Važnost živčano-mišićne koordinacije nakon ozljede prednje ukrižene sveze koljenog zgloba

Aim: To evaluate if the restoration of neuromuscular coordination in knee ACL-injured patients could be estimated by the stimulation of neuromuscular control during the rehabilitation or if operative stabilisation should be performed previously. The study had to examine a short-term and long-term efficiency by monitoring the indicators of joint functionality in the early stages, from one month to one year after the injury/operation. Patients and methods: We analysed 53 ACL-injured patients treated operatively and non-operatively. All the patients underwent a functional rehabilitation programme with balance exercises. The measuring of static and dynamic balance on SportKAT 2000 device was performed, and the results were compared with the healthy subjects and the healthy limb of the same subject. Results: Measuring the static and dynamic balance indexes, a dysfunction of neuromuscular control was found in the maintenance of balance in the patient groups. Exercises that included stimulation of the neuromuscular coordination, as a part of the rehabilitation procedure following ACL injuries, soon lead to an improvement of both balance indexes (p<0,001) in both groups, however, no long term impact was noted in non-operatively treated group. Namely, if the above exercises are not conducted on a regular daily basis, the balance indexes will deteriorate. Contrary, after the operative joint stabilization the balance indexes tend to improve to the ‘normal’ balance (p<0,001). Conclusion: In order to restore dynamic stