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Effect of Backward Walking Exercise on ROM, VAS score and Proprioception in Anterior Cruciate Ligament Reconstruction Patients

전방십자인대 재건술 환자의 후방보행 재활운동이 관절의 가동범위 및 통증점수, 고유수용성감각에 미치는 영향

  • Moon, Dae-Hyung (Dept. of Kinesiology & Medical Science, Graduate School, Dankook University) ;
  • Oh, Du-Hwan (Dept. of Kinesiology & Medical Science, Graduate School, Dankook University) ;
  • Zhang, Seok-Am (Dept. of Kinesiology & Medical Science, Graduate School, Dankook University) ;
  • Lee, Jang-Kyu (Dept. of Kinesiology & Medical Science, Graduate School, Dankook University)
  • 문대형 (단국대학교 대학원 운동의과학과) ;
  • 오두환 (단국대학교 대학원 운동의과학과) ;
  • 장석암 (단국대학교 대학원 운동의과학과) ;
  • 이장규 (단국대학교 대학원 운동의과학과)
  • Received : 2016.04.22
  • Accepted : 2016.05.12
  • Published : 2016.05.31

Abstract

This study examined the effects of 4-weeks of backward walking exercise on ROM, VAS (Visual Analogue Scale) score and proprioception in anterior cruciate reconstruction patients. Fourteen subjects were randomly assigned to either a backward walking group (BWG, n=7) or a control group (CON, n=7) and then participated in rehabilitation program for 4 weeks. The ROM of the flexion significantly decreased in both groups (BWG, p<0.001 vs CON, p<0.01), while ROM of extension significantly decreased only in the BWG (p<.05) post exercise, but no significant difference was observed between groups. Additionally, VAS score decreased significantly in both groups (P<0.001) and BWG was lower than CON post exercise (p<0.001). Finally, proprioception decreased significantly in both groups (BWG, p<0.001 vs CON, p<0.05), but did not differ significantly between groups. These results suggest that the 4 week backward walking rehabilitation program improves ROM, VAS score, and proprioception and has positive effects on functional recovery of anterior cruciate ligament reconstruction patients.

본 연구는 전방십자인대 재건술을 시행한 환자를 대상으로 후방보행을 포함한 재활운동 프로그램이 환자의 통증지수와 ROM, 고유수용성감각에 어떠한 영향을 미치는지 구명하고자 하였다. 이 연구의 대상자는 전방십자인대 손상으로 재건술을 시행한 환자 14명으로 하였으며 후방보행 집단(n=7)과 통제집단(n=7)으로 무선배정 하였고 4주간 각각의 재활운동프로그램을 실시하였다. 이 연구의 결과에서, 굴곡 관절가동범위는 운동 전 후, 후방보행 집단(p<.001)과 통제집단(p<.01) 모두 운동 후 유의하게 감소되었으며 신전 관절가동범위에서는 후방보행 집단(p<.05)에서만 운동 후 유의한 차이를 나타내었고 두 변인 모두 집단 간의 차이는 보이지 않았다. 통증지수에 대한 결과에서는 운동 후, 두 집단 모두 유의하게 감소되었고(p<.001) 집단 간 차이에서는 운동 후, 후방보행 집단이 통제집단보다 유의하게 낮은 것으로 나타났으며(p<.001), 고유수용성감각에서는 후방보행 집단(p<.001)과 통제집단(p<.05) 모두 운동 후 유의하게 감소하였으나 집단 간의 차이는 나타나지 않았다. 이러한 결과는 후방보행의 재활운동이 전방십자인대 재건술을 시행한 환자의 통증을 감소시키고 관절의 가동범위 확보와 고유수용성감각을 회복하는데 긍정적인 효과가 있는 것으로 사료된다.

