The Effect of Cross Eercise on the Quadriceps Muscle Strength after Anterior Cruciate Ligament Reconstruction

Document Type : Original Article

Authors

1 PhD Student of Sport Injury and Corrective Exercise, University of Isfahan, Iran

2 Associate Professor, School of Physical Education and Sport Sciences, ferdowsi University of Mashhad, Iran

3 Assistant Professor, ِDepartment of Orthopaedic, Medical Sciences University of Mashhad, Iran

4 Assistant Professor, Faculty of physical education & sport sciences, Ferdowsi university of Mashhad. Iran

Abstract

Purpose:
Quadriceps muscle strength was reduced significantly after anterior cruciate ligament reconstruction. Finding a solution to overcome this problem is crucial. The objective of the present study is to investigate the effect of eight weeks cross exercise on the quadriceps muscle strength, in men after anterior cruciate ligament reconstruction.
Methods:
Twenty patients with anterior cruciate ligament tear, with an average age of 22.02±1.55 years and mean weight of 71.7±7.15 kilograms, were selected as volunteers. They were divided into two groups: experimental group and control. The experimental group, in addition to physiotherapy, performed eight weeks cross exercise with uninjured leg, three sessions per week and each session lasted for 20 minutes. The control group just received physiotherapy. Before three days of ACLR and After 9 weeks and performing 24 sessions of cross exercise, isometric strength of quadriceps muscle in both groups were measured at 60 degrees of flexion in both legs, by Isokinetic BIODEX system.. Data were analyzed by paired and independent samples t-test at a significance level of pResults:
The results showed that following eight weeks of cross exercise, the quadriceps muscles strength in uninjured leg, in the experimental group was significantly increased (P=0.002). Likewise, after reconstruction of the ACL, the amount of reduction in quadriceps muscles in the experimental group was significantly lower than the control group (P=0.001).
Conclusion:
The degree of strength loss can be positively reduced by continuum concentric cross exercises. Along with the optimization of the healthy organs, these exercises enhance the strength of organs, which underwent surgery.

