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DOI: 10.1055/s-2005-872904
© Georg Thieme Verlag KG Stuttgart · New York
Specific Adaptations of Neuromuscular Control and Knee Joint Stiffness Following Sensorimotor Training
Publication History
Accepted after revision: August 30, 2005
Publication Date:
06 December 2005 (online)
![](https://www.thieme-connect.de/media/sportsmed/200608/lookinside/thumbnails/10.1055-s-2005-872904-1.jpg)
Abstract
The aim of this study was to examine how fixations of the ankle joint during sensorimotor training (SMT) influence adaptations in mechanical stiffness and neuromuscular control of the knee joint. Sixty-three healthy subjects were randomly assigned to three training groups that differed in their degree of ankle joint fixation, which was either barefooted, with an ankle brace or with a ski boot. Mechanical knee joint stiffness and reflex control of m. vastus medialis, m. vastus lateralis, m. biceps femoris, and m. semitendinosus were tested during force controlled anterior tibial displacements. This force was applied as both a fast and a slow stimulus. After the training period the group that trained barefooted showed an increase in mechanical stiffness of the knee joint from 79 ± 21 (Mean ± SD) N/mm to 110 ± 38 N/mm (p < 0.05) in the fast stimulus. The training group that trained with ski boots was able to improve knee joint stiffness from 67 ± 26 N/mm to 96 ± 47 N/mm (p < 0.05) in the slow stimulus. These improvements correspond with an enhanced activity of the hamstring muscles (m. biceps femoris and m. semitendinosus). From a more functional point of view, specific adaptations due to the fixation of the ankle joint may be helpful in the prevention and rehabilitation of knee joint injuries.
Key words
Prevention - rehabilitation - ACL injury - reflex-activity
References
- 1 Bahr R, Lian O, Bahr I A. A twofold reduction in the incidence of acute ankle sprains in volleyball after the introduction of an injury prevention program: a prospective cohort study. Scand J Med Sci Sports. 1997; 7 172-177
- 2 Baratta R, Solomonow M, Zhou B H, Letson D, Chuinard R, D'Ambrosia R. Muscular coactivation. The role of the antagonist musculature in maintaining knee stability. Am J Sports Med. 1988; 16 113-122
- 3 Beynnon B D, Johnson R J, Fleming B C, Peura G D, Renstrom P A, Nichols C E, Pope M H. The effect of functional knee bracing on the anterior cruciate ligament in the weightbearing and nonweightbearing knee. Am J Sports Med. 1997; 25 353-359
- 4 Bruhn S, Gollhofer A. Funktionelle Stabilität am Kniegelenk - eine neue Untersuchungsmethode. Dt Z Sportmed. 1998; 49 212-216
- 5 Bruhn S, Gruber M, Gollhofer A. Proprioception training for prevention and rehabilitation of knee joint injuries. Eur J Sports Traumatol Rel Res. 2001; 23 82-89
- 6 Caraffa A, Cerulli G, Projetti M, Aisa G, Rizzo A. Prevention of anterior cruciate ligament injuries in soccer. A prospective controlled study of proprioceptive training. Knee Surg Sports Traumatol Arthrosc. 1996; 4 19-21
-
7 Enoka R M, Fuglevand A J.
Neuromuscular basis of the maximum voluntary force capacity of muscle. Grabiner MD Current Issues in Biomechanics. Champaign, IL; Human Kinetics 1993: 215-235 - 8 Gauchard G C, Jeandel C, Tessier A, Perrin P P. Beneficial effect of proprioceptive physical activities on balance control in elderly human subjects. Neurosci Lett. 1999; 273 81-84
- 9 Grüber J, Wolter D, Lierse W. Der vordere Kreuzbandreflex (LCA-Reflex). Unfallchirurg. 1986; 89 551-554
- 10 Gruber M, Gollhofer A. Impact of sensorimotor training on the rate of force development and neural activation. Eur J Appl Physiol. 2004; 92 98-105
- 11 Hirokawa S, Solomonow M, Luo Z, Lu Y, D'Ambrosia R. Muscular cocontraction and control of knee stability. J Electromyogr Kinesiol. 1991; 1 199-208
- 12 Hoffman M, Payne V G. The effects of proprioceptive ankle disk training on healthy subjects. J Orthop Sports Phys Ther. 1995; 21 90-93
- 13 Johansson H, Sjolander P, Sojka P. Activity in receptor afferents from the anterior cruciate ligament evokes reflex effects on fusimotor neurones. Neurosci Res. 1990; 8 54-59
- 14 Johansson H, Sjolander P, Sojka P. Receptors in the knee joint ligaments and their role in the biomechanics of the joint. Crit Rev Biomed Eng. 1991; 18 341-368
- 15 Markolf K L, Gorek J F, Kabo J M, Shapiro M S. Direct measurement of resultant forces in the anterior cruciate ligament. J Bone Joint Surg. 1990; 72-A 557-567
- 16 Markolf K L, Graff-Radford A, Amstutz H C. In vivo knee stability. J Bone Joint Surg. 1978; 60-A 664-667
- 17 Markolf K L, O'Neill G, Jackson S R, McAllister D R. Effects of applied quadriceps and hamstrings muscle loads on forces in the anterior and posterior cruciate ligaments. Am J Sports Med. 2004; 32 1144-1149
- 18 Markolf K L, Wascher D C, Finerman G AM. Direct in vitro measurement of forces in the cruciate ligaments. J Bone Joint Surg. 1993; 72-A 387-394
- 19 McNair P J, Wood G A, Marshall R N. Stiffness of the hamstring muscle and its relationship to function in anterior cruciate ligament deficient individuals. Clin Biomech. 1992; 7 131-137
- 20 Moore R C, Karras B T, Neiman R, Fritschy D, Woo S LY, Daniel D M. Hamstrings - an anterior cruciate ligament protagonist. Am J Sports Med. 1993; 21 231-237
- 21 O'Connor J J. Can muscle co-contraction protect knee ligaments after injury or repair?. J Bone Joint Surg Br. 1993; 75 41-48
- 22 Osborne M D, Chou L S, Laskowski E R, Smith J, Kaufman K R. The effect of ankle disk training on muscle reaction time in subjects with a history of ankle sprain. Am J Sports Med. 2001; 29 627-632
- 23 Rozzi S L, Lephart S M, Sterner R, Kuligowski L. Balance training for persons with functionally unstable ankles. J Orthop Sports Phys Ther. 1999; 29 478-486
- 24 Shelburne K B, Torry M R, Pandy M G. Effect of muscle compensation on knee instability during ACL-deficient gait. Med Sci Sports Exerc. 2005; 37 642-648
- 25 Sheth P, Yu B, Laskowski E R, An K N. Ankle disk training influences reaction times of selected muscles in a simulated ankle sprain. Am J Sports Med. 1997; 25 538-543
- 26 Soderman K, Werner S, Pietila T, Engstrom B, Alfredson H. Balance board training: prevention of traumatic injuries of the lower extremities in female soccer players? A prospective randomized intervention study. Knee Surg Sports Traumatol Arthrosc. 2000; 8 356-363
- 27 Sojka P, Johansson H, Sjolander P, Lorentzon R, Djupsjobacka M. Fusimotor neurones can be reflexly influenced by activity in receptor afferents from the posterior cruciate ligament. Brain Res. 1989; 483 177-183
- 28 Solomonow M, Baratta R, Zhou B H, Shoji H, Bose W, Beck C, D'Ambrosia R. The synergistic action of the anterior cruciate ligament and thigh muscles in maintaining joint stability. Am J Sports Med. 1987; 15 207-213
- 29 Tropp H, Askling C, Gillquist J. Prevention of ankle sprains. Am J Sports Med. 1985; 13 259-262
- 30 Tsuda E, Okamura Y, Otsuka H, Komatsu T, Tokuya S. Direct evidence of the anterior cruciate ligament-hamstring reflex arc in humans. Am J Sports Med. 2001; 29 83-87
- 31 Verhagen E, van der B A, Twisk J, Bouter L, Bahr R, Van Mechelen W. The effect of a proprioceptive balance board training program for the prevention of ankle sprains: a prospective controlled trial. Am J Sports Med. 2004; 32 1385-1393
- 32 Wedderkopp N, Kaltoft M, Lundgaard B, Rosendahl M, Froberg K. Prevention of injuries in young female players in European team handball. A prospective intervention study. Scand J Med Sci Sports. 1999; 9 41-47
M. Gruber
Department of Sport Science
University of Freiburg
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Germany
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