Background: Many of the athletes returning to sport after Anterior Cruciate Ligament (ACL) Reconstruction have deficits in proprioceptive and motor control level, different sensations compared to the controlateral knee and inadequate psychological readiness. These elements seem to influence sports performance and increase the risk of recurrence. The Focal Muscle Vibration is a little known treatment which seems to act directly on these aspects. Indeed, through the activation of the neuromuscular spindles and Golgi tendon organs, this treatment can select the affiliations sent to the CNS, change the excitability of certain areas of the brain and obtain a response from it. This process seems to facilitate an improvement of the motor control, a better management of muscle recruitment and an increase of the aspects concerning the proprioceptivity, the coordination and the stability of the structure involved. Objective: To observe the effects generated by a cycle of Focal Muscle Vibration on athletes who returned to sport after ACL Reconstruction, especially with regard to sports performance, kinesiophobia and the sensations felt at knee level. Materials and methods: The subjects underwent the treatment, carried out using the Crosystem equipment (NEMOCO srl, Italy), for 3 sessions of 30 minutes each, on 3 consecutive days. The vibration was characterized by a fixed frequency (100 Hz) and low amplitude (0,2-0,5 mm). It was applied at the level of the quadriceps of the operated limb and the subjects were required to maintain a slight isometric contraction of the leg throughout the treatment. The athletes were evaluated before carrying out the vibration cycle and 15, 45 and 90 days after the end of the cycle. Sports performance was analyzed through a battery of tests such as the Hop Test, the Y Balance Test and the Agility T-Test. The psychological aspects and perceived sensations were instead measured using the ACL-RSI, the Tampa Scale and the KOOS. Results: The inclusion and exclusion criteria led to the identification of 6 subjects who gave their consent. The average values of the ACL-RSI, Tampa Scale and KOOS improved in all reevaluations, especially after 15 and 90 days. Also regarding the performance of the operated limb, compared to the controlateral one, the Hop Tests and the Y Balance Test showed an increase in the average values in the 3 reevaluations, especially in the medium and long term. Considering the Agility T-Test, however, the improvements occurred only 45 and 90 days after the end of the treatment. From the analysis of the data, the greater age of the athlete seems to have slightly limited the increases in scores. Meanwhile, there seems to be a slight positive correlation with a greater number of hours of training per week and a greater distance from the data of surgery. However, the type of graft used and the side of the operated limb do not seem to highlight any particular differences. Conclusions: Focal Vibration seems able to play a role in improving the sensations perceived at the knee level and sports performance, in particular with regard to motor control and stability of the knee in jumping activities, changes of direction or in manteining monopodalic balance. At the same time, the athlete’s awareness, safety and psychological readiness seem to increase. Considering the results obtained and the limitations of the study, further investigation is necessary to evaluate the effectiveness, of the treatment in these athletes, certainly including at least a control group and increasing the sample.
Background: Numerosi atleti che ritornano allo sport dopo ricostruzione del legamento crociato anteriore (LCA) presentano deficit a livello propriocettivo e di controllo motorio, sensazioni differenti rispetto al ginocchio controlaterale e un’inadeguata prontezza dal punto di vista psicologico. Questi elementi sembrano influenzare la performance sportiva ed incrementare il rischio di recidiva. Un trattamento poco conosciuto, che sembra agire direttamente su questi aspetti, è la Vibrazione Muscolare Focale. Quest’ultima infatti è in grado, attraverso l’attivazione dei fusi neuromuscolari e degli organi tendinei di Golgi, di selezionare le afferenze inviate al SNC, modificare l’eccitabilità di determinate aree dell’encefalo e ottenere una risposta da parte di quest’ultimo. Tale processo sembra favorire un miglioramento del controllo motorio, una miglior gestione dei reclutamenti muscolari e un incremento degli aspetti riguardanti la propriocettività, la coordinazione e la stabilità del distretto coinvolto. Obiettivo: Osservare gli effetti generati da un ciclo di Vibrazione Muscolare Focale su atleti ritornati allo sport dopo intervento di ricostruzione del LCA, in particolar modo per quanto riguarda la performance sportiva, la kinesiofobia e le sensazioni percepite a livello del ginocchio. Materiali e metodi: I soggetti sono stati sottoposti al trattamento, effettuato tramite l’apparecchiatura Crosystem (NEMOCO srl, Italia), per 3 sedute da 30 minuti ciascuna, in 3 giorni consecutivi. La vibrazione era caratterizzata da una frequenza fissa (100 Hz) e da una bassa ampiezza (0,2-0,5 mm). Essa è stata applicata a livello del quadricipite dell’arto operato ed è stato richiesto di mantenere una lieve contrazione isometrica di quest’ultimo durante tutto il trattamento. Gli atleti sono stati valutati prima di effettuare il ciclo di vibrazione e a distanza di 15, 45 e 90 gg dalla fine di quest’ultimo. La performance sportiva è stata analizzata attraverso una batteria di test quali gli Hop Test, l’Y Balance Test e l’Agility T-Test. Gli aspetti