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MSK – Muskuloskelettale Physiotherapie 2022; 26(02): 105-114
DOI: 10.1055/a-1778-2772
Originalarbeit

Einfluss einer muskulären Ermüdung auf den Limb Symmetry Index nach VKB-Rekonstruktion

Quasi-Experimentelle StudieEffects of Muscular Fatigue on the Limb Symmetry Index after ACL ReconstructionQuasi-Experimental study
Patrick Höll
1   fortis – Studio für Therapie und Training, Freiburg
2   Interfakultärer Fachbereich für Sport- und Bewegungswissenschaft, Paris-Lodron-Universität Salzburg
,
Josef Kröll
2   Interfakultärer Fachbereich für Sport- und Bewegungswissenschaft, Paris-Lodron-Universität Salzburg
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Zusammenfassung

Auch wenn Athlet*innen die Return to Sport (RTS) Kriterien nach einer vorderen Kreuzbandrekonstruktion (VKBR) erfüllen, erleiden sie dennoch häufig eine erneute Verletzung des vorderen Kreuzbandes (VKB). Ein Grund für das erhöhte Risiko könnte darin bestehen, dass die Kriterien nicht unter ermüdeten Bedingungen getestet werden, obwohl eine muskuläre Ermüdung ein Risiko für Verletzungen darstellt. Das Ziel dieser Studie war es, den Einfluss einer muskulären Ermüdung auf den Limb Symmetry Index (LSI) bei Athlet*innen nach einer VKBR und gesunden Proband*innen zu untersuchen.

Neun Proband*innen nach einer unilateralen VKBR und 17 Gesunde (28,1 ± 5,2 LJ.) absolvierten eine Serie von 3 Sprungtests – Side Hop Test (SH), Single Leg Vertical Jump (SLVJ), Single Leg Hop for Distance (SLHD) – in einem nicht ermüdeten und einem muskulär ermüdeten Zustand. Mittels einer 2 × 3 ANOVA mit Messwiederholung wurden die LSI-Werte vor und nach der muskulären Ermüdung miteinander verglichen.

Die VKBR-Gruppe erreichte im Gesamt-LSI 91,3 ± 12,3 %, die Kontrollgruppe 100,1 ± 11,9 %. Innerhalb der Gruppen bestand kein signifikanter Unterschied zwischen dem ermüdeten und nicht ermüdeten Zustand. Es konnten keine signifikanten Interaktionseffekte (p > 0,05) oder Zeiteffekte (p > 0,05) des LSI hinsichtlich der Ermüdung festgestellt werden, jedoch zeigten der LSI des SLVJ und der Gesamt-LSI hoch signifikante Gruppeneffekte (p = 0,003, p = 0,001). Patient*innen nach einer VKBR wiesen niedrigere LSI-Werte als die gesunde Kontrollgruppe auf. Der geringere LSI der VKBR-Gruppe kann einen möglichen Risikofaktor für eine Wiederverletzung darstellen.

Eine muskuläre Ermüdung hatte keinen signifikanten Einfluss auf den LSI. Ein LSI unter ermüdeten Bedingungen scheint somit als RTS-Kriterium ungeeignet zu sein. Der bisherige Cut-off-Wert des LSI von 90 % sollte in Frage gestellt und eine Erhöhung dieses Grenzwertes in Betracht gezogen werden.

Abstract

Even when athletes meet the criteria for a Return to Sports (RTS) after a reconstruction of the anterior cruciate ligament (ACLR), they often suffer renewed injuries of the anterior cruciate ligament (ACL). One of the reasons for the increased risk could be that the criteria are not tested under fatigue conditions, although muscular fatigue is a known injury risk. It was the aim of this study to investigate the effects of muscular fatigue on the Limb Symmetry Index (LSI) in athletes after ACLR and healthy subjects.

Nine subjects after unilateral ACLR and 17 healthy subjects (28.1 ± 5.2 YO) performed a series of 3 jump tests – Side Hop Test (SH), Single Leg Vertical Jump (SLVJ), Single Leg Hop for Distance (SLHD) – in a non-fatigued and a muscularly fatigued state. LSI values before and after muscular fatigue were compared using 2 × 3 ANOVA with repeat measurements.

The ACLR group achieved overall LSI values of 91.3 ± 12.3 %, compared to 100.1 ± 11.9 % for the control group. Within the groups, there were no significant differences between the fatigued and the non-fatigued state. No significant interaction (p > 0.05) or time effects (p > 0.05) of the LSI showed with regard to fatigue, but highly significant group effects were observed for both the LSI of the SLVJ (p = 0.003) and the overall LSI (p = 0.001). Patients after ACLR demonstrated lower LSI values than healthy subjects. Lower LSI values of the ACLR group may constitute a potential risk factor for renewed injuries.

Muscular fatigue had no significant effect on the LSI. Consequently, the LSI under fatigue conditions seems unsuitable as a criterion for RTS. The previous LSI cut-off value of 90 % should be called into question and an increase of this limit considered.

Schlüsselwörter

Vorderes Kreuzband - Return to Sport - Limb Symmetry Index - Ermüdung

Key words

anterior cruciate ligament - Return to Sport - Limb Symmetry Index - fatigue


Publication History

Received: 12 July 2021

Accepted: 08 August 2021

Article published online:
18 May 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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