Comparison of an Innovative Rehabilitation, Combining Reduced Conventional Rehabilitation with Balneotherapy, and a Conventional Rehabilitation after Anterior Cruciate Ligament Reconstruction in Athletes.
Identifieur interne : 000458 ( Main/Curation ); précédent : 000457; suivant : 000459Comparison of an Innovative Rehabilitation, Combining Reduced Conventional Rehabilitation with Balneotherapy, and a Conventional Rehabilitation after Anterior Cruciate Ligament Reconstruction in Athletes.
Auteurs : Laetitia Peultier-Celli [France] ; Didier Mainard [France] ; Frank Wein [France] ; Nicolas Paris [France] ; Patrick Boisseau [France] ; Alexandre Ferry [France] ; René Gueguen [France] ; Isabelle Chary-Valckenaere [France] ; Jean Paysant [France] ; Philippe Perrin [France]Source :
- Frontiers in surgery [ 2296-875X ] ; 2017.
Abstract
Background
Instability of the knee, related to anterior cruciate ligament injury, is treated by surgical reconstruction. During recovery, a loss of proprioceptive input can have a significant impact. Few studies have evaluated the benefits of rehabilitation of the knee in aquatic environment on functional outcomes.
Objective
This study aimed to compare an innovative rehabilitation protocol combining reduced conventional rehabilitation with aquatic rehabilitation, with a conventional rehabilitation, according to the National French Health Authority, in terms of kinetics, development of proprioceptive skills, and functional improvement of the knee.
Methods
67 patients, who were amateur or professional athletes, were randomized into two groups: 35 patients followed the conventional rehabilitation protocol (Gr1) and 32 patients followed the innovative rehabilitation protocol (Gr2). Patients were evaluated before surgery, and at 2 weeks, 1, 2, and 6 months after surgery using posturography, and evaluation of muscular strength, walking performance and proprioception. This study is multicenter, prospective, randomized, and controlled with a group of patients following conventional rehabilitation (level of evidence I).
Results
For the same quality of postural control, Gr2 relied more on somesthesia than Gr1 at 6 months. The affected side had an impact on postural control and in particular on the preoperative lateralization, at 2 weeks and at 1 month. Lateralization depended on the affected knee, with less important lateralization in Gr2 preoperatively and at 1 month. The quadriceps muscular strength was higher in Gr2 than in Gr1 at 2 and 6 months and muscle strength of the external hamstring was greater in Gr2 than in Gr1 at 6 months. The isokinetic test showed a greater quadriceps muscular strength in Gr2. Gr2 showed a greater walking distance than Gr1 at one month. Gr2 showed an improvement in the proprioceptive capacities of the operated limb in flexion for the first 2 months.
Conclusion
The effectiveness of the innovative rehabilitation program permits faster recovery, allowing for an earlier return to social, sporting, and professional activities. Faster retrieval of knee function following aquatic rehabilitation would prevent both short-term risk of lesions of the contralateral limb due to overcompensation and long-term risk of surgery due to osteoarthritis.
Registration of clinical trials
NCT02225613.
