بررسی برخی عوامل خطرزای عصبی- عضلانی مرتبط با آسیب ACL در افراد دچار ناهنجاری پرونیشن مچ پا

نوع مقاله: مقاله پژوهشی

نویسندگان

1 دانشجوی کارشناسی‌ارشد، حرکات اصلاحی و آسیبشناسی ورزشی، دانشکدۀ تربیت بدنی و علوم ورزشی، دانشگاه تهران، تهران، ایران

2 استادیار،گروه طب ورزشی، دانشکدۀ تربیت بدنی و علوم ورزشی، دانشگاه تهران، تهران، ایران

چکیده

راستای مکانیکی اندام تحتانی به‌طور کلی بر ثبات مفصل زانوی­ ورزشکاران اثر دارد. تحقیقات اشاره دارند که پرونیشن مچ پا در شیوع آسیب ACL مؤثر است، ولی مطالعه­ای در زمینۀ کنترل عصبی -عضلانی­ ورزشکاران دارای پرونیشن افزایش‌یافتۀ مچ پا در رابطه با آسیب ACL صورت نگرفته است. ازاین‌رو هدف از این تحقیق، بررسی برخی عوامل خطرزای عصبی- عضلانی مرتبط با آسیب ACL در افراد دچار ناهنجاری پرونیشن مچ پا بود.
پانزده ورزشکار دارای پرونیشن افزایش‌یافتۀ مچ پا و پانزده ورزشکار سالم به‌صورت هدفمند به‌عنوان نمونۀ آماری انتخاب شدند. سیگنال‌های الکترومیوگرافی با استفاده از الکترود سطحی از چهار عضله (گلوتوس مدیوس، لترال همسترینگ، واستوس لترالیس و سولئوس) ثبت شد.
نتایج آزمون MANOVA نشان داد در عضلات گلوتئوس مدیوس (029/0=P) و بایسپس فموریس (001/0P=) در مرحلۀ فیدفورواردی و در عضلۀ گلوتئوس مدیوس (005/0P=) در مرحلۀ فیدبکی، بین دو گروه تفاوت معنا‌دار وجود دارد و در فعالیت فیدفورواردی و فیدبکی عضلات واستوس لترالیس و سولئوس بین دو گروه ارتباط معنا‌داری وجود ندارد (05/.≤P). بنابراین ناهنجاری پرونیشن مچ پا با تغییر عملکرد عصبی - عضلانی عضلات گلوتئوس مدیوس و لترال همسترینگ، می‌تواند به‌عنوان عامل خطرآفرین در بروز آسیب‌های ACL دخیل باشد.

کلیدواژه‌ها


عنوان مقاله [English]

Investigating Some Neuromuscular Risk Factors of ACL Injury in Athletes with Ankle Pronation Deformity

نویسندگان [English]

  • noorollah javdaneh 1
  • hooman Minoonejad 2
  • elham shirzad 2
1 MSc Student of Corrective Exercises and Sport Injury, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
2 Assistant Professor, Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
چکیده [English]

athletes. Researches show that pronation of ankle affects the incidence of anterior cruciate ligament (ACL) injury but no researches have been conducted on neuromuscular control related to ACL injury in athletes with increased pronation of ankle. Therefore, the aim of this study was to investigate some neuromuscular risk factors of ACL injury in athletes with ankle pronation deformity. 15 athletes with increased pronation of ankle and 15 normal athletes were purposively selected as the ample of the study. Electromyographic signals were recorded with surface electrode from four muscles (gluteus medius, lateral hamstring, vastus lateralis and soleus). MANOVA results showed a significant difference between the two groups in feed forward phase of gluteus medius (P=0.029) and biceps femoris (P=0.001) and in feedback phase of gluteus medius (P=0.005) although there were no significant differences in feed forward and feedback activities of vastus lateralis and soleus between the two groups (P≥0.05). So pronation of ankle can be a risk factor in ACL injury incidence through a change in neuromuscular function of gluteus medius and lateral hamstring muscles.
 

کلیدواژه‌ها [English]

  • ACL injury
  • ankle pronation
  • feedback activity
  • forward activity
  • risk factors

