The Study Of Proprioception And Brain Plasticity After Anterior Cruciate Ligament Rupture And Reconstruction

Study 1:The changes of proprioception and grey matter volume after anterior cruciate ligament ruptureObjective: To investigate the changes of proprioception and grey matter volume(GMV)after anterior cruciate ligament(ACL)rupture.Methods: This analysis included 18 male patients with ACL rupture(diagnosed previously by clinical examination and MRI)not treated surgically who attended the Sports Medicine and Rehabilitation Center,Qingdao Municipal Hospital,China between June 2017 and June 2018.And 18 right-handed healthy male were enrolled as healthy group.Proprioception,balance and functional performance were assessed both groups using the Lysholm Scale,anteroposterior shift of the tibia(APST),active angle reproduction test(AART),modified star excursion balance test(m SEBT)and single hop distance(SHD).MRI(3.0T)was used to collect the brain structure images and SPM8 software was used to do voxel-based morphometry(VBM)study.Then,the correlation analysis was done by SPSS between the change of function and GMV.Results: The ACL rupture group resulted in significant differences in Lysholm scores,APST,AART,SEBT and SHD when compared with the healthy group(p<0.001).AART were positively correlated with APST(r=0.54,p < 0.05)in ACL rupture group.The GMV of some brain areas of the patients changes,when compared with the healthy group,the GMV of Cerebelum?Crus1?L was significantly increased,but,Supp?Motor?Area?R,Parietal?Sup?R,Parietal?Inf?R,Caudate?R and Para Hippocampal?R were significantly decreased.Supp?Motor?Area?R(r=-0.55),Parietal?Sup?R(r=-0.54),Parietal?Inf?R(r=-0.58),Caudate?R(r=-0.59)were negatively correlated with m SEBT scores(p<0.05).Conclusions:(1)the ACL rupture patients ability of neuromuscular controldecrease,AART was corralated with APST.(2)brain structure plasticity of patients with ACL rupture has been changed.(3)the cortical motor control strategy of patients with ACL rupture shift to subcortical motor control strategy.Study 2: The effect of proprioception,balance and functional performance of the knee with ACL rupture after Kinesio taping application.Objective: It is no doubt that proprioception,balance and functional performance are all influenced after anterior cruciate ligament(ACL)rupture.In comparison,there is still objection about the effect of kinesio taping(KT)using on the knee.The present study provided a positive evidence of KT application on ACL rupture.Methods: This analysis included 16 male patients with ACL rupture(diagnosed previously by clinical examination and MRI)not treated surgically who attended the Sports Medicine and Rehabilitation Center,Qingdao Municipal Hospital,China between June 2017 and June 2018.Before and after KT,Lysholm Scale,anteroposterior shift of the tibia(APST),the active angle reproduction test(AART),the modified star excursion balance test(m SEBT),single hop distance(SHD)were adopted to assess proprioception,balance and functional performance respectively in every patient,meanwhile,the healthy limb was measured for control.Result: the result of the affected limb showed significant improvements.In detail,the Lysholm scale improved from 76.00±3.78 to 84.06±3.66(p < 0.01),AART improved from 4.06°±1.06°to 2.44°±0.81°(p < 0.01),m SEBT improved from0.84±0.04 m to 0.94±0.04m(p < 0.01),SHD improved from 0.92±0.27 m to1.06±0.38m(p < 0.01).However,when compared with the control,there were still significant differences.Moreover,AART were negatively correlated with Lysholm scales(r=-0.659,p<0.01)after KT used.Conclusions: KT has a supportive effect on proprioception,balance and functional performance in patients with ACL rupture,but KT cannot completelycompensate the function lost from ACL deficiency.After KT used,the patients knee proprioception was corralated with functional scales.Therefore,the injured knee joint may partially benefit from KT application when being treated conservatively.Study 3: the study of proprioception recovery and brain functional plasticity of ACL reconstruction patients after Neuromuscular Training.Objective: To investigate the proprioception recovery of ACL reconstruction patients after Neuromuscular Training(NT),and to study the characteristics of their brain functional plasticity by using f MRI.Methods: This analysis included 24 male ACL reconstruction patients who did the surgery in the Sports Medicine and Rehabilitation Center,Qingdao Municipal Hospital,China between August 2017 and August 2018.The patients were divided into two groups randomly.The control group(n=12)was given a regular rehabilitation program for 3 months after surgery and following another 3 months of family rehabilitation,The NT group(n=12)was given a NT rehabilitation program after 3 months of regular rehabilitation,60 min each time,2 times per week,totally 6months.After 6 months of rehabilitation,the Lysholm Scale,active angle reproduction test(AART),and modified star excursion balance test(m SEBT)were noted.Furthermore,the patients had to do an task(knee flexion and extension activly),by using functional MRI with a block-designed task.Then,data analysis went on by using SPM8,caught the activation changed brain areas which were called region of interest(ROI),the correlation analysis was done by SPSS between the scores of functional tests and the means of activation.Results:(1)After a treatment phase of 6 months,when compared with before the operation,both groups were significantly improved in Lysholm scale,APST and AART.(2)After rehabilitation treatment,AART was positively correlated with the Lysholm scores and ASPT in both groups.(3)According to the outcomes of f MRItask after rehabilitation treatment,when compared with the control group,the significantly increased activation area in NT group is Cerebelum(Vermis)and cingulate gyrus,decreased activation is inferior temporal gyrus and lingual gyrus.(4)After rehabilitation treatment,in NT group,the Lysholm score was positively correlated with Cerebelum(Vermis)activation,and in control group,positively correlated with inferior temporal gyrus and lingual gyrus activation.Conclusions:(1)After NT program,the knee function and proprioception recovery of the ACL reconstruction patients were better than regular rehabilitation.(2)patients report outcome scales of the tibia and anteroposterior shift cannot be separately used as an indicator of the knee proprioception function.(3)Neuromuscular Training after ACL reconstruction can help patients decrease visual assistant and increase the integration of motor learning.