DOI: 10.3389/fsurg.2017.00061
PubMed: 29164130
PubMed Central: PMC5674009
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Lorraine, EA 3450, Development, Adaptation and Handicap, Villers-lès-Nancy</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>Laboratory for the Analysis of Posture, Equilibrium and Motor Function (LAPEM), University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Laboratory for the Analysis of Posture, Equilibrium and Motor Function (LAPEM), University Hospital of Nancy, Vandoeuvre-lès-Nancy</wicri:regionArea></affiliation></author><author><name sortKey="Mainard, Didier" sort="Mainard, Didier" uniqKey="Mainard D" first="Didier" last="Mainard">Didier Mainard</name><affiliation wicri:level="1"><nlm:affiliation>Department of Orthopedics and Trauma Surgery, University Hospital of Nancy, Nancy, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Orthopedics and Trauma Surgery, University Hospital of Nancy, Nancy</wicri:regionArea></affiliation></author><author><name sortKey="Wein, Frank" sort="Wein, Frank" uniqKey="Wein F" first="Frank" last="Wein">Frank Wein</name><affiliation wicri:level="1"><nlm:affiliation>Department of Orthopedics Surgery, Médipôle Gentilly-Saint-Jacques, Maxéville, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Orthopedics Surgery, Médipôle Gentilly-Saint-Jacques, Maxéville</wicri:regionArea></affiliation></author><author><name sortKey="Paris, Nicolas" sort="Paris, Nicolas" uniqKey="Paris N" first="Nicolas" last="Paris">Nicolas Paris</name><affiliation wicri:level="1"><nlm:affiliation>Department of Orthopedics Surgery, Médipôle Gentilly-Saint-Jacques, Maxéville, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Orthopedics Surgery, Médipôle Gentilly-Saint-Jacques, Maxéville</wicri:regionArea></affiliation></author><author><name sortKey="Boisseau, Patrick" sort="Boisseau, Patrick" uniqKey="Boisseau P" first="Patrick" last="Boisseau">Patrick Boisseau</name><affiliation wicri:level="1"><nlm:affiliation>Institut de Formation en Masso-Kinésithérapie, Nancy, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut de Formation en Masso-Kinésithérapie, Nancy</wicri:regionArea></affiliation></author><author><name sortKey="Ferry, Alexandre" sort="Ferry, Alexandre" uniqKey="Ferry A" first="Alexandre" last="Ferry">Alexandre Ferry</name><affiliation wicri:level="1"><nlm:affiliation>Institut de Formation en Masso-Kinésithérapie, Nancy, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut de Formation en Masso-Kinésithérapie, Nancy</wicri:regionArea></affiliation></author><author><name sortKey="Gueguen, Rene" sort="Gueguen, Rene" uniqKey="Gueguen R" first="René" last="Gueguen">René Gueguen</name><affiliation wicri:level="1"><nlm:affiliation>Faculty of Medicine and UFR STAPS, University of Lorraine, EA 3450, Development, Adaptation and Handicap, Villers-lès-Nancy, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Faculty of Medicine and UFR STAPS, University of Lorraine, EA 3450, Development, Adaptation and Handicap, Villers-lès-Nancy</wicri:regionArea></affiliation></author><author><name sortKey="Chary Valckenaere, Isabelle" sort="Chary Valckenaere, Isabelle" uniqKey="Chary Valckenaere I" first="Isabelle" last="Chary-Valckenaere">Isabelle Chary-Valckenaere</name><affiliation wicri:level="1"><nlm:affiliation>Department of Rheumatology, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Rheumatology, University Hospital of Nancy, Vandoeuvre-lès-Nancy</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>IMoPA, UMR 7365 CNRS, Vandoeuvre-lès-Nancy, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>IMoPA, UMR 7365 CNRS, Vandoeuvre-lès-Nancy</wicri:regionArea></affiliation></author><author><name sortKey="Paysant, Jean" sort="Paysant, Jean" uniqKey="Paysant J" first="Jean" last="Paysant">Jean Paysant</name><affiliation wicri:level="1"><nlm:affiliation>Faculty of Medicine and UFR STAPS, University of Lorraine, EA 3450, Development, Adaptation and Handicap, Villers-lès-Nancy, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Faculty of Medicine and UFR STAPS, University of Lorraine, EA 3450, Development, Adaptation and Handicap, Villers-lès-Nancy</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>Regional Institute of Physical Medicine and Rehabilitation, Nancy Cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Regional Institute of Physical Medicine and Rehabilitation, Nancy Cedex</wicri:regionArea></affiliation></author><author><name sortKey="Perrin, Philippe" sort="Perrin, Philippe" uniqKey="Perrin P" first="Philippe" last="Perrin">Philippe Perrin</name><affiliation wicri:level="1"><nlm:affiliation>Faculty of Medicine and UFR STAPS, University of Lorraine, EA 3450, Development, Adaptation and Handicap, Villers-lès-Nancy, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Faculty of Medicine and UFR STAPS, University of Lorraine, EA 