Keywords

References

  1. "Number of gym club and number of member", Korea Council of Sport for all, 2012.
  2. Nordin M, & Frankel V. H. "Basic biomechanics of the musculoskeletal system" Lea & Febiger, Philadelphia, 1982.
  3. Yoon S. W. "Anterior cruciate ligament damage and rehabilitation exercise", Sport Science. 80(0), pp. 21-29, 2002.
  4. Barry C. S, & Joan M. M. "The role of weight bearing in the clinical assessment of knee joint position sense", Australian Journal of Physiotherapy, 47(4), pp. 247-253, 2001. DOI: http://dx.doi.org/10.1016/S0004-9514(14)60272-5
  5. Bilko T. E, Paulos L. E, Feagin J. A, Jr Lambert K. L, & Cunningham H. R. "Current trends in repair and rehabilitation of complete (acute) anterior cruciate ligament injuries", American Journal of Sports Medicine, 14(2), pp. 143-147, 1986. DOI: http://dx.doi.org/10.1177/036354658601400209
  6. Smith F. W, Rosenlund E. A, Aune A. K, Maclean J. A, & Hills S. W. "Subjiective functional assessments and the return to competitive sport after anterior cruciate ligament reconstruction", British Journal of Sports Medicine, 8(3), pp. 279-284, 2004. DOI: http://dx.doi.org/10.1136/bjsm.2002.001982
  7. Giugliano D. N, & Solomon J. L. "ACL tears in female athletes. physical medicine and rehabilitation", Clinics of North America. 18(3), pp. 417-38, 2007.
  8. Paulos L, Noyes F. R, Grood E, & Butler D. L. "Knee rehabilitation after anterior cruciate ligament reconstruction and repair", American Journal of Sports Medicine, 9(3), pp. 140-149, 1981. DOI: http://dx.doi.org/10.1177/036354658100900303
  9. Shelbourne K. D, & Nitz P. "Accelerated rehabilitation after anterior cruciate ligament reconstruction", American Journal of Sports Medicine, 18(3), pp. 292-299, 1990. DOI: http://dx.doi.org/10.1177/036354659001800313
  10. Kim J. K, & Jang J. H. "Differences in the recovery of muscular function in knee joint according to application time of exercise rehabilitation program after anterior cruciate ligament reconstruction", The Korea Journal of Sports Science, 21(2), pp. 1045-1058, 2012.
  11. Lee I. S, Lim J. Y, Kin Y. S, Jung S. K, Han T. R, & Kim T. K. "New isokinetic parameters for the outcome assessment of accelerated rehabilitation after anterior cruciate ligament reconstruction", The korea Journal of Sports Medicine, 23(3), pp. 251-256, 2005.
  12. Kim T. S, Kim S. H, & Hwang B. G. "Biomechanical for rehabilitation of the knee", The Journal of Korean Society of Physical Therapy, (12)2, pp. 239-247, 2000.
  13. Goradia V. K, Rochat M. C, Kida M, & Grana W. A. "Natural history of a hamstring tendon autograft used for anterior cruciate ligament reconstruction in a sheep model", American Journal of Sports Medicine, 28(1), pp. 40-46, 2000. DOI: http://dx.doi.org/10.1177/03635465000280011901
  14. Jo S. H, & Kim S. K. "The effect of depending on variations of speed in backward walking on lower extremities muscle", Journal of the Korea Academia-Industrial cooperation Society. 13(5), pp. 2199-2105, 2012. DOI: http://dx.doi.org/10.5762/KAIS.2012.13.5.2199
  15. Thorstensson A. "How is the normal locomotor program modified to produce backward walking?", Experimental Brain Research, 61(3), pp. 664-668, 1986. DOI: http://dx.doi.org/10.1007/BF00237595
  16. Threlkeld A. J, Horn T. S, Wojtowitcz G. M, Rooney J. G, & Shapiro R. "Kinematics, ground reaction force, and muscle balance produced by backward running", The Journal of Othopaedic and Sports Physical Therapy, 11(2), pp. 56-62, 1989. DOI: http://dx.doi.org/10.2519/jospt.1989.11.2.56
  17. Devita P, & Stribling J. "Lower extremity joint kinetics and energetics during backward running." Medicine and Science in Sports and Exercise, 23(5), pp. 602-610, 1991. DOI: http://dx.doi.org/10.1249/00005768-199105000-00013
