title: [The importance of neuromuscular coordination for athletic stress of the knee joint after anterior cruciate ligament injuries. A gait and locomotion analysis with EMG on treadmill].
abstract: Anterior cruciate ligament (ACL) injuries are considered of high prevalence in sports medicine and are of socio-economical relevance. Indications for operative treatment and the ability for physical activity after ACL injuries are discussed controversially. Although it is known that the ACL has neurosensory functions, no test system has been developed which takes this biological function into account. The first goal of this study was to determine the neurosensory function after ACL reconstruction, and the second goal was to develop predictive markers for functional results after surgery. 20 healthy athletes (10 male, 10 female) (control group) and twenty ACL deficient patients (10 male, 10 female) (study group) were included in a prospective, controlled study. Electromyograms (EMG) were performed under defined load conditions of the knee. Important results of our study are: 1. Previously described parameters can be reproduced with EMG techniques. Their validity was proved. Typical contraction patterns (m. quadriceps, hamstrings, m. gastrocnemius) for defined load conditions can be recorded. 2. Statistically significant differences can be shown between the control group and the study group as well as between the two legs (injured/noninjured) of the same patient in the study group. 3. The results suggest that the diminished innervation of the m. biceps femoris and m. gastrocnemius in down-ramp-running as an important parameter for ACL deficiency. 4. Distinct differences of innervation patterns of the muscles, which stabilise the knee in downramp walking suggest that despite a subjective stability, altered load conditions may result. Innervation patterns seem to vary from individual to individual. 5. Concluding from our findings, we suggest that clinical methods should be developed to allow a patient-specific assessment of physical activity.
authors.affiliation: Orthopädischen Klinik, Universität Ulm.
authors.forename: R
authors.initials: R
authors.lastname: Eckhardt
authors.forename: H P
authors.initials: HP
authors.lastname: Scharf
authors.forename: W
authors.initials: W
authors.lastname: Puhl
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D001265:Athletic Injuries / Q000503:physiopathology / Q000601:surgery*; D005080:Exercise Test / Q000295:instrumentation; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D009132:Muscles / Q000294:innervation*; D009469:Neuromuscular Junction / Q000503:physiopathology*; D011183:Postoperative Complications / Q000503:physiopathology*; D012016:Reference Values; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation
vernacular_title: Die Bedeutung der neuromuskulären Koordination für die sportliche Belastbarkeit des Kniegelenkes nach vorderen Kreuzbandverletzungen. Eine Gang- und Laufanalyse mittels EMG auf dem Laufband.