3450, Development, Adaptation and Handicap, Villers-lès-Nancy</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>Laboratory for the Analysis of Posture, Equilibrium and Motor Function (LAPEM), University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Laboratory for the Analysis of Posture, Equilibrium and Motor Function (LAPEM), University Hospital of Nancy, Vandoeuvre-lès-Nancy</wicri:regionArea></affiliation></author></analytic><series><title level="j">Frontiers in surgery</title><idno type="ISSN">2296-875X</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Background</b></p><p>Instability of the knee, related to anterior cruciate ligament injury, is treated by surgical reconstruction. During recovery, a loss of proprioceptive input can have a significant impact. Few studies have evaluated the benefits of rehabilitation of the knee in aquatic environment on functional outcomes.</p></div><div type="abstract" xml:lang="en"><p><b>Objective</b></p><p>This study aimed to compare an innovative rehabilitation protocol combining reduced conventional rehabilitation with aquatic rehabilitation, with a conventional rehabilitation, according to the National French Health Authority, in terms of kinetics, development of proprioceptive skills, and functional improvement of the knee.</p></div><div type="abstract" xml:lang="en"><p><b>Methods</b></p><p>67 patients, who were amateur or professional athletes, were randomized into two groups: 35 patients followed the conventional rehabilitation protocol (Gr1) and 32 patients followed the innovative rehabilitation protocol (Gr2). Patients were evaluated before surgery, and at 2 weeks, 1, 2, and 6 months after surgery using posturography, and evaluation of muscular strength, walking performance and proprioception. This study is multicenter, prospective, randomized, and controlled with a group of patients following conventional rehabilitation (level of evidence I).</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>For the same quality of postural control, Gr2 relied more on somesthesia than Gr1 at 6 months. The affected side had an impact on postural control and in particular on the preoperative lateralization, at 2 weeks and at 1 month. Lateralization depended on the affected knee, with less important lateralization in Gr2 preoperatively and at 1 month. The quadriceps muscular strength was higher in Gr2 than in Gr1 at 2 and 6 months and muscle strength of the external hamstring was greater in Gr2 than in Gr1 at 6 months. The isokinetic test showed a greater quadriceps muscular strength in Gr2. Gr2 showed a greater walking distance than Gr1 at one month. Gr2 showed an improvement in the proprioceptive capacities of the operated limb in flexion for the first 2 months.</p></div><div type="abstract" xml:lang="en"><p><b>Conclusion</b></p><p>The effectiveness of the innovative rehabilitation program permits faster recovery, allowing for an earlier return to social, sporting, and professional activities. Faster retrieval of knee function following aquatic rehabilitation would prevent both short-term risk of lesions of the contralateral limb due to overcompensation and long-term risk of surgery due to osteoarthritis.</p></div><div type="abstract" xml:lang="en"><p><b>Registration of clinical trials</b></p><p>NCT02225613.</p></div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">29164130</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>29</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">2296-875X</ISSN><JournalIssue CitedMedium="Print"><Volume>4</Volume><PubDate><Year>2017</Year></PubDate></JournalIssue><Title>Frontiers in surgery</Title><ISOAbbreviation>Front Surg</ISOAbbreviation></Journal><ArticleTitle>Comparison of an Innovative Rehabilitation, Combining Reduced Conventional Rehabilitation with Balneotherapy, and a Conventional Rehabilitation after Anterior Cruciate Ligament Reconstruction in Athletes.</ArticleTitle><Pagination><MedlinePgn>61</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3389/fsurg.2017.00061</ELocationID><Abstract><AbstractText Label="Background" NlmCategory="UNASSIGNED">Instability of the knee, related to anterior cruciate ligament injury, is treated by surgical reconstruction. During recovery, a loss of proprioceptive input can have a significant impact. Few studies have evaluated the benefits of rehabilitation of the knee in aquatic environment on functional outcomes.</AbstractText><AbstractText Label="Objective" NlmCategory="UNASSIGNED">This study aimed to compare an innovative rehabilitation protocol combining reduced conventional rehabilitation with aquatic rehabilitation, with a conventional rehabilitation, according to the National French Health Authority, in terms of kinetics, development of proprioceptive skills, and functional improvement of the knee.