  18. Flynn T. W, & Soutas-Little R. W. "Mechanical power and masculation during forward and backward running", The Journal of Orthopaedic and Sports Physical Therapy, 17(2), pp. 108-112, 1993. DOI: http://dx.doi.org/10.2519/jospt.1993.17.2.108
  19. Cynthia C, Norkin D, & Joyce W. "Measurement of joint motion", A Guide to Goniometry, 2011.
  20. Akarcali I, Tugay N, Erden Z, Atay A, Leblebicioglu G, & Doral M. N. "Patellofemoral pain rehabilitation: outcomes of a home based program", Journal of Arthroplasty Arthroscopic Surgery, (12), pp. 56-60, 2001.
  21. Gottlob C. A, Baker C. L, Jr Pellissier J. M, & Colvin L. "Cost effectiveness of anterior cruciate ligament reconstruction in young adults", Clinical Orthopaedics and Related Research, (367), pp. 272-282, 1999. DOI: http://dx.doi.org/10.1097/00003086-199910000-00034
  22. Hooper T. L, Dunn D. M, & Props J. E. "The effect of graded forward and backward walking on heart rate and oxygen consumption", The Journal of Orthopaedic and Sports Physical Therapy, 34(2), pp. 65-71, 2004. https://doi.org/10.2519/jospt.2004.34.2.65
  23. Delfico A. J, & Garrett W. E. Jr. "Mechanisms of injury of the anterior cruciate ligament in soccer players", Clinics in Sports Medicine, 17(4)779-485, 1998. DOI: http://dx.doi.org/10.1016/S0278-5919(05)70118-6
  24. Cosgarea A. J, Sebastianelli W. J, & DeHaven K. E. "Prevention of arthrofibrosis after anterior cruciate ligament reconstruction using the central third patellar tendon autograft", The American Journal of Sports Medicine, 23(1), pp. 87-92, 1995. DOI: http://dx.doi.org/10.1177/036354659502300115
  25. Henriksson M, Rockborn P, & Good L. "Range of motion training in brace vs plaster immobilization after anterior cruciate ligament reconstruction : a prospective randomized comparison with a 2-year follow-up", Scandinavian Journal of Medicine & Science in Sports, 12(2), pp. 73-80, 2002. DOI: http://dx.doi.org/10.1034/j.1600-0838.2002.120203.x
  26. David J. M. "Jumper's knee", The Journal of Orthopaedic and Sports Physical Therapy, 11(4), pp. 137-141, 1989. DOI: http://dx.doi.org/10.2519/jospt.1989.11.4.137
  27. McArdle W. F, Katch F, & Katch V. "Exercise physiology: energy, nutrition, and human performance", Philadelphia, 483-511, 2001.
  28. Kim Y. H, Kim G. W, Min H. J, Yoon Y. S, Cho K. H, Kim D. Y, & Kim S, L. "Analysis of the factors that Influence the range of motion after total knee Arthroplasty", Knee Surgery & Related Research. 11(1), pp. 20-25, 1999.
  29. Kisner C, & Colby L. A. "Therapeutic exercise. foundations and techniques", philadelphia, 61-108, 109-112, 1996.
  30. Seo H. D, & Nam H. C. "The effect of treadmill backward walking training on knee joint muscle strength, thigh circumference, soft lean mass, flexibility and body fat mass", Sports Science & Physical Therapy, 2(1), pp. 53-59, 2006.
  31. Park G. J. "Effect on flexibility of the body is agility", The Journal of Korean Olympic Committee, 103(0), pp. 44-47, 1971.
  32. Kang S. Y. "General conceptions of physical therapy", Human Science, 8(12), pp. 23-30, 1984.
  33. Lee H. J, & Park C. W. "Rehabilitation after anterior cruciate ligament reconstruction", Knee Surgery & Related Research, 23(2), pp. 69-79, 2011. DOI: http://dx.doi.org/10.5792/jkks.2011.23.2.69
  34. Cho J. H, & Kim R. B. "Effect of the MBT shoes on lower extremity joints dynamics during walking", Journal of Sports and Leisure Studies, 48(2), pp. 825-834, 2012.
  35. Kim R. B, & Cho J. H. "An analysis on the contribution of lower limb joint according to the gender and gait velocity". Korean Journal of Sport Biomechanics, 23(2), pp. 159-167, 2013. DOI: http://dx.doi.org/10.5103/KJSB.2013.23.2.159
  36. Katsavelis D, Mukherjee D. L, & Stergiou N. "Variability of lower extremity joint kinematics during backward walking in a virtual environment", Nonlinear Dynamics Psychology and Life Sciences, 14(2), pp. 165-179, 2010.