Keywords

Main Subjects


1. Frobell RB, Roos EM, Roos HP, Ranstam J, Lohmander LS. A randomized trial of treatment for acute anterior cruciate ligament tears. New England Journal of Medicine 2010; 363(4): 331-42.
2. Radice F, Yánez R, Gutiérrez V, Rosales J, Pinedo M, Coda S. Comparison of magnetic resonance imaging findings in anterior cruciate ligament grafts with and without autologous platelet-derived growth factors. Arthroscopy: The Journal of Arthroscopic & Related Surgery 2010; 26(1): 50-7.
3. Streich NA, Barié A, Gotterbarm T, Keil M, Schmitt H. Transphyseal reconstruction of the anterior cruciate ligament in prepubescent athletes. Knee Surgery, Sports Traumatology, Arthroscopy 2010; 18(11): 1481-6.
4. McHugh MP, Tyler TF, Browne MG, Gleim GW, Nicholas SJ. Electromyographic predictors of residual quadriceps muscle weakness after anterior cruciate ligament reconstruction. The American Journal of Sports Medicine 2002; 30(3): 334-9.
5. Papandreou M, Billis E, Papathanasiou G, Spyropoulos P, Papaioannou N. Cross-exercise on quadriceps deficit after ACL reconstruction. J Knee Surg 2013; 26: 51-8.
6. Gerber JP, Marcus RL, Dibble LE, Greis PE, Burks RT, LaStayo PC. Effects of early progressive eccentric exercise on muscle size and function after anterior cruciate ligament reconstruction: a 1-year follow-up study of a randomized clinical trial. Physical therapy 2009; 89(1): 51-9.
7.  Magnus CR, Barss TS, Lanovaz JL, Farthing JP. Effects of cross-education on the muscle after a period of unilateral limb immobilization using a shoulder sling and swathe. Journal of Applied Physiology 2010; 109(6): 1887-94.
8.  Zhou S. Chronic neural adaptations to unilateral exercise: mechanisms of cross education. Exercise and sport sciences reviews 2000; 28(4): 177-84.
9. Jackson SW, Turner DL. Prolonged muscle vibration reduces maximal voluntary knee extension performance in both the ipsilateral and the contralateral limb in man. European journal of applied physiology 2003; 88(4-5): 380-6.
10. Arai M, Shimizu H, Shimizu M, Tanaka Y, Yanagisawa K. Effects of the use of cross-education to the affected side through various resistive exercises of the sound side and settings of the length of the affected muscles. Hiroshima journal of medical sciences 2001; 50(3): 65-73.
11. Magnus CR, Arnold CM, Johnston G, Dal-Bello Haas V, Basran J, Krentz JR, et al. Cross-education for improving strength and mobility after distal radius fractures: a randomized controlled trial. Archives of physical medicine and rehabilitation 2013; 94(7): 1247-55.
12. Papandreou M, Billis E, Papathanasiou G, Spyropoulos P, Papaioannou N. Cross-Exercise on Quadriceps Deficit after ACL Reconstruction. The journal of knee surgery. 2012.
13.Papandreou M, Papaioannou N, Antonogiannakis E, Zeeris H, Papandreou MG. The effect of cross exercise on quadriceps strength in different knee angles after the anterior cruciate ligament reconstruction. Br J of Biometricity 2007; 1: 123-37.
14. Wigerstad-Lossing I, Grimby G, Jonsson T, Morelli B, Peterson L, Renström P. Effects of electrical muscle stimulation combined with voluntary contractions after knee ligament surgery. Medicine and Science in Sports and exercise 1988; 20(1): 93.
15.  Fitzgerald GK. Open versus closed kinetic chain exercise: issues in rehabilitation after anterior cruciate ligament reconstructive surgery. Physical therapy 1997; 77(12): 1747-54.
16. Housh T, Housh D, Weir J, Weir L. Effects of eccentric-only resistance training and detraining. International journal of sports medicine 1996; 17(2): 145-8.
17. Kannus P, Alosa D, Cook L, Johnson R, Renström P, Pope M, et al. Effect of one-legged exercise on the strength, power and endurance of the contralateral leg. European journal of applied physiology and occupational physiology 1992; 64(2): 117-26.
18. Magnus C. Clinical application of cross-education to unilateral limb immobilization. 2013.
19. Farthing JP, Krentz JR, Magnus CR. Strength training the free limb attenuates strength loss during unilateral immobilization. Journal of Applied Physiology 2009; 106(3): 830-6.
20.   Jozsa L, Thöring J, Järvinen M, Kannus P, Lehto M, Kvist M. Quantitative alterations in intramuscular connective tissue following immobilization: an experimental study in the rat calf muscles. Experimental and molecular pathology 1988; 49(2): 267-78.
21. Hendy AM, Spittle M, Kidgell DJ. Cross education and immobilisation: mechanisms and implications for injury rehabilitation. Journal of science and medicine in sport 2012; 15(2): 94-101.
22. Pierrot-Deseilligny E, Burke D. The circuitry of the human spinal cord: its role in motor control and movement disorders: Cambridge University Press; 2005.
23. Hortobágyi T, Taylor JL, Petersen NT, Russell G, Gandevia SC. Changes in segmental and motor cortical output with contralateral muscle contractions and altered sensory inputs in humans. Journal of Neurophysiology 2003; 90(4): 2451-9.
24. Dragert K, Zehr EP. Bilateral neuromuscular plasticity from unilateral training of the ankle dorsiflexors. Experimental brain research 2011; 208(2): 217-27. 25. Carroll TJ, Herbert RD, Munn J, Lee M, Gandevia SC. Contralateral effects of unilateral strength training: evidence and possible mechanisms. Journal of Applied Physiology 2006; 101(5): 1514-22.
26. Eliassen JC, Baynes K, Gazzaniga MS. Direction information coordinated via the posterior third of the corpus callosum during bimanual movements. Experimental brain research 1999; 128(4): 573-7.
27. Iwamura Y, Taoka M, Iriki A. Book Review: Bilateral Activity and Callosal Connections in the Somatosensory Cortex. The Neuroscientist. 2001;7(5): 419-29.
28. Dettmers C, Ridding MC, Stephan KM, Lemon RN, Rothwell JC, Frackowiak R. Comparison of regional cerebral blood flow with transcranial magnetic stimulation at different forces. Journal of Applied Physiology 1996; 81(2): 596-603.
29. Farthing JP, Borowsky R, Chilibeck PD, Binsted G, Sarty GE. Neuro-physiological adaptations associated with cross-education of strength. Brain topography 2007; 20(2): 77-88.