</AbstractText><AbstractText Label="Methods" NlmCategory="UNASSIGNED">67 patients, who were amateur or professional athletes, were randomized into two groups: 35 patients followed the conventional rehabilitation protocol (Gr1) and 32 patients followed the innovative rehabilitation protocol (Gr2). Patients were evaluated before surgery, and at 2 weeks, 1, 2, and 6 months after surgery using posturography, and evaluation of muscular strength, walking performance and proprioception. This study is multicenter, prospective, randomized, and controlled with a group of patients following conventional rehabilitation (level of evidence I).</AbstractText><AbstractText Label="Results" NlmCategory="UNASSIGNED">For the same quality of postural control, Gr2 relied more on somesthesia than Gr1 at 6 months. The affected side had an impact on postural control and in particular on the preoperative lateralization, at 2 weeks and at 1 month. Lateralization depended on the affected knee, with less important lateralization in Gr2 preoperatively and at 1 month. The quadriceps muscular strength was higher in Gr2 than in Gr1 at 2 and 6 months and muscle strength of the external hamstring was greater in Gr2 than in Gr1 at 6 months. The isokinetic test showed a greater quadriceps muscular strength in Gr2. Gr2 showed a greater walking distance than Gr1 at one month. Gr2 showed an improvement in the proprioceptive capacities of the operated limb in flexion for the first 2 months.</AbstractText><AbstractText Label="Conclusion" NlmCategory="UNASSIGNED">The effectiveness of the innovative rehabilitation program permits faster recovery, allowing for an earlier return to social, sporting, and professional activities. Faster retrieval of knee function following aquatic rehabilitation would prevent both short-term risk of lesions of the contralateral limb due to overcompensation and long-term risk of surgery due to osteoarthritis.</AbstractText><AbstractText Label="Registration of clinical trials" NlmCategory="UNASSIGNED">NCT02225613.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Peultier-Celli</LastName><ForeName>Laetitia</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Faculty of Medicine and UFR STAPS, University of Lorraine, EA 3450, Development, Adaptation and Handicap, Villers-lès-Nancy, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Laboratory for the Analysis of Posture, Equilibrium and Motor Function (LAPEM), University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mainard</LastName><ForeName>Didier</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Orthopedics and Trauma Surgery, University Hospital of Nancy, Nancy, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wein</LastName><ForeName>Frank</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Orthopedics Surgery, Médipôle Gentilly-Saint-Jacques, Maxéville, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Paris</LastName><ForeName>Nicolas</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Orthopedics Surgery, Médipôle Gentilly-Saint-Jacques, Maxéville, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boisseau</LastName><ForeName>Patrick</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Institut de Formation en Masso-Kinésithérapie, Nancy, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ferry</LastName><ForeName>Alexandre</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Institut de Formation en Masso-Kinésithérapie, Nancy, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gueguen</LastName><ForeName>René</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Faculty of Medicine and UFR STAPS, University of Lorraine, EA 3450, Development, Adaptation and Handicap, Villers-lès-Nancy, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chary-Valckenaere</LastName><ForeName>Isabelle</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Department of Rheumatology, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>IMoPA, UMR 7365 CNRS, Vandoeuvre-lès-Nancy, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Paysant</LastName><ForeName>Jean</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Faculty of Medicine and UFR STAPS, University of Lorraine, EA 3450, Development, Adaptation and Handicap, Villers-lès-Nancy, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Regional Institute of Physical Medicine and Rehabilitation, Nancy Cedex, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Perrin</LastName><ForeName>Philippe</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Faculty of Medicine and UFR STAPS, University of Lorraine, EA 3450, Development, Adaptation and Handicap, Villers-lès-Nancy, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Laboratory for the Analysis of Posture, Equilibrium and Motor Function (LAPEM), University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><DataBankList 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