Restoration Of Proprioception Research Articles

Progress of Proprioceptive Training in the Treatment of Traumatic Shoulder Instability.

In individuals with traumatic shoulder instability, there is a loss of proprioception. This paper reviews the academic literature on shoulder instability and functional impairment in recent years and combines it with clinical practice experience to summarize several techniques of proprioceptive regeneration following traumatic shoulder instability. Many issues were discovered, including a lack of literature on the role of sensory input, a lack of basic proprioceptive research, insufficient sample size in proprioceptive research, and a lack of systematic and standardized standards for the evaluation and training of proprioception in clinical practice, among others. In the future, we will need to better understand the mechanism of proprioception and conduct research on various groups of people, with a focus on discussing the optimal intensity, frequency, and duration of various training methods, as well as implementing proprioceptive training in stages throughout the rehabilitation process. The reestablishment of shoulder joint function, the restoration of proprioception, and the enhancement of daily activities are all critical.

Наш погляд на відновне лікування після пластики передньої хрестоподібної зв’язки колінного суглоба

Summary. The article presents rehabilitation program for the patients after anterior cruciate ligament reconstruction. The program is used at the Feofaniya Hospital’s Center of Orthopedics, Traumatology and Sports Medicine and at the Department of Sports and Ballet Injuries of the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine”. The rehabilitation course is divided on five periods: 1) preoperative period; 2) early postoperative period (acute) (0–2 weeks); 3) function restoring period (up to 9 week); 4) period of preparing and gradual returning to recreation and sports activity (from 9 week); 5) period of returning to full sports activity (after 6–9 months, depending on the type of sport). Principles of postoperative care and rehabilitation in our clinics are as follows: 1) decreasing pain, swelling, and inflammation; 2) full load of the operated on limb with or without crutches; 3) immediate exercises to restore range of motion from 0° to 60–90°, with gradually increase to 120° and full flexion after 6–9 weeks postoperatively (using continuous passive motion; passive, active assisted, and active exercises); 4) exercises for training quadriceps muscle, shin flexor muscles and all lower limb and pelvis muscles, with increasing resistance in close and open kinetic chains; 5) exercises for training proprioception and coordination (from early postoperative period); 6) return to work after 3–6 weeks, health-improvement and sports activity after 4, 6, and 9 months; 7) close cooperation between a surgeon, a rehabilitologist, and a patient during rehabilitation. We focus on achieving the fastest full extension of the knee joint, muscle control and restoration of proprioception. Exercises are performed in closed and open kinetic chains, with muscles tension in the back of the thigh and shin, in the way to avoid too much stress on transplantate. In cases of athletes and recreational active patients, elements of sports specific exercises were included to the rehabilitation program (from early postoperative period). That helped to restore proper patterns of movements and to overcome physical barrier in returning to full sports activity. Return to sport was allowed patients when achieved full range of motion, normal proprioception and balance of muscles; functional tests results were about 90% of the norm and there was no pain or swelling during exercise loads.

Re-Tensioning Technique to Cover the Graft With Remnant in Anterior Cruciate Ligament Reconstruction

A number of remnant-preserving techniques to restore proprioceptive function in anterior cruciate ligament reconstruction have been described. However, they might not cover the significant amount of the graft with the synovium of the remnant in many cases. We introduce a simple technique that can cover nearly the entire graft with the synovium by re-tensioning the remnant, which might enhance synovialization of the graft and restoration of proprioception.

The Evaluation of Proprioceptive Function and Effectiveness of Joint Position Sense Test after Meniscal Allograft Transplantation

To evaluate the effects on the restoration of proprioception, we compared joint position sense (JPS) after meniscal allograft transplantation. Nine patients who underwent meniscal allograft transplantation between March 2008 and January 2010 were evaluated at preoperation and 6 months post-operation. International Knee Documentation Committee (IKDC) subjective score and Lysholm score were evaluated. The peak torque of the isokinetic flexor and extensor strength test was performed using Biodex system III. Passive JPS was assessed to evaluate proprioceptive function. In the results, IKDC subjective score and Lysholm score were improved (p=0.05). The flexor and extensor power decreased, however there was no statistically significant difference. In the assessment of JPS, there was improvement from 6.56 and 4.11 to 4.89 and 1.89, however, this was not statistically significant. Although, proprioception was improved in JPS at 6 months after meniscus transplantation, it did not show statistic significance. Therefore, future studies using combined methods will be needed to evaluate proprioceptive function after meniscal allograft transplantation.

Proprioception after rehabilitation and reconstruction in knees with deficiency of the anterior cruciate ligament

We assessed proprioception in the knee using the angle reproduction test in 20 healthy volunteers, ten patients with acute anterior instability and 20 patients with chronic anterior instability after reconstruction of the anterior cruciate ligament (ACL). In addition, the Lysholm-knee score, ligament laxity and patient satisfaction were determined. Acute trauma causes extensive damage to proprioception which is not restored by rehabilitation alone. Three months after operation, there remained a slight decrease in proprioception compared with the preoperative recordings, but six months after reconstruction, restoration of proprioception was seen near full extension and full flexion. In the mid-range position, proprioception was not restored. At follow-up, 3.7 ± 0.3 years after reconstruction, there was further improvement of proprioception in the mid-range position. There was no difference between open and arthroscopic techniques. The highest correlation was found between proprioception and patient satisfaction. After reconstruction of the ACL reduced proprioception may explain the poor functional outcome in some patients, despite restoration of mechanical stability.