therefore, new therapeutic tools targeting the central neural system, i.e., the higher centers of motor control, should be investigated and integrated into current rehabilitation practice. To improve motor performance when overt movement cannot be fully performed (e.g., due to pain, impaired motor control, and/or joint immobilization), several techniques have been developed to increase physical and mental activation without the need to perform overt movements. Among the most popular cognitive techniques used to increase physical performance are motor imagery and action observation practices. This review, which examines the available evidence, presents the underlying mechanisms of the efficacy of cognitive interventions and provides guidelines for their use at home.
Highlights
Motor Imagery and Action Observation as Appropriate Strategies for Home-Based Rehabilitation: A Mini-Review Focusing on Improving Physical Function in Orthopedic Patients
It becomes clear that current rehabilitation after knee surgery is not sufficient to address the functional limitations after anterior cruciate ligament (ACL) reconstruction even years after surgery
To construct comprehensive rehabilitation practice and prescribe it with greater certainty, it is imperative to understand the clinical value of skeletal muscle strength and the underlying mechanism of strength weaknesses caused by surgery
Summary
The knee ligaments injuries are common in pivoting sports (Anderson et al, 2019; Tabben et al, 2020). The high axial and torsional forces applied to the knee joint during sports-specific actions such as sudden change of direction, rapid accelerations and decelerations, along with joint loading occurring following jumping activities represents the main sports-related risk factors for non-contact ligaments injuries (Laible and Sherman, 2014) Serious injuries, such as anterior cruciate ligament (ACL) injury require surgery to restore normal knee function. Later imply that current rehabilitation practice needs to be revisited, whereas new and innovative therapeutic tools targeting central neural system i.e., higher centers of motor control should be examined and implemented (Rush et al, 2021) Such strategies were recognized through cognitive practice that has been able to improve the physical function of both symptomatic (Marusic et al, 2018; Paravlic et al, 2020a) and asymptomatic population (Paravlic et al, 2018). Among the most popular MSP techniques used to enhance physical performance, the literature highlights MI and action observation (AO) practices (Mulder et al, 2005)
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