Physiotherapy procedures after anterior cruciate ligament reconstructive procedures – literature review

Uvod: Pretrganje sprednje križne vezi je najpogostejša poškodba kolenskega sklepa pri odraslih med 20. in 29. letom, ki se ukvarjajo s kontaktnimi športi ali športi, ki vključujejo poskoke ali sunkovito zaustavljanje. Namen: Namen diplomskega dela je predstaviti novejše fizioterapevtske postopke po rekonstrukciji sprednje križne vezi. Metode dela: Od julija 2014 do julija 2019 smo pregledali podatkovno zbirko PubMed. Uporabljena je bila naslednja iskalna kombinacija v angleškem jeziku: physiotherapy AND ACL reconstruction. V pregled literature so bile vključene randomizirane kontrolirane raziskave v angleškem jeziku, ki so obravnavale novejše fizioterapevtske postopke po rekonstrukciji sprednje križne vezi. Izključene so bile raziskave, v katerih preiskovanci niso imeli izolirane poškodbe sprednje križne vezi. V pregled literature smo vključili 6 raziskav, ki so ustrezale našim vključitvenim kriterijem. Rezultati: Z navzkrižnim učenjem ne povečamo statične ali dinamične stabilnosti sklepa. Razlika volumna mišice kvadriceps med operirano in zdravo nogo je prisotna pred operacijo, prav tako pa tudi 4 in 12 tednov po operaciji. Po terapiji suhega zbadanja prožilne točke se izboljša obseg giba in funkcionalnost. Predoperativna ishemična vadba pa ne izboljša funkcije sklepa po rekonstrukciji sprednje križne vezi. Vadba ravnotežja ne izboljša statične stabilnosti kolena po rekonstrukciji sprednje križne vezi, prav tako se ne izboljša dinamična stabilnost. Aplikacija kineziološkega traku po operaciji ne vpliva na zmanjšanje bolečine. Razprava in zaključek: Po opravljenem pregledu člankov lahko sklepamo, da opisani fizioterapevtski postopki aplicirani pred ali po rekonstrukciji sprednje križne vezi z različnimi kirurškimi presadki, statistično in klinično niso bolj učinkoviti kot standardna fizioterapija.Introduction: Anterior cruciate ligament is the most common knee joint injury in adults between the ages of 20 and 29 who engage in contact sports or sports involving jumps or quick stopping. Purpose: The purpose of this thesis is to present recent physiotherapy procedures after reconstruction of the anterior cruciate ligament. Methods: From July 2014 until July 2019, we had reviewed the PubMed database. The following search combination was used in English: physiotherapy AND ACL reconstruciton. Randomized controlled English-language trials addressing recent physiotherapy procedures after anterior cruciate ligament reconstruction were included in the literature review. Studies in which subjects did not have an isolated anterior cruciate ligament injury were excluded. We included 6 studies in the literature review that met our inclusion criteria. Results: Cross-training does not increase the static or dynamic stability of the joint. A difference in quadriceps muscle volume between the operated and healthy leg is present before surgery, as well as 4 and 12 weeks after surgery. After dry-needling therapy at the trigger point of the quadriceps muscle, range of motion and functionality are improved. Preoperative ischemic exercise, however, does not improve joint function after anterior cruciate reconstruction. Balancing exercise does not improve the static stability of the knee after reconstruction of the anterior cruciate ligament, nor does it improve dynamic stability. The application of kinesiology tape after surgery does not affect the reduction of pain. Discussion and conclusion: After reviewing the articles, it can be concluded that the described physiotherapy procedures applied before or after reconstruction of anterior cruciate ligament with various surgical grafts are not statistically and clinically more effective than standard physiotherapy