Techniques of proprioceptive evaluation of the anterior cruciate knee ligament

Authors

  • Angélica Castilho Alonso Universidade de São Paulo. Faculdade de Medicina
  • Guilherme Carlos Brech Universidade de São Paulo. Faculdade de Medicina
  • Julia Maria D’Andréa Greve Universidade de São Paulo. Faculdade de Medicina

DOI:

https://doi.org/10.11606/issn.2317-0190.v17i3a103374

Keywords:

Proprioception, Postural Balance, Anterior Cruciate Ligament, Evaluation

Abstract

The increasing interest in sports activities, combined with the knee’s anatomical vulnerability and complexity, justifies the increasing number of patients with ligament injuries, especially the anterior cruciate ligament (ACL). What then would be the best way to evaluate the knee proprioception? The objective of this study was to identify the techniques of proprioceptive evaluation of the anterior cruciate knee ligament (ACL), and to determine whether a better technique is available. The method was to review the literature, including only those studies published in indexed scientific journals that referred to evaluation tools and/or knee proprioception measurement. The discussion of the different methods of evaluating ACL proprioception, according to the literature, included: morphological anatomical studies; neurophysiologic evaluation, and clinical evaluation which was divided into three types: a) sense of static position; b) kinesthetic posture; and c) postural balance. Although proprioception is important to the final results of a treatment involving ligament injury, its evaluation is still a problem. The conclusion was that the ideal method should have high sensitivity and specificity, in addition to good reproducibility and accuracy. There is lack of consensus in literature regarding the best evaluation technique and the results are also contradictory, despite the balance evaluation being a modern technique used in major research centers, it was not possible to isolate the proprioceptive system from other systems: visual and vestibular.

Downloads

Download data is not yet available.

References

Strobel M. Joelho procedimentos diagnósticos. São Paulo: Revinter; 2000.

Freeman MA, Wyke B. The innervation of the knee joint. An anatomical and histological study in the cat. J Anat. 1967;101(Pt 3):505-32.

Solomonow M, Baratta R, Zhou BH, Shoji H, Bose W, Beck C, et al. The synergistic action of the anterior cruciate ligament and thigh muscles in maintaining joint stability. Am J Sports Med. 1987;15(3):207-13.

Voight M, Blackburn T. Treinamento e testes de propriocepção e equilíbrio após a lesão. In: Ellenbecker TS. Reabilitação dos ligamentos do joelho. São Paulo: Manole; 2002.

Tookuni KS, Bolliger Neto R, Pereira CAM, Souza DR, Greve JMA, Ayala AD. Análise comparativa do controle posturas de indivíduos com e sem lesão do ligamento cruzado anterior do joelho. Acta Ortop Bras. 2005;13(3):115-9.

Alonso AC, Vieira PR, Macedo OG. Avaliação e reeducação proprioceptiva. In: Greve JMD. Tratado de medicina de reabilitação. São Paulo: Roca; 2007. p. 997-1004.

Schultz RA, Miller DC, Kerr CS, Micheli L. Mechanoreceptors in human cruciate ligaments. A histological study. J Bone Joint Surg Am. 1984;66(7):1072-6.

Schutte MJ, Dabezies EJ, Zimny ML, Happel LT. Neural anatomy of the human anterior cruciate ligament. J Bone Joint Surg Am. 1987;69(2):243-7.

Johansson H, Sjölander P, Sojka P. A sensory role for the cruciate ligaments. Clin Orthop Relat Res. 1991;(268):161-78.

Iwasa J, Ochi M, Adachi N, Tobita M, Katsube K, Uchio Y. Proprioceptive improvement in knees with anterior cruciate ligament reconstruction. Clin Orthop Relat Res. 2000;(381):168-76.

Fremerey RW, Lobenhoffer P, Zeichen J, Skutek M, Bosch U, Tscherne H. Proprioception after rehabilitation and reconstruction in knees with deficiency of the anterior cruciate ligament: a prospective, longitudinal study. J Bone Joint Surg Br. 2000;82(6):801-6.

Denti M, Monteleone M, Berardi A, Panni AS. Anterior cruciate ligament mechanoreceptors. Histologic studies on lesions and reconstruction. Clin Orthop Relat Res. 1994 Nov;(308):29-32.