منابع و مآخذ

  1. Allen, M.K. and W.M. Glasoe.(2000)."Metrecom measurement of navicular drop in subjects with anterior cruciate ligament injury".Journal of athletic training,35(4), PP: 403-406.
  2. Arendt, E. and R. Dick.(1995)."Knee injury patterns among men and women in collegiate basketball and soccer NCAA data and review of literature".The American Journal of Sports Medicin, 23(6),PP: 694-701.
  3. Ahmad CS, Clark AM, Heilmann N, Schoeb JS, Gardner TR, Levine WN.(2006)."Effect of gender and maturity on quadriceps-to-hamstring strength ratio and anterior cruciate ligament laxity".The American journal of sports medicine, 34(3),PP: 370-374.
  4. Baratta R, Solomonow M, Zhou BH, Letson D, Chuinard R, D'Ambrosia R.(1988)."Muscular coactivation The role of the antagonist musculature in maintaining knee stability".The American journal of sports medicine, 16(2), PP: 113-122.
  5. Beckett, M.(1992)."Incidence of hyperpronation in the ACL injured knee: a clinical perspective". Journal of athletic training, 27(1), PP: 58-62.
  6. Beynnon B, Howe JG, Pope MH, Johnson RJ, Fleming B.(1992)"The measurement of anterior cruciate ligament strain in vivo."International orthopaedics Journal, 16(1), PP: 1-12.
  7. Boden BP, Torg JS, Knowles SB, Hewett T.(2009)."Video analysis of anterior cruciate ligament injury abnormalities in hip and ankle kinematics". The American Journal of Sports Medicine, 37(2) ,PP: 252-259.
  8. Boden BP, Dean GS, Feagin JA, Jr., Garrett WE, Jr.(2000)."Mechanisms of anterior cruciate ligament injury".Orthopedics Journal, 23(6) ,PP: 573-578.
  9. Chang, J.S.(2012)."Differences of ground reaction forces and kinematics of lower extremity according to landing height between flat and normal feet".Journal of back and musculoskeletal rehabilitation, 22(4) ,PP: 21-26.
  10. Colby S, Francisco A, Yu B. Kirkendall D, Finch M, Garrett W, Jr .(2000)."Electromyographic and kinematic analysis of cutting maneuvers implications for anterior cruciate ligament injury". The American journal of sports medicine, 28(2), PP: 234-240.
  11. Daneshmandi, H., Saki, F (2009). "The study of static lower extremity posture in female athletes with ACL injuries". Harkat Sport Medicine, 1,PP:.75-91.[In Persian] .
  12. Duval, K., T. Lam, and D. Sanderson.(2010)."The mechanical relationship between the rearfoot, pelvis and low-back".Gait & posture Journal ,32(4), PP: 637-640.
  13. Elias, J.(2003)."The Soleus Muscle Acts as an Agonist for the Anterior Cruciate Ligament An In Vitro Experimental Study".The American journal of sports medicine, 31(2), PP: 241-246.
  14. Griffin, L.Y.(2006)."Understanding and Preventing Noncontact Anterior Cruciate Ligament Injuries A Review of the Hunt Valley II Meeting January 2005". The American journal of sports medicine, 34(9),PP: 1512-1532.
  15. Hewett TE, Ford KR, Hoogenboom BJ, Myer GD.(2010)."Understanding and preventing ACL injuries: current biomechanical and epidemiologic considerations-update 2010". North American journal of sports physical therapy: NAJSPT, 5(4) ,P: 234.
  16. Hertel, J., J.H. Dorfman, and R.A. Braham.(2004)."Lower extremity malalignments and anterior cruciate ligament injury history". Journal Sports Sci Med. 3(4),PP: 220-225.
  17. Hertel, J., M.R. Gay, and C.R. Denegar.(2002)."Differences in postural control during single-leg stance among healthy individuals with different foot types".Journal of athletic training, 37(2), P: 129.
  18. Hewett TE, Zazulak BT, Myer GD, Ford KR.(2005)."A review of electromyographic activation levels, timing differences, and increased anterior cruciate ligament injury incidence in female athletes".British journal of sports medicine, 39(6), PP: 347-350.
  19. Howell, S.M.(1990)."Anterior tibial translation during a maximum quadriceps contraction: Is it clinically significant?".The American journal of sports medicine, 18(6), PP: 573-578.
  20. Hagood S, Solomonow M, Baratta R, Zhou BH, D'Ambrosia R.(1990)."The effect of joint velocity on the contribution of the antagonist musculature to knee stiffness and laxity".The American journal of sports medicine, 18(2), PP: 182-187.
  21. Hollman JH, Ginos BE, Kozuchowski J, Vaughn AS, Krause DA, Youdas JW.(2009)."Relationships between knee valgus, hip-muscle strength, and hip-muscle recruitment during a single-limb step-down".Journal of sport rehabilitation, 18(1), PP:104-117.
  22. Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G.(2000)."Development of recommendations for SEMG sensors and sensor placement procedures".Journal of electromyography and Kinesiology, 10(5), PP: 361-374.
