Journal of Research in Rehabilitation Sciences

The Effects of 8-Weeks Selected Exercises on Muscle Torque and Proprioception of Knee in Athletes with Injured Meniscus: A Clinical Trial study

Document Type : Original Articles

Authors

1 PhD Student, Department of Sport Injuries and Corrective Exercises, School of Exercise Science, University of Isfahan, Isfahan, Iran

2 Associate Professor, Department of Sport Injuries and Corrective Exercises, School of Exercise Science, University of Isfahan, Isfahan, Iran

10.22122/jrrs.v16i0.3606

Abstract

Introduction: Applying rehabilitative exercise instructions before surgery is fundamental to minimize surgery complications and rehabilitation period as well. The aim of this research was to study the effects of 8 weeks of selected exercises on knee muscle torque and proprioception among the athletes with injured meniscus.Materials and Methods: This was an applied research with quasi-experimental method. Subjects were 24 athletes with injured meniscus who were selected through convenience judgmental sampling. Based on the orthopedic surgeon’s decision and their availability, subjects were divided equally into two experimental and control groups. Subject’s muscle torque and proprioception of the injured knee was recorded at the beginning and after eight weeks of selective exercises. The intervention was performed one hour a day on daily basis. Repeated measures variance ANOVA, within the 0.05 level of significance, was used for inferential data analysis and the probable differences between group means.Results: In both groups, maximum knee flexion and extension muscle torque and proprioception changed significantly (P < 0.001 for all three variables). Moreover, between groups differences were significant (P < 0.001).Conclusion: In this study, positive effects of exercise on torque and proprioception of knee in athletes with injured meniscus were reported. It seems that applying proper exercises challenging functional system can be an effective means of progressing knee motor function preoperatively.