Pitman MI, Nainzadeh N, Menche D, Gasalberti R, Song EK. The intraoperative evaluation of the neurosensory function of the anterior cruciate ligament in humans using somatosensory evoked potentials. Arthroscopy. 1992;8(4):442-7.

Beard DJ, Kyberd PJ, Fergusson CM, Dodd CA. Proprioception after rupture of the anterior cruciate ligament. An objective indication of the need for surgery? J Bone Joint Surg Br. 1993;75(2):311-5.

Barrack RL, Lund PJ, Munn BG, Wink C, Happel L. Evidence of reinnervation of free patellar tendon autograft used for anterior cruciate ligament reconstruction. Am J Sports Med. 1997;25(2):196-202.

Ochi M, Iwasa J, Uchio Y, Adachi N, Sumen Y. The regeneration of sensory neurones in the reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br. 1999;81(5):902-6.

Bonfim TR, Paccola CAJ. Propriocepção após a reconstrução do ligamento cruzado anterior usando ligamento patelar homólogo e autólogo. Rev Bras Ortop. 2000;35(6):194-201.

Perrin DH, Shultz SJ. Models for clinical research involving proprioception ad nuromuscular control. In: Lephart SM, Fu FH. Proprioception and neuromuscular control in joint stability. Champaign: Human Kinetics; 2000. p. 349-62.

Carter ND, Jenkinson TR, Wilson D, Jones DW, Torode AS. Joint position sense and rehabilitation in the anterior cruciate ligament deficient knee. Br J Sports Med. 1997;31(3):209-12.

Good L, Roos H, Gottlieb DJ, Renström PA, Beynnon BD. Joint position sense is not changed after acute disruption of the anterior cruciate ligament. Acta Orthop Scand. 1999;70(2):194-8.

Fonseca ST, Ocarino JM, Silva PLP, Lage CA, Guimarães RB, Oliveira MTC. Análise da propriocepção e sua relação com o desempenho funcional de indivíduos com deficiência do ligamento cruzado anterior. Rev Bras Fisio. 2003;7(3):253-59.

Bonfim TR, Jansen Paccola CA, Barela JA. Proprioceptive and behavior impairments in individuals with anterior cruciate ligament reconstructed knees. Arch Phys Med Rehabil. 2003;84(8):1217-23.

Mir SM, Hadian MR, Talebian S, Nasseri N. Functional assessment of knee joint position sense following anterior cruciate ligament reconstruction. Br J Sports Med. 2008;42(4):300-3.

Barrack RL, Skinner HB, Buckley SL. Proprioception in the anterior cruciate deficient knee. Am J Sports Med. 1989;17(1):1-6.

Fridén T, Roberts D, Zätterström R, Lindstrand A, Moritz U. Proprioception in the nearly extended knee. Measurements of position and movement in healthy individuals and in symptomatic anterior cruciate ligament injured patients. Knee Surg Sports Traumatol Arthrosc. 1996;4(4):217-24.

Pap G, Machner A, Nebelung W, Awiszus F. Detailed analysis of proprioception in normal and ACL-deficient knees. J Bone Joint Surg Br. 1999;81(5):764-8.

Fridèn T, Roberts D, Zätterström R, Lindstrand A, Moritz U. Proprioceptive defects after an anterior cruciate ligament rupture - the relation to associated anatomical lesions and subjective knee function. Knee Surg Sports Traumatol Arthrosc. 1999;7(4):226-31.

Fridén T, Roberts D, Movin T, Wredmark T. Function after anterior cruciate ligament injuries. Influence of visual control and proprioception. Acta Orthop Scand. 1998;69(6):590-4.

Risberg MA, Beynnon BD, Peura GD, Uh BS. Proprioception after anterior cruciate ligament reconstruction with and without bracing. Knee Surg Sports Traumatol Arthrosc. 1999;7(5):303-9.

Beynnon BD, Renström PA, Konradsen L, Emlqvist LG, Gotlieb D, Dirks M. Validation of techniques to measure knee proprioception. In: Lephart SM, Fu FH. Proprioception and neuromuscular control in joint stability. Champaign: Human Kinestics; 2000. p.127-138.

Greve J, Alonso A, Bordini AC, Camanho GL. Correlation between body mass index and postural balance. Clinics. 2007;62(6):717-20.