  23. Hewett TE, Stroupe AL, Nance TA, Noyes F.(1996)."Plyometric training in female athletes decreased impact forces and increased hamstring torques".The American Journal of Sports Medicine,24(6), PP: 765-773.
  24. Haddadnezhad M(2013). "Compairing the effect of functional stabilization and plyometric training on lumbo-pelvic muscle electromyogheraphy index of active females with trunk control deficiet( prone to acl injury)".University of Tehran,(PHD thesis), PP:61-63 [In Persian].
  25. Katie KB.(2010)."An Investigation into the Hamstring to Quadriceps Strength Ratio and Injury in". Journal THE British school of osteopathy.14(2),PP:26-35.
  26. KalantariyanM,Minoonejad H, Rajabi R, Beyranvand R.( 2013)" The comparison of the electromyography activity of selected muscles of the ankle joint in athletes  with ankle dorsiflexion range of motion limitation with healthy athletes during the single-leg jump landing". Journal Rehabilitation Medicine, 2(2),PP: 14-23.[In Persian].
  27. Levangie, P.K. and C.C. Norkin.(2011)."Joint structure and function: a comprehensive analysis".Copyright by F. A. Davis company 2005, Fourth Edition , PP.147-148.
  28. Lephart SM, Ferris CM, Riemann BL, Myers JB, Fu FH.(2002)".Gender differences in strength and lower extremity kinematics during landing".Clinical orthopaedics and related research, 401,PP: 162-169.
  29. Loudon, J.K., W. Jenkins, and K.L. Loudon.(1996)."The relationship between static posture and ACL injury in female athletes".Journal of Orthopaedic & Sports Physical Therapy,24(2), PP: 91-97.
  30. Myer GD, Ford KR, McLean SG, Hewett T..(2009)."The relationship of hamstrings and quadriceps strength to anterior cruciate ligament injury in female athletes".Clinical Journal of Sport Medicine ,19(1), PP: 3-8.
  31. Myer GD, Ford KR, Palumbo JP, Hewett T.(2011)."Real-time assessment and neuromuscular training feedback techniques to prevent ACL injury in female athletes".Strength and conditioning journal, 33(3), PP: 21-33.
  32. Murley GS, Menz HB, Landorf KB(2009)."Foot posture influences the electromyographic activity ofselected lower limb muscles during gait". Journal Foot Ankle Res,2(1), PP:35- 43.
  33. Minoonezhad H(2012). "The electromyographic study of a six week open،closed and combined kinematic chain exercises on anterior knee pain syndrome". University of Tehran,(PHD thesis), PP:70-71 [In Persian].
  34. O'Connor, J.( 1993)."Can muscle co-contraction protect knee ligaments after injury or repair?"Journal of Bone & Joint Surgery, British , sport medicine, 75(1), PP: 41-48.
  35. Olsen OE, Myklebust G, Engebretsen L, Bahr R.(2004)."Injury mechanisms for anterior cruciate ligament injuries in team handball a systematic video analysis".The American Journal of Sports Medicine, 32(4),PP: 1002-1012.
  36. Patrek MF, Kernozek TW, Willson JD, Wright GA, Doberstein S.(2011)."Hip-abductor fatigue and single-leg landing mechanics in women athletes".Journal of athletic training, 2011 ,46(1),PP: 31-42.
  37. Post, W.R., R. Teitge, and A. Amis.(2002)."Patellofemoral malalignment: looking beyond the viewbox". Clinics in sports medicine Journal.21(3),PP: 521-546.
  38. Renstrom P, Arms SW, Stanwyck TS, Johnson RJ, Pope MH.(1986)."Strain within the anterior cruciate ligament during hamstring and quadriceps activity".The American journal of sports medicine, 14(1), PP: 83-87.
  39. Souza, R.B. and C.M. Powers.(2009)."Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain".Journal of orthopaedic & sports physical therapy ,39(1),PP: 12-19.
  40. Silder, A.(2008)."MR observations of long-term musculotendon remodeling following a hamstring strain injury".Skeletal radiology Journal, 37(12), PP: 1101-1109.
  41. Silvers, H.J. and B.R.(2011)."Mandelbaum, ACL injury prevention in the athlete".Sport-Orthopädie-Sport-Traumatologie-Sports Orthopaedics and Traumatology, 27(1), PP: 18-26.
  42. Winter DA,Fuglevand AJ and Archer SE(1994): "Crosstalk in surface electromyography: theoretical and practical estimates". Journal Electromyography Kinesiology, 4(1), PP:15-26.
  43. Yu, B. and W.E. Garrett.(2007)."Mechanisms of non-contact ACL injuries".British journal of sports medicine, 41(suppl 1), PP: i47-i51.
  44. Zazulak BT, Ponce PL, Straub SJ, Medvecky MJ, Avedisian L, Hewett T.(2005)."Gender comparison of hip muscle activity during single-leg landing".Journal of Orthopaedic & Sports Physical Therapy, 35(5), PP: 292-299.