Abstract
The aim of this study in anterior cruciate ligament reconstruction (ACLR) patients was to assess the effect of six months of supervised physiotherapy with a higher number of visits (SPHNV) compared to supervised physiotherapy with a lower number of visits (SPLNV) on the maximal peak torque (PT) and isometric torque (IT) of values obtained for hamstring (H) and quadriceps (Q) muscles of the knee joints under isokinetic and isometric conditions. Hypothesis: SPHNV improves IT and PT more than SPLNV. Group I had ACLR with a higher number of visits (n = 20), Group II had ACLR with a lower number of visits (n = 20), and Group III served as the control (n = 20). In Groups I and II, IT values were measured for quadriceps and hamstring muscles of the knee joints in the 13th and 24th weeks and for PT in the 18th and 24th weeks after ACLR (60 and 180 °/s). In group III, the measurements were taken once. The isometric torque and isokinetic peak torque values were measured in N*m and they were normalized to body mass as relative IT (RIT) and relative PT (RPT) were expressed in N*m/kg. Results: In both ACLR groups, the RIT and RPT values obtained from the operated knee joints significantly increased in the 24 weeks following ACLR compared to the uninvolved side. Group II had significantly lower RIT and RPT values for quadriceps and hamstring muscles of the operated limbs compared with the uninvolved limbs (p = 0.008, p = 0.001). In group I, the larger number of visits positively correlated with the higher PT for quadriceps and hamstring muscles of the operated and uninvolved knees (from r = 0.506; p = 0.023 too r = 0.566; p = 0.009), respectively. Six months of SPHNV positively correlated with and improved the IT and PT values in patients after ACLR much more significantly than six months of SPLNV.
Highlights
I, in the twenty-fourth week after anterior cruciate ligament reconstruction (ACLR) in five of six cases, no significant differences in relative isometric torque (RIT) and relative peak torque (RPT) values were noted between the muscle groups of the operated knee joints and the uninvolved side
(control) in five of six cases, no significant differences in RIT and RPT values were noted between the muscle groups of the right and the left knee joints (Table 4)
Our research has shown that the hypothesis that a higher number and frequency of supervised physiotherapy visits carried out six months after ACLR positively influences the relative isometric and peak torque values obtained for hamstring and quadriceps knee joint muscles, compared to the lower number and lower frequency of supervised physiotherapy visits, has been confirmed
Summary
Anterior cruciate ligament (ACL) injuries account for up to 60% of all knee injuries in dynamic and pivoting sports [1]. For every 100,000 people, isolated ACL tears occur in 70 knees [2] This problem is important for public health policy because it often concerns the treatment of people who are professionally and physically active, which is related to health, economic, and social aspects. Inadequate orthopedic and physiotherapeutic treatment promotes the occurrence of re-injuries of the knee joints, which in turn increases the costs and time of treatment, reduces its effectiveness, causes absenteeism in sports and professional work, and, in the long term, contributes to the earlier occurrence of osteoarthritis, a common disease in the population [3,4].
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