전방십자인대 재건술 전 가정 재활운동이 슬관절 근력과 고유수용감각에 미치는 영향. = Effect of Pre-operative Home-based Exercise on Knee Strength and Proprioceptive Functions after Anterior Cruciate Ligament Reconstruction

다국어 초록 (Multilingual Abstract)

[INTRODUCTION] The purpose of this study was to examine the effect of 6 week pre-operative home based exercise on muscle strength and proprioceptive functions after anterior cruciate ligament(ACL) reconstruction. [METHOD] Forth ACL reconstruction patients were randomly assigned into two groups; Pre-op Exercise Group (PEG, n=20) and Pre-op Non-Exercise Group (PNEG, n=20). PEG participated in 6weeks of home-based pre-op and 12 weeks of post-op exercise while PNEG participated only in the 12 weeks of post-op exercise. They were tested on muscle strength and proprioceptive functions 6 weeks before operations and 3 months after operations. Knee strength measurements at 60°/sec and 180°/sec on an isokinetic dynamometry were analyzed to compare their muscle strength. proprioceptive functions have been assessed using joint position sense and dynamic postural stability. [RESULT] The deficit of the knee extensor peak torque of uninvolved/involved at 60°/sec and 180°/sec were significant difference between PEG and PNEG. In PEG, deficit of the knee extensor peak torque of uninvolved/involved was reduced by 36.19% to 22.58% and 29.67% to 18.65%, respectively. In dynamic postural stability index test, PEG showed a significantly improved instability of 12.6% whereas PNEG resulted that of 23.3%(p=0.0231). However, no significant difference was found between PEG and PNEG in joint position sense test . [CONCLUSION] The 6 week home-based pre-op exercise may encourage many positive changes for ACLR patients by reducing the deficit between uninvolved and involved knees and improving proprioceptive functions.

국문 초록 (Abstract)

[서론] 본 연구의 목적은 전방십자인대 재건술 전 6주간의 가정 재활운동이 슬관절 근력과 고유수용감각에 미치는 영향을 알아보기 위한 것이다. [방법] 전방십자인대 파열로 인해 재건술이 필요한 남자 40명을 대상으로 하여, 수술 전 운동군(PEG, n=20)과 수술 전 비운동군(PNEG, n=20) 2집단으로 나누었다. 수술 전 운동군은 수술 전 6주간의 가정운동과 수술 후 12주간의 재활운동에 참여하였고, 수술 전 비운동군은 수술 후 12주간의 재활운동에만 참여하였다. 측정은 운동 참여 전인 수술 6주전과 수술 후 12주간의 재활이 시행된 후 각각 시행하여 슬관절 근력과 고유수용감각기능을 비교하였다. 슬관절 근력은 등속성 장비를 사용하여 각속도 60°/sec, 180°/sec에서 측정하였으며, 고유수용감각은 관절위치감각 검사와 동적자세유지능력 검사을 시행하였다. [결과] 분석결과 각속도 60°/sec에서 수술전 운동군의 건측에 대한 환측의 신전근 결손율이 36.19%에서 22.58%로 유의한 변화를 보였으며(p=0.018), 180°/sec의 각속도에서도 수술 전 운동군은 29.67%에서 18.65%로 유의하게 감소된 변화를 보여 두 집단 간에 통계적으로 유의한 차이를 보였다(p=0.042). 또한 동적자세유지능력에서도 수술 전 운동군이 30.25%에서 12.62%로 수술 전 비운동군 보다 더욱 향상된 동적자세유지능력을 보였다(p=0.0231). 하지만 관절위치감각 검사결과에서는 두 집단 간 차이를 보이지 않았다. [결론] 전방십자인대 재건술 환자에 있어서 수술 전 운동은 대퇴근 위축을 효과적으로 억제시키고 빠른 근력의 회복을 가져왔다. 또한 동적자세유지능력도 향상시키기 때문에 슬관절의 안정성에도 도움이 되는 것으로 사료된다.

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