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Der Einfluss einer aktiven Bewegungsschiene auf die Propriozeption nach vorderer Kreuzbandplastik

Eine prospektiv randomisierte Studie

The influence of a controlled active motion splint on proprioception after anterior cruciate ligament plasty

A prospective rndomized study

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Zusammenfassung

Hintergrund

Nach einer VKB-Ruptur besteht neben der mechanischen eine durch das propriozeptive Defizit bedingte funktionelle Instabilität. Es sollte überprüft werden, ob durch Einsatz von CAM-Schienen unmittelbar postoperativ das propriozeptive Defizit gesenkt werden kann.

Patienten und Methoden

In dieser prospektiv randomisierten Studie wurden 50 Patienten nach VKB-Plastik in eine PT-Gruppe (Physiotherapie) und eine CAM-Gruppe (Physiotherapie + aktive Bewegungsschiene) eingeteilt. Die propriozeptive Leistung wurde mit einem passiven Winkelreproduktionstest gemessen.

Ergebnisse

Bei Entlassung wurde bei 80% der CAM-Patienten und 25% der PT-Patienten eine Reduktion des propriozeptiven Defizits gemessen. Die CAM-Gruppe zeigte in der Hauptzielgröße eine Verbesserung um 83,7%. Die PT-Gruppe verschlechterte sich um 39,3%. Es bestand kein signifikanter Unterschied zwischen der CAM-Gruppe und einer gesunden Kontrollgruppe.

Schlussfolgerung

Durch den postoperativen Einsatz der CAM-Schiene kann das propriozeptive Defizit gegenüber einer alleinigen Physiotherapie signifikant reduziert werden.

Abstract

Background

A ruptured anterior cruciate ligament (ACL) leads to both mechanical and functional instability. Functional instability is caused by proprioceptive deficit. The aim of this study was to determine whether the proprioceptive deficit can be reduced by using a controlled active motion (CAM) splint postoperatively.

Patients and methods

A total of 50 patients with ACL rupture were randomized into two groups. After ACL plasty the PT group received postoperative physiotherapy, while the CAM group were managed with a CAM splint and physiotherapy. Proprioceptive ability was measured with a passive angle-reproduction test.

Results

On the day of discharge 80% of the patients in the CAM group and 25% in the PT group had a reduced proprioceptive deficit. Overall the main measured value in the CAM group improved by 83.7%, but deteriorated by 39.3% in the PT group. There was no significant difference between the CAM group and a healthy control group.

Conclusion

Using a CAM splint in addition to physiotherapy after ACL plasty in comparison to physiotherapy alone decreases the proprioceptive deficit significantly. We recommend the use of a CAM splint in the postoperative management following ACL plasty.

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Authors and Affiliations

  1. Bundeswehrkrankenhaus Ulm

    B. Friemert, F. v. Lübken, R. Schmidt, C. Jouini & H. Gerngroß

  2. Bundeswehrkrankenhaus Ulm, Abt. Chirurgie, Oberer Eselsberg 40, 89081 , Ulm

    B. Friemert

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  1. B. Friemert
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Correspondence to B. Friemert.

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Friemert, B., v. Lübken, F., Schmidt, R. et al. Der Einfluss einer aktiven Bewegungsschiene auf die Propriozeption nach vorderer Kreuzbandplastik. Unfallchirurg 109, 22–29 (2006). https://doi.org/10.1007/s00113-005-1006-0

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