| Abstract [eng] |
Effect of Preoperative Education on Patient‘s After Cruciate Ligament Reconstruction Functional Status Goal of the research: Evaluation of the effect of preoperative education on patients’ functional state after anterior cruciate ligament reconstruction. Research objectives: 1. Evaluate and compare different preoperative training programs’ effects on participants’ subjective knee functional status and manifestation of motion of fear. 2. Evaluate and compare different preoperative training programs’ effects on knee joint range of motion, swelling development, calf bending and stretching muscles hypotrophy and isometric muscle strength. 3. Identify the different preoperative training programs’ effects on participants’ knee joint functional status parameters 3 months after ACL plastic. Methods and materials: 21 patients (32.9 ± 9.99) after ACL plastic participated in the research. They were divided into an experimental group which was subjected to a detailed preoperative training and a control group which received a brief oral training. They were tested before ACL plastic and a month after. To assess long-term training effects, 11 participants (31,82 ± 10,18) returned to the research 3 months after ACL plastic. Lysholm questionnaire, Tampa kinesiophobia scale, VAS, a goniometer for knee bend and extension amplitude measurement, tape-stripe for thigh and calf volume measuring, 10 meters speed walk test, Lafayette machine for isometric thigh muscle force measurement were used for the research. To evaluate the long-term effects of training as objectively as possible, an isokinetic dynamometer “Biodex 4 system” was used for muscle strength testing after 3 months. Data analysis programs: “R x64 3.0.3” and Microsoft Office Excel 2010. Results: A month after ACL plastic, the experimental gr. rated their knee joint functional status as average, while the control group rated it as bad (p <0.05). Fear of movement was slightly lower in the experimental than in the control group (p>0.05). After one month the experimental gr. felt an average pain of 0,64 points while it was 2,1 (p <0.05) in the control gr. In the experimental gr. knee joint volumes in terms swelling were not significantly increased (p<0.05) unlike as in the control group (p>0.05). Knee joint ranges of motion were reduced in both groups after ACL plastic, but in the experimental group -4.09 °±2,9 was lacking to full knee extension while it was -7,2 °±3,1 (p <0.05) in the control group. In both groups walking speed was reduced (p<0.05). Thigh muscle hypotrophy of the damaged leg was found in both groups, while calf muscle hypotrophy was found only in the control gr. (p<0.05). Isometric muscle strength in flexion 47,17N and extension 84,65N calf muscles of the healthy leg and extension 82,65N muscles of the damaged leg was higher in the experimental gr. than in the control gr. (p>0.05). 3 months after ACL plastic, experimental gr. rated their knee joint functional status 8,18 points better than the control group (p<0.05). There was a statistically significant difference in the evaluation of knee joint flexion and isometric extensor muscle force (p>0.05) of the damaged leg calf. Isokinetic dynamometer results showed a significant change in torque and the total work indicators of the damaged leg calf extension muscles. Conclusions: After a month exeprimental gr. rated their knee joint functional status better than control gr. (p<0.05). Also, the experimental gr. participants after ACL plastic felt less knee pain, had closer to the norm knee extension amplitude, greater calf extensor muscle isometric strength of both damaged and healthy legs and of the healthy leg calf flexion muscle than the control gr. (p <0.05). After 3 months it was determined that the knee joint subjective status, damaged leg knee bending amplitude, calf extensor muscle isometric force, torque and the joint work results were higher in the experimental gr. than in the control gr. (p<0.05 ). |
