Grisell, Maggie

Hutchison, Randolph

Tartaro, Andrea

English

Furman University

ACKNOWLEDGEMENTS:  Funding: Furman Advantage CONTACT:  maggie.grisell@furman.edu; andrea.tartaro@furman.edu; randolph.hutchison@furman.edu OPPORTUNITIES FOR ADVANCING ANTERIOR CRUCIATE LIGAMENT REHABILITATION WITH SINGLE LEGGED CYCLING AND STANDARDIZED PERTURBATIONS  Maggie Grisell: Collaboration with Dr. Randolph Hutchison & Dr. Andrea Tartaro DEPARTMENT OF COMPUTER SCIENCE • FURMAN UNIVERSITY • The knee is constructed of four main ligaments (a) that keep the knee is place functionally and restrain it from bending too far in one direction • The anterior cruciate ligament pulls the knee forward to keep it in the meniscus  • The meniscus is cartilage located between the tibia and the femur and acts as a shock absorber and weight distributor for the knee • ACL tears result because of valgus (outward bending of the knee) collapse, specifically when the “leg (thigh) falls in adduction and internal rotation, while the knee (tibia) moves into a position of abduction as the ankle and foot move into eversion during weight-bearing motions” (c) • Usually occurs during the cutting movement (b) so frequently seen in highly agile sports  I. BACKGROUND: The Anterior Cruciate Ligament • Advantages of Cycling: provides a low-impact, non-weight bearing, cardio-vascular, closed-chain exercise; can be easily manipuled to target varying muscle groups • Extremely low strain on the ACL • Useful for endurance training and strength training II. BACKGROUND: Cycling as Rehabiliation 1. Extreme postoperative loss of muscle mass in quadriceps femoris • Strength training may actualy be more important to restor than cardiovascular endurance or agility • Difficult to rebuild because of compensation by the uninjured leg and within the injured leg itself • Thus, a huge opportunity remains for a closed chain and ACL-sensitive method that would specifically activate the quadriceps for the injured leg alone • A cycling machine that instigates single-legged pedaling could be the answer. The two-legged motion could remain, but if the power came only from the injured leg, then the compensation from the other leg would be mute (creating a “master/slave” experience)  2. Perturbation Training: a type of neuromuscular training that aids in stabilization through muscular contractions (d) • A physician applies unpredictable and varying forces to an unstable surface on which the patient is standing  • Manual perturbations are imprecise and hard to measure • An interface could be created on a cycling machine that provides a “slip” where, during pedaling, there is a random and unpredictable change in resistance • The same neuromusclar pathways would be activiated • The frequency and severity of the slip could be manipulated in a study in order to determine how much force and in which way is most effective to improve anterior cruciate ligament rehabilitation   III. LIMITATIONS OF CURRENT PRACTICE • Single Legged Cycling with ACL rehabilitation • Standardized Perturbations with ACL rehabilitation • A programmed ergometer, such as the Tilt Cycle, could perform such studies IV. FUTURE STUDIES (a) Ligaments of the knee (b) The common cutting movement (c) Movement for ACL tear (d) Current Perturbation Training Technique V. REFERENCES Fitzgerald, Kelley G., Michael J. Axe, and Lynn Snyder-Mackler. "The Efficacy of Perturbation Training in Nonoperative Anterior Cruciate Ligament Rehabilitation Programs for Physically Active Individuals." Physical Therapy Journal . 80.2 (2000): 128-140. Web. 5 Jul. 2013. <http://ptjournal.apta.org/content/80/2/128.full>.  Giove, TP, SJ 3rd Miller, et al. "Non-operative Treatment of the Torn Anterior Cruciate Ligament." J Bone Joint Surg Am. 65.2 (1983): 184-192. Web. 3 Jul. 2013. <http://www.ncbi.nlm.nih.gov/pubmed/6822581>. Irrgang , JJ. "Modern trends in anterior cruciate ligament rehabilitation: nonoperative and postoperative management." Clin Sports Medicine. 12.4 (1993): 797-813. Web. 3 Jul. 2013. <http://www.ncbi.nlm.nih.gov/pubmed/8261526>. Hunt, Michael A., David J. Sanderson, et al. "Interlimb Asymmetry in Persons With and Without an Anterior Cruciate Ligament Deficiency During Stationary Cycling." Archives of Physical Medicine and Rehabilitation. 85.1 (2004): 1-5. Web. 4 Jul. 2013. <http://educ.ubc.ca/faculty/sanderson/lab/CLFbiom/Downloads/Hunt, Sanderson, Inglis, Moffet.pdf>. Palmitier, R. A., K. N. An, S. G. Scott and E. Y. S. Chao. Kinetic chain exercise in knee rehabilitation. Sports Med. 11:402– 413, 1991. Strength Agility Sports Specific Movements Current Rehabilitation Practice Categories Endurance 

Opportunities for Advancing Anterior Cruciate Ligament Rehabilitation with Single Legged Cycling and Standardized Perturbations

https://scholarexchange.furman.edu/cgi/viewcontent.cgi?article=1484&amp;context=furmanengaged

Opportunities for Advancing Anterior Cruciate Ligament Rehabilitation with Single Legged Cycling and Standardized Perturbations

Abstract

Similar works

Full text

Available Versions

Furman University