  37. Winter D. A, Pluck N. & Yang J. F. "Backward walking, a simple reversal of forward walking?", Journal of Motor Behavior, 21(3), pp. 291-305, 1989. DOI: http://dx.doi.org/10.1080/00222895.1989.10735483
  38. Gondhalekar G. A, Deo M. V. "Retro walking as an adjunct to conventional treatment versus conventional treatment alone on pain and disability in patients with acute exacerbation of chronic knee osteoarthritis: a randomized clinical trial", North American Journal of Medical Sciences, 5(2), pp. 108-12, 2013. DOI: http://dx.doi.org/10.4103/1947-2714.107527
  39. Lee M. H, Son J. S, Kim J. Y, & Kim Y. H. "Biomechanical analysis of lower-limb joint during backward walking", The Journal of the Korean Society for Precision Engineering, 2011(6), pp. 1421-1422, 2011.
  40. Christanell F, Hoser C, Huber R, Fink C, & Luomajoki H. "The influence of electromyographic biofeedback therapy on knee extension following anterior cruciate ligament reconstruction: a randomized controlled trial", Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology, 4(1), pp. 41, 2012. DOI: http://dx.doi.org/10.1186/1758-2555-4-41
  41. Ji Y. S, Lee J. C, & Yang J. S. "The effect of rehabilitative exercise on musculoarticular functions and VAS in athletes with meniscus repair", Journal of Coaching Development, 8(4), pp. 209-218, 2006.
  42. Chaloupka E. C, Kang J, Mastrangelo M. A, & Donnelly M. S. "Cardiorespiratory and metabolic responses during forward and backward walking", The Journal of Orthopaedic and Sports Physical Therapy, (25)5: 302-306, 1997. DOI: http://dx.doi.org/10.2519/jospt.1997.25.5.302
  43. Witvrow E, Lysens R, Bellemans J, Peers K, & Vanerstraeten G. "Open versus closed kinetic chain exercises for patellofemoral pain; a prospective, randomized study", The American Journal of Sports Medicine, 28(5), pp. 687-694, 2000. https://doi.org/10.1177/03635465000280051201
  44. Bae J. J, Lee J, C, Han S. W, "The effect of backward walking on respiratory factor and VAS in the rehabilitation training for knee injury", The Korean Journal of Physical Education, 44(4), pp. 347-346, 2005.
  45. Flynn T. W, & Soutas-Little R. W. "Patellofemoral joint compressive forces in forward and backward running", Journal of Orthopaedic and Sports Physical Therapy, 21(5), pp. 277-282, 1995. DOI: http://dx.doi.org/10.2519/jospt.1995.21.5.277
  46. Myatt G, Baxter R, Dougherty R, Williams G, Halle J, Stetts D. & Underwood F. "The cardiopulmonary cost of backward walking at selected speeds", The Journal of Orthopaedic and Sports Physical Therapy, 21(3), pp. 132-8, 1995. DOI: http://dx.doi.org/10.2519/jospt.1995.21.3.132
  47. Oh S. J, Yang S. J, Ha J. K, Seo J. G, Choi J. Y, & Kim J. K. "Clinical article : the effectiveness of joint position sense test in evaluating the proprioceptive function after anterior cruciate ligament reconstruction", The Korea Journal of Sports Medicine, 29(2), pp. 83-88, 2011. DOI: http://dx.doi.org/10.5763/kjsm.2011.29.2.83
  48. Corrigan J. P, Cashman W. F, & Brady M. P. "Proprioception in the cruciate deficient knee", Journal of Bone and Joint Surgery, 74(2), pp. 247-250, 1992.
  49. Mir S. M, Hadian M. R, Talebian S, & Nasseri N. "Functional assessment of knee joint position sense following anterior cruciate ligament reconstruction", British Journal of Sports Medicine, 42(4), pp. 300-303, 2008. DOI: http://dx.doi.org/10.1136/bjsm.2007.044875
  50. Henriksson M, Ledin T, & Good L. "Postural control after anterior cruciate ligament reconstruction and functional rehabilitation", The American Journal of Sports Medicine, 29(3), pp. 359-366, 2001. https://doi.org/10.1177/03635465010290031801
  51. Hyun D. S, & Choi J, D. "The effects of backward walking with rhythmic auditory stimulation on gait and balance in patients with stroke", Journal of the Korea Academia-Industrial cooperation Society", 14(12), pp. 6237-6245, 2013. https://doi.org/10.5762/KAIS.2013.14.12.6237