Barrack RL, Munn BG. Effects of Knee ligament Injury and reconstruction on Proprioception. In: Lephart SM, Fu FH. Proprioception and Neuromuscular Control in Joint Stability. USA: Human Kinestics; 2000. p. 197-212.

Riemann BL, Myers JB, Lephart SM. Comparison of the ankle, knee, hip, and trunk corrective action shown during single-leg stance on firm, foam, and multiaxial surfaces. Arch Phys Med Rehabil. 2003;84(1):90-5.

Testerman C, Vander Griend R. Evaluation of ankle instability using the Biodex Stability System. Foot Ankle Int. 1999;20(5):317-21.

Riemann BL, Guskiewicz KM. Contribuition of the Peripheral Somatosensory System to balance and Postural. In: Lephart SM, Fu FH. Proprioception and neuromuscular control in joint stability. Champaign: Human Kinestics; 2000. p. 37-51.

Schmitz R, Arnold B. Intertester and intratester reliability of a dynamic balance protocol using the biodex stability system. J Sport Rehabil. 1998;7:95-101.

Arnold BL, Schmitz RJ. Examination of balance measures produced by the biodex stability system. J Athl Train. 1998;33(4):323-7.

Cachupe WJC, Shifflett B, Kahanov L, Wughalter EH. Reliability of Biodex Balance System measures. Measurem Phys Educ Exerc Sci. 2001;5:97-108.

Beard D, Refshauge K. Effects of ACL reconstruction on proprioception and neuromuscular performance. In: Proprioception and neuromuscular control in joint stability. Champaign: Human Kinestics; 2000. p. 213-24.

Ageberg E, Zätterström R, Moritz U, Fridén T. Influence of supervised and nonsupervised training on postural control after an acute anterior cruciate ligament rupture: a threeyear longitudinal prospective study. J Orthop Sports Phys Ther. 2001;31(11):632-44.

Henriksson M, Ledin T, Good L. Postural control after anterior cruciate ligament reconstruction and functional rehabilitation. Am J Sports Med. 2001;29(3):359-66.

Alonso AC, Greve JMD, Camanho GL. Evaluating the center of gravity of dislocations in soccer players with and without reconstruction of the anterior cruciate ligament using a balance platform. Clinics. 2009;64(3):163-70.

Alonso AC, Luna NMS. Avaliação funcional do movimento-equilíbrio. In: Greve JMD. Medicina de reabilitação aplicada à ortopedia e traumatologia. 2 ed. São Paulo: Roca; No prelo 2010.

Kejonen P, Kauranen K, Vanharanta H. The relationship between anthropometric factors and body-balancing movements in postural balance. Arch Phys Med Rehabil. 2003 Jan;84(1):17-22.

Davlin CD. Dynamic balance in high level athletes. Percept Mot Skills. 2004;98(3 Pt 2):1171-6.

Alonso AC, Greve JMD, Macedo OG, Pereira CAM, Souza PCM. Avaliação isocinética dos inversores e eversores de tornozelo: estudo comparativo entre atletas de futebol e sedentários normais. Rev Bras Fisioter. 2003;7(3):195-99.

Birmingham TB, Kramer JF, Kirkley A, Inglis JT, Spaulding SJ, Vandervoort AA. Knee bracing after ACL reconstruction: effects on postural control and proprioception. Med Sci Sports Exerc. 2001;33(8):1253-8.

Hinman MR. Factors affecting reliability of the biodex balance system: a summary of four studies. J Sport Rehab. 2009;9(3):240-52.

Ingersoll CD, Grindstaff TL, Pietrosimone BG, Hart JM. Neuromuscular consequences of anterior cruciate ligament injury. Clin Sports Med. 2008;27(3):383-404

Alonso AC, Bronzatto Filho E, Brech GC, Moscoli F. Estudo comparativo do equilibrio postural entre atletas de judô e indivíduos sedentários. Rev Bras Biom. 2008;9(17):130-7.

Published

2010-09-09

Issue

Section

Review Article

How to Cite

1.
Alonso AC, Brech GC, Greve JMD. Techniques of proprioceptive evaluation of the anterior cruciate knee ligament. Acta Fisiátr. [Internet]. 2010 Sep. 9 [cited 2024 May 25];17(3):134-40. Available from: https://revistas.usp.br/actafisiatrica/article/view/103374