Keywords

  1. Andrews S, Shrive N, Ronsky J. The shocking truth about meniscus. J Biomech 2011; 44(16): 2737-40.
  2. Li Q, Doyran B, Gamer LW, Lu XL, Qin L, Ortiz C, et al. Biomechanical properties of murine meniscus surface via AFM-based nanoindentation. J Biomech 2015; 48(8): 1364-70.
  3. Li Q, Qu F, Han B, Wang C, Li H, Mauck RL, et al. Micromechanical anisotropy and heterogeneity of the meniscus extracellular matrix. Acta Biomater 2017; 54: 356-66.
  4. Carter TE, Taylor KA, Spritzer CE, Utturkar GM, Taylor DC, Moorman CT 3rd, et al. In vivo cartilage strain increases following medial meniscal tear and correlates with synovial fluid matrix metalloproteinase activity. J Biomech 2015; 48(8): 1461-8.
  5. Li Q, Wang C, Han B, Qu F, Qi H, Li CY, et al. Impacts of maturation on the micromechanics of the meniscus extracellular matrix. J Biomech 2018; 72: 252-7.
  6. Mow VC, Huiskes R. Basic Orthopaedic Biomechanics & Mechano-biology. Philadelphia, PA: Lippincott Williams and Wilkins; 2005.
  7. Petrigliano FA, Musahl V, Suero EM, Citak M, Pearle AD. Effect of meniscal loss on knee stability after single-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2011; 19(Suppl 1): S86-S93.
  8. Barrett DS, Cobb AG, Bentley G. Joint proprioception in normal, osteoarthritic and replaced knees. J Bone Joint Surg Br 1991; 73(1): 53-6.
  9. Bayramoglu M, Toprak R, Sozay S. Effects of osteoarthritis and fatigue on proprioception of the knee joint. Arch Phys Med Rehabil 2007; 88(3): 346-50.
  10. Jan MH, Lin CH, Lin YF, Lin JJ, Lin DH. Effects of weight-bearing versus nonweight-bearing exercise on function, walking speed, and position sense in participants with knee osteoarthritis: a randomized controlled trial. Arch Phys Med Rehabil 2009; 90(6): 897-904.
  11. Jerosch J, Prymka M. Proprioception and joint stability. Knee Surg Sports Traumatol Arthrosc 1996; 4(3): 171-9.
  12. Lin DH, Lin YF, Chai HM, Han YC, Jan MH. Comparison of proprioceptive functions between computerized proprioception facilitation exercise and closed kinetic chain exercise in patients with knee osteoarthritis. Clin Rheumatol 2007; 26(4): 520-8.
  13. Wada M, Kawahara H, Shimada S, Miyazaki T, Baba H. Joint proprioception before and after total knee arthroplasty. Clin Orthop Relat Res 2002; (403): 161-7.
  14. Kang DG, Park YJ, Yu JH, Oh JB, Lee DY. A systematic review and meta-analysis of arthroscopic meniscus repair in young patients: Comparison of all-inside and inside-out suture techniques. Knee Surg Relat Res 2019; 31(1): 1-11.
  15. Brelin AM, Rue JP. Return to play following meniscus surgery. Clin Sports Med 2016; 35(4): 669-78.
  16. Feucht MJ, Bigdon S, Bode G, Salzmann GM, Dovi-Akue D, Sudkamp NP, et al. Associated tears of the lateral meniscus in anterior cruciate ligament injuries: risk factors for different tear patterns. J Orthop Surg Res 2015; 10: 34.
  17. Musahl V, Rahnemai-Azar AA, Costello J, Arner JW, Fu FH, Hoshino Y, et al. The influence of meniscal and anterolateral capsular injury on knee laxity in patients with anterior cruciate ligament injuries. Am J Sports Med 2016; 44(12): 3126-31.
  18. Herbst E, Hoser C, Tecklenburg K, Filipovic M, Dallapozza C, Herbort M, et al. The lateral femoral notch sign following ACL injury: frequency, morphology and relation to meniscal injury and sports activity. Knee Surg Sports Traumatol Arthrosc 2015; 23(8): 2250-8.
  19. Rongen JJ, van Tienen TG, Buma P, Hannink G. Meniscus surgery is still widely performed in the treatment of degenerative meniscus tears in The Netherlands. Knee Surg Sports Traumatol Arthrosc 2018; 26(4): 1123-9.
  20. Roos EM, Herzog W, Block JA, Bennell KL. Muscle weakness, afferent sensory dysfunction and exercise in knee osteoarthritis. Nat Rev Rheumatol 2011; 7(1): 57-63.
  21. Kaya D, Calik M, Callaghan MJ, Yosmaoglu B, Doral MN. Proprioception after knee injury, surgery and rehabilitation. in: kaya d, yosmaoglu b, doral mn, editors. proprioception in orthopaedics, sports medicine and rehabilitation. Cham, Switzerland: Springer International Publishing; 2018. p. 123-42.
  22. Spang Iii RC, Nasr MC, Mohamadi A, DeAngelis JP, Nazarian A, Ramappa AJ. Rehabilitation following meniscal repair: a systematic review. BMJ Open Sport Exerc Med 2018; 4(1): e000212.
  23. Wheatley WB, Krome J, Martin DF. Rehabilitation programmes following arthroscopic meniscectomy in athletes. Sports Med 1996; 21(6): 447-56.
  24. Cengiz IF, Pereira H, Silva-Correia J, Ripoll PL, Espregueira-Mendes J, Kaz R, et al. Meniscal lesions: From basic science to clinical management in footballers. In: van Dijk CN, Neyret P, Cohen M, Della Villa S, Pereira H, Oliveira JM, et al., editors. Injuries and Health Problems in Football: What everyone should know. Berlin, Heidelberg: Springer Berlin Heidelberg; 2017. p. 145-63.
