RESUMEN
BACKGROUND: People who have undergone anterior cruciate ligament reconstruction have an increased risk of osteoarthritis. Abnormality of lower limb kinematics will occur after the operation. This may be related to lower limb muscle strength, the co-excitation of hamstrings and quadriceps femoris, and the weakness of proprioception. Proprioceptive training can improve the proprioception of lower limbs and promote the recovery of lower limb kinematics. Our research objective is to observe whether proprioceptive training can improve the proprioception of lower limbs within 3 months after surgery and whether the recovery of proprioception can correct the abnormal lower limb kinematics. The secondary objective is to explore the underlying mechanism of postoperative lower limb gait abnormalities. METHODS/DESIGN: This study is a prospective single-center randomized clinical trial to be conducted in the Sports Medicine and Orthopedics of Zhongda Hospital Southeast University. Forty participants aged 18-50, preparing to undergo anterior cruciate ligament reconstruction, and initial anterior cruciate ligament reconstruction using hamstring tendons as grafts will be randomly assigned to the intervention or comparator group. People in the intervention group will add proprioceptive training three times a week, 20 min each time. The intervention will be conducted on the first day after surgery. The researcher mainly collects the data of joint of sense, gait, and plantar pressure. The assessment will be divided into three stages: after signing the informed consent form (within 2 weeks before surgery), 6 weeks after surgery, and 12 weeks after surgery. DISCUSSION: The main purpose of our study is to explore whether the proprioception of patients after anterior cruciate ligament reconstruction is weakened, whether the lower limb kinematics is abnormal and whether the lower limb kinematics can be corrected through proprioceptive training. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2200065808. Registered on 15 November 2022; Version 1.
Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Reconstrucción del Ligamento Cruzado Anterior , Humanos , Lesiones del Ligamento Cruzado Anterior/diagnóstico , Lesiones del Ligamento Cruzado Anterior/cirugía , Estudios Prospectivos , Resultado del Tratamiento , Reconstrucción del Ligamento Cruzado Anterior/efectos adversos , Reconstrucción del Ligamento Cruzado Anterior/métodos , Marcha , Propiocepción , Articulación de la Rodilla/cirugía , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Objective:To explore the effects of aerobic exercise combined with resistance exercise on patients with diabetic peripheral neuropathy (DPN).Methods:A total of 60 patients with DPN in Sixth Affiliated Hospital of Nantong University from June 2018 to October 2019 were selected, and randomly divided into control group (20 cases), aerobic exercise group (20 cases) and combined training group (20 cases). Three groups all received the routine medication management and dietary guide. The control group had no other intervention. The aerobic exercise group received moderate intensity cycle ergometer, 40 min/time, once a day, three times a week. In addition to the moderate intensity aerobic exercise, patients in the combined training group conducted resistance exercise with elastic belt, 40 min/time, once a day, three times a week. The curative effect was evaluated after 12 weeks, which included fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), nerve conduction velocity and static balance function of eye-opened and eye-closed condition in Pro-Kin 254 balance assessment equipment.Results:Before exercise intervention, there were no significant differences in any measurements among the three groups (all P>0.05). After exercise intervention, the FBG, HbA1c, motor nerve conduction velocity of common peroneal nerve, sensory nerve conduction velocity of common peroneal nerve, sway length and area in the eye closed test of Pro-Kin254 balance assessment in the aerobic exercise group were significantly better than those in the control group[(6.26±0.28) vs. (6.76±0.68) mmol/L, (5.75±0.42)% vs. (6.48±0.37)%, (45.36±8.78) vs. (42.16±6.78) m/s, (38.75±8.14) vs. (35.45±8.34) m/s, (513±39) vs. (613±71) mm, (678±58) vs. (1 024±98) mm 2] (all P<0.05); the above indexes of the combined training group [(6.03±0.36) mmol/L, (5.27±0.35)%, (49.51±9.76) m/s, (42.87±7.18) m/s, (425±38) mm, (535±47) mm 2] were significantly better than those in the other two groups, the sway length and area in the eye open test of Pro-Kin254 balance assessment were also significantly superior to those in the other two groups [(316±21) vs. (395±18), (436±28) mm and (689±33) vs. (782±30), (824±70) mm 2] (all P<0.05). Conclusion:Aerobic exercise combined with resistance exercise can better improve the levels of blood glucose and HbA1c, increase nerve conduction rate and improve static balance ability compared with simple aerobic exercise in patients with DPN.