We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Cross-education does not accelerate the rehabilitation of neuromuscular functions after ACL reconstruction: a randomized controlled clinical trial.
- Authors
Zult, Tjerk; Gokeler, Alli; van Raay, Jos J. A. M.; Brouwer, Reinoud W.; Zijdewind, Inge; Farthing, Jonathan P.; Hortobágyi, Tibor
- Abstract
<bold>Purpose: </bold>Cross-education reduces quadriceps weakness 8 weeks after anterior cruciate ligament (ACL) surgery, but the long-term effects are unknown. We investigated whether cross-education, as an adjuvant to the standard rehabilitation, would accelerate recovery of quadriceps strength and neuromuscular function up to 26 weeks post-surgery.<bold>Methods: </bold>Group allocation was randomized. The experimental (n = 22) and control (n = 21) group received standard rehabilitation. In addition, the experimental group strength trained the quadriceps of the non-injured leg in weeks 1-12 post-surgery (i.e., cross-education). Primary and secondary outcomes were measured in both legs 29 ± 23 days prior to surgery and at 5, 12, and 26 weeks post-surgery.<bold>Results: </bold>The primary outcome showed time and cross-education effects. Maximal quadriceps strength in the reconstructed leg decreased 35% and 12% at, respectively, 5 and 12 weeks post-surgery and improved 11% at 26 weeks post-surgery, where strength of the non-injured leg showed a gradual increase post-surgery up to 14% (all p ≤ 0.015). Limb symmetry deteriorated 9-10% more for the experimental than control group at 5 and 12 weeks post-surgery (both p ≤ 0.030). One of 34 secondary outcomes revealed a cross-education effect: Voluntary quadriceps activation of the reconstructed leg was 6% reduced for the experimental vs. control group at 12 weeks post-surgery (p = 0.023). Both legs improved force control (22-34%) and dynamic balance (6-7%) at 26 weeks post-surgery (all p ≤ 0.043). Knee joint proprioception and static balance remained unchanged.<bold>Conclusion: </bold>Standard rehabilitation improved maximal quadriceps strength, force control, and dynamic balance in both legs relative to pre-surgery but adding cross-education did not accelerate recovery following ACL reconstruction.
- Subjects
ANTERIOR cruciate ligament surgery; QUADRICEPS muscle; REHABILITATION nursing; NEUROMUSCULAR system; RANDOMIZED controlled trials; CONVALESCENCE; EXERCISE; MUSCLE strength; NEUROPHYSIOLOGY; POSTOPERATIVE period; PROPRIOCEPTION; STATISTICAL sampling; CONTROL groups; RESISTANCE training; REHABILITATION
- Publication
European Journal of Applied Physiology, 2018, Vol 118, Issue 8, p1609
- ISSN
1439-6319
- Publication type
journal article
- DOI
10.1007/s00421-018-3892-1