psicologici e le sensazioni percepite sono stati invece misurati tramite l’ACL-RSI, la Tampa Scale e la KOOS. Risultati: I criteri di inclusione ed esclusione hanno portato all’individuazione di 6 soggetti che hanno dato il loro consenso. I valori medi dell’ACL-RSI, della Tampa Scale e della KOOS sono migliorati in tutte le rivalutazioni, in particolar modo dopo 15 e 90 gg. Anche per quanto riguarda la performance dell’arto operato, confrontata a quello controlaterale, gli Hop Test e l’Y Balance Test hanno mostrato un incremento dei valori medi nelle 3 rivalutazioni, soprattutto a medio e lungo termine. Considerando l’Agility T-Test invece, i miglioramenti si sono verificati solo a distanza di 45 e 90 gg dalla fine del trattamento. Dall’analisi dei dati, la maggior età dell’atleta sembra aver limitato leggermente gli incrementi dei punteggi, mentre sembra esserci una lieve correlazione positiva con un maggior numero di ore di allenamento settimanali e una maggior distanza dalla data dell’intervento. La tipologia di graft utilizzato e il lato dell’arto operato non sembrano invece evidenziare particolari differenze. Conclusioni: La Vibrazione Focale sembra poter avere un ruolo nel miglioramento delle sensazioni percepite a livello del ginocchio e della performance sportiva, in particolar modo per quanto riguarda il controllo motorio e la stabilità del ginocchio in attività di salto, cambi di direzione o nel mantenimento dell’equilibrio monopodalico. Parallelamente sembra incrementare la consapevolezza, la sicurezza e la prontezza psicologica da parte dell’atleta. In considerazione dei risultati ottenuti e dei limiti comunque presenti nello studio, si rendono necessarie ulteriori indagini per valutare l’efficacia del trattamento in questi atleti, includendo sicuramente almeno un gruppo di controllo e aumentando il campione.
EFFETTI DELLA VIBRAZIONE MUSCOLARE FOCALE SU ATLETI RITORNATI ALLO SPORT DOPO RICOSTRUZIONE DEL LEGAMENTO CROCIATO ANTERIORE
ALBA, MATTIA
2022/2023
Abstract
Background: Many of the athletes returning to sport after Anterior Cruciate Ligament (ACL) Reconstruction have deficits in proprioceptive and motor control level, different sensations compared to the controlateral knee and inadequate psychological readiness. These elements seem to influence sports performance and increase the risk of recurrence. The Focal Muscle Vibration is a little known treatment which seems to act directly on these aspects. Indeed, through the activation of the neuromuscular spindles and Golgi tendon organs, this treatment can select the affiliations sent to the CNS, change the excitability of certain areas of the brain and obtain a response from it. This process seems to facilitate an improvement of the motor control, a better management of muscle recruitment and an increase of the aspects concerning the proprioceptivity, the coordination and the stability of the structure involved. Objective: To observe the effects generated by a cycle of Focal Muscle Vibration on athletes who returned to sport after ACL Reconstruction, especially with regard to sports performance, kinesiophobia and the sensations felt at knee level. Materials and methods: The subjects underwent the treatment, carried out using the Crosystem equipment (NEMOCO srl, Italy), for 3 sessions of 30 minutes each, on 3 consecutive days. The vibration was characterized by a fixed frequency (100 Hz) and low amplitude (0,2-0,5 mm). It was applied at the level of the quadriceps of the operated limb and the subjects were required to maintain a slight isometric contraction of the leg throughout the treatment. The athletes were evaluated before carrying out the vibration cycle and 15, 45 and 90 days after the end of the cycle. Sports performance was analyzed through a battery of tests such as the Hop Test, the Y Balance Test and the Agility T-Test. The psychological aspects and perceived sensations were instead measured using the ACL-RSI, the Tampa Scale and the KOOS. Results: The inclusion and exclusion criteria led to the identification of 6 subjects who gave their consent. The average values of the ACL-RSI, Tampa Scale and KOOS improved in all reevaluations, especially after 15 and 90 days. Also regarding the performance of the operated limb, compared to the controlateral one, the Hop Tests and the Y Balance Test showed an increase in the average values in the 3 reevaluations, especially in the medium and long term. Considering the Agility T-Test, however, the improvements occurred only 45 and 90 days after the end of the treatment. From the analysis of the data, the greater age of the athlete seems to have slightly limited the increases in scores. Meanwhile, there seems to be a slight positive correlation with a greater number of hours of training per week and a greater distance from the data of surgery. However, the type of graft used and the side of the operated limb do not seem to highlight any particular differences. Conclusions: Focal Vibration seems able to play a role in improving the sensations perceived at the knee level and sports performance, in particular with regard to motor control and stability of the knee in jumping activities, changes of direction or in manteining monopodalic balance. At the same time, the athlete’s awareness, safety and psychological readiness seem to increase. Considering the results obtained and the limitations of the study, further investigation is necessary to evaluate the effectiveness, of the treatment in these athletes, certainly including at least a control group and increasing the sample.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/58525