The effects of backward locomotion as part of a rehabilitation program on the functional ability of patients following knee injury

Date
2010-12
Authors
Brink, Marisa
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : University of Stellenbosch
Abstract
ENGLISH ABSTRACT: Knee injuries are common among the physically active population and are often severe enough that it requires surgery. Rehabilitation specialists are on the constant look-out for the most efficient and cost-effective treatment alternatives to provide athletes with an early return to sport. The inclusion of backward locomotion in knee rehabilitation programs has been proposed since it is considered a safe closed kinetic chain exercise which has been found to increase quadriceps strength and power as well as cardiorespiratory fitness. The primary aim of the study was to establish the efficacy of backward locomotion training during a knee rehabilitation program. Thirty nine men and women (aged 18 to 59 years) with knee pathologies volunteered for the study and were randomly assigned to the experimental group (EXP, n = 20) and control group (CON, n = 19). All participants underwent a 24 session knee rehabilitation program which included 20 – 30 minutes of cardiorespiratory training, either in backward mode (EXP), or forward mode (CON). Aerobic fitness, quadriceps and hamstrings strength and power, single leg balance, lower limb circumferences, and lower limb flexibility were measured before and after the rehabilitation program. Backward locomotion training resulted in a borderline statistical significant improvement in ventilatory threshold (VT) (p = 0.07) and a statistical significant improvement in peak power output (PPO) (p < 0.05). The VT and PPO of the backward locomotion group increased by 9 and 14%, respectively, compared to 0 and 4% in the forward locomotion group. Both groups showed statistically significant improvements in quadriceps and hamstrings strength, except the quadriceps of the uninvolved leg of the forward locomotion group. Similarly, both groups showed a statistically significant improvement in quadriceps and hamstrings average power, except the quadriceps of the uninvolved leg of the forward locomotion group. Single leg balance of the involved and uninvolved legs improved statistically significantly in both groups (p < 0.05). The differences in change between the two interventions were not statistically significantly different (p > 0.05) and the practical differences were small (ES ± 0.2). No statistically significant differences in the change in leg circumferences were observed between the two groups. Only the change in flexibility of the involved soleus was significantly different between the EXP and CON groups. The results show that backward locomotion training result in greater improvements in aerobic fitness and equal or greater improvements in quadriceps and hamstrings muscle strength and power, compared to forward locomotion training. Backward locomotion as well as forward locomotion contributes to the recovery of knee injuries, however, the practical significance of backward locomotion is greater than for forward locomotion. The conclusion of this is that backward locomotion is a better alternative rehabilitation program for athletes as this will affect a quicker return to their sport.
AFRIKAANSE OPSOMMING: Kniebeserings kom algemeen voor in die fisiek aktiewe bevolking en is dikwels so ernstig dat dit chirurgie vereis. Rehabilitasie-spesialiste is voortdurend op soek na die mees doeltreffende en koste-effektiewe alternatief vir behandeling om die atlete vinnig te laat terugkeer na hul sport. Die insluiting van agteruitbeweging in knie-rehabilitasieprogramme is al in die verlede voorgestel, aangesien dit beskou word as 'n veilige geslote-kinetieseketting oefening wat al geskik bevind is om quadriceps sterkte en krag, asook kardiorespiratoriese fiksheid te verbeter. Die hoofdoel van die studie was om die effektiwiteit van agteruitbewegingoefening in 'n knierehabilitasieprogram te bepaal. Nege-en-dertig mans en vroue (tussen die ouderdom van 18 en 59 jaar) met kniepatologieë het vrywillig ingestem om aan die studie deel te neem en is lukraak verdeel in die eksperimentele groep (EXP, n = 20) en kontrole groep (CON, n = 19). Alle deelnemers het 24 sessies voltooi waarvan 20 – 30 minute kardiorespiratoriese oefeninge was. Dit het óf in die agteruitrigting (EXP), óf vorentoe-rigting (CON) plaasgevind. Aërobiese fiksheid, quadriceps en hamstrings sterkte en krag, eenbeenbalans, omtrekke van die onderste ledemaat, en soepelheid van die onderste ledemaat is gemeet, voor en na die rehabilitasieprogram. Agteruitbeweging-oefening het 'n geringe verbetering in ventilatoriese draaipunt (VT) (p = 0.07) opgelewer wat grens aan 'n statisties betekenisvolle verbetering, asook 'n statisties betekenisvolle verbetering in piek kraguitset (PPO) (p <0.05). Die VT en PPO van die agteruitbeweging groep het onderskeidelik verbeter met 9 en 14%, in vergelyking met 0 en 4% in die vorentoe-beweging groep. Beide groepe het statisties betekenisvolle verbeteringe in quadriceps en hamstrings sterkte getoon, behalwe die quadriceps van die onbeseerde been van die vorentoe-beweging groep. Soortgelyk daaraan het beide groepe statisties betekenisvolle verbeteringe in quadriceps en hamstrings gemiddelde krag getoon, behalwe die quadriceps van die onbeseerde been van die vorentoe-beweging groep. Eenbeenbalans van die beseerde en onbeseerde bene het statisties betekenisvol verbeter in beide groepe (p < 0.05). Die verskil in verandering tussen die twee intervensies was nie statisties betekenisvol verskillend nie en die praktiese verskil was klein (ES ± 0.2). Geen statisties betekenisvolle verskille is waargeneem tussen die twee groepe in die verandering in beenomtrekke nie. Slegs die soepelheid van die beseerde soleus van die EXP groep het statisties betekenisvol verbeter tussen die twee groepe. Die resultate toon dat agteruitbeweging-oefening tot groter verbetering gelei het in aërobiese fiksheid en gelyke of groter verbetering in quadriceps en hamstrings sterkte en krag, in vergelyking met vorentoe-beweging oefening. Agteruitbeweging-oefening sowel as vorentoe-beweging oefening dra by tot die herstel van kniebeserings, maar die praktiese beduidendheid van agteruitbeweging-oefening is groter as vorentoe-beweging oefening. Die gevolgtrekking van die studie is dat agteruitbeweging 'n beter alternatiewe rehabilitasieprogram vir atlete is, met 'n gevolglike vinniger terugkeer na hul sport.
Description
Thesis (M Sport Sc (Sport Science)--University of Stellenbosch, 2010.
Keywords
Backward locomotion, Knee injuries -- Rehabilitation, Theses -- Sport science, Dissertations -- Sport science
Citation