  25. Petty C, Lubowitz J. Does arthroscopic partial meniscectomy result in knee osteoarthritis? A systematic review with a minimum of 8 years' follow-up. Arthroscopy 2010; 27: 419-24.
  26. Shamsehkohan P, Sadeghi H. Overview of the mechanical function of tissue cells affecting human movement. J Rehab Med 2016; 5(4): 271-81. [In Persian].
  27. Shaarani SR, O'Hare C, Quinn A, Moyna N, Moran R, O'Byrne JM. Effect of prehabilitation on the outcome of anterior cruciate ligament reconstruction. Am J Sports Med 2013; 41(9): 2117-27.
  28. Zhang X, Hu M, Lou Z, Liao B. Effects of strength and neuromuscular training on functional performance in athletes after partial medial meniscectomy. J Exerc Rehabil 2017; 13(1): 110-6.
  29. Kise NJ, Risberg MA, Stensrud S, Ranstam J, Engebretsen L, Roos EM. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: Randomised controlled trial with two year follow-up. Br J Sports Med 2016; 50(23): 1473-80.
  30. Richardson K, Levett DZH, Jack S, Grocott MPW. Fit for surgery? Perspectives on preoperative exercise testing and training. Br J Anaesth 2017; 119(suppl_1): i34-i43.
  31. Pouwels S, Hageman D, Gommans LN, Willigendael EM, Nienhuijs SW, Scheltinga MR, et al. Preoperative exercise therapy in surgical care: a scoping review. J Clin Anesth 2016; 33: 476-90.
  32. Kim DK, Hwang JH, Park WH. Effects of 4 weeks preoperative exercise on knee extensor strength after anterior cruciate ligament reconstruction. J Phys Ther Sci 2015; 27(9): 2693-6.
  33. Zatsiorsky VM, Duarte M. Instant equilibrium point and its migration in standing tasks: rambling and trembling components of the stabilogram. Motor Control 1999; 3(1): 28-38.
  34. Arifin WN, Zahiruddin WM. Sample size calculation in animal studies using resource equation approach. Malays J Med Sci 2017; 24(5): 101-5.
  35. Lennon O, Totlis T. Rehabilitation and return to play following meniscal repair. Operative Techniques in Sports Medicine 2017; 25(3): 194-207.
  36. Duarte JP, Valente-Dos-Santos J, Coelho-E-Silva MJ, Couto P, Costa D, Martinho D, et al. Reproducibility of isokinetic strength assessment of knee muscle actions in adult athletes: Torques and antagonist-agonist ratios derived at the same angle position. PLoS One 2018; 13(8): e0202261.
  37. Van Driessch S, Van Roie E, Vanwanseele B, Delecluse C. Test-retest reliability of knee extensor rate of velocity and power development in older adults using the isotonic mode on a Biodex System 3 dynamometer. PLoS One 2018; 13(5): e0196838.
  38. Torres R, Vasques J, Duarte JA, Cabri JM. Knee proprioception after exercise-induced muscle damage. Int J Sports Med 2010; 31(6): 410-5.
  39. Safi S. comparative study of portmanteau tests for the residuals autocorrelation in ARMA models. Science Journal of Applied Mathematics and Statistics 2014; 2(1): 1-13.
  40. Lee Y. What repeated measures analysis of variances really tells us. Korean J Anesthesiol 2015; 68(4): 340-5.
  41. Kise NJ, Risberg MA, Stensrud S, Ranstam J, Engebretsen L, Roos EM. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: Randomised controlled trial with two year follow-up. BMJ 2016; 354: i3740.
  42. Osteras H, Osteras B, Torstensen TA. Is postoperative exercise therapy necessary in patients with degenerative meniscus? A randomized controlled trial with one year follow-up. Knee Surg Sports Traumatol Arthrosc 2014; 22(1): 200-6.
  43. Dias JM, Mazuquin BF, Mostagi FQ, Lima TB, Silva MA, Resende BN, et al. The effectiveness of postoperative physical therapy treatment in patients who have undergone arthroscopic partial meniscectomy: Systematic review with meta-analysis. J Orthop Sports Phys Ther 2013; 43(8): 560-76.
  44. Ericsson YB, Dahlberg LE, Roos EM. Effects of functional exercise training on performance and muscle strength after meniscectomy: A randomized trial. Scand J Med Sci Sports 2009; 19(2): 156-65.
  45. Wang XF, Ma ZH, Teng XR. Isokinetic strength test of muscle strength and motor function in total knee arthroplasty. Orthop Surg 2020; 12(3): 878-89.
  46. Englund DA, Price LL, Grosicki GJ, Iwai M, Kashiwa M, Liu C, et al. Progressive resistance training improves torque capacity and strength in mobility-limited older adults. J Gerontol A Biol Sci Med Sci 2019; 74(8): 1316-21.
  47. Yang S, Chen C, Du S, Tang Y, Li K, Yu X, et al. Assessment of isokinetic trunk muscle strength and its association with health-related quality of life in patients with degenerative spinal deformity. BMC Musculoskelet Disord 2020; 21(1): 827.
  48. Osawa Y, Studenski SA, Ferrucci L. Knee extension rate of torque development and peak torque: associations with lower extremity function. J Cachexia Sarcopenia Muscle 2018; 9(3): 530-9.
  49. Tsang WW, Hui-Chan CW. Comparison of muscle torque, balance, and confidence in older tai chi and healthy adults. Med Sci Sports Exerc 2005; 37(2): 280-9.
  50. Santos AN, Pavao SL, Avila MA, Salvini TF, Rocha NA. Reliability of isokinetic evaluation in passive mode for knee flexors and extensors in healthy children. Braz J Phys Ther 2013; 17(2): 112-20.
  51. Munoz-Bermejo L, Perez-Gomez J, Manzano F, Collado-Mateo D, Villafaina S, Adsuar JC. Reliability of isokinetic knee strength measurements in children: A systematic review and meta-analysis. PLoS One 2019; 14(12): e0226274.
  52. Cobian DG, Koch CM, Amendola A, Williams GN. Knee extensor rate of torque development before and after arthroscopic partial meniscectomy, with analysis of neuromuscular mechanisms. J Orthop Sports Phys Ther 2017; 47(12): 945-56.
  53. Perry BD, Levinger P, Morris HG, Petersen AC, Garnham AP, Levinger I, et al. The effects of knee injury on skeletal muscle function, Na+, K+-ATPase content, and isoform abundance. Physiol Rep 2015; 3(2).
  54. Osteras H, Osteras B, Torstensen TA. Medical exercise therapy, and not arthroscopic surgery, resulted in decreased depression and anxiety in patients with degenerative meniscus injury. J Bodyw Mov Ther 2012; 16(4): 456-63.
  55. Trezise J, Blazevich AJ. Anatomical and neuromuscular determinants of strength change in previously untrained men following heavy strength training. Front Physiol 2019; 10: 1001.
  56. Wakeling JM, Uehli K, Rozitis AI. Muscle fibre recruitment can respond to the mechanics of the muscle contraction. J R Soc Interface 2006; 3(9): 533-44.
  57. Paul J, Nagaraj MS, Solomon J. Effectiveness of coordination exercise on proprioception of knee injured male professional footballers. Drug Invention Today 2018; 10: 1887-91.
  58. Stensrud S, Roos EM, Risberg MA. A 12-week exercise therapy program in middle-aged patients with degenerative meniscus tears: A case series with 1-year follow-up. J Orthop Sports Phys Ther 2012; 42(11): 919-31.
  59. Malliou P, Gioftsidou A, Pafis G, Rokka S, Kofotolis N, Mavromoustakos S, et al. Proprioception and functional deficits of partial meniscectomized knees. Eur J Phys Rehabil Med 2012; 48(2): 231-6.
  60. Karahan M, Kocaoglu B, Cabukoglu C, Akgun U, Nuran R. Effect of partial medial meniscectomy on the proprioceptive function of the knee. Arch Orthop Trauma Surg 2010; 130(3): 427-31.
  61. Ashton-Miller JA, Wojtys EM, Huston LJ, Fry-Welch D. Can proprioception really be improved by exercises? Knee Surg Sports Traumatol Arthrosc 2001; 9(3): 128-36.
  62. Proske U, Gandevia SC. The proprioceptive senses: Their roles in signaling body shape, body position and movement, and muscle force. Physiol Rev 2012; 92(4): 1651-97.
  63. Nagai T, Bates NA, Hewett TE, Schilaty ND. Effects of localized vibration on knee joint position sense in individuals with anterior cruciate ligament reconstruction. Clin Biomech (Bristol, Avon) 2018; 55: 40-4.
  64. Smilde HA, Vincent JA, Baan GC, Nardelli P, Lodder JC, Mansvelder HD, et al. Changes in muscle spindle firing in response to length changes of neighboring muscles. J Neurophysiol 2016; 115(6): 3146-55.
  65. Chen L, Deng H, Cui H, Fang J, Zuo Z, Deng J, et al. Inflammatory responses and inflammation-associated diseases in organs. Oncotarget 2018; 9(6): 7204-18.
  66. Smith H. Current therapy in pain. Philadelphia, PA: Saunders; 2009.
  67. VanderHave KL, Perkins C, Le M. Weightbearing versus nonweightbearing after meniscus repair. Sports Health 2015; 7(5): 399-402.
  68. DeFroda SF, Bokshan SL, Boulos A, Owens BD. Variability of online available physical therapy protocols from academic orthopedic surgery programs for arthroscopic meniscus repair. Phys Sportsmed 2018; 46(3): 355-60.
  69. Grant T. The effect of psychological response on recovery of sport injury: A review of the literature. Kinesiology, Sport Studies, and Physical Education Synthesis Projects; 2018.
  70. Kellezi B, Coupland C, Morriss R, Beckett K, Joseph S, Barnes J, et al. The impact of psychological factors on recovery from injury: A smulticentre cohort study. Soc Psychiatry Psychiatr Epidemiol 2017; 52(7): 855-66.
Journal of Research in Rehabilitation Sciences
Volume 16, Issue 1 - Serial Number 1
April 2020
Pages 358-369
  • Receive Date: 20 September 2020
  • Revise Date: 02 June 2022
  • Accept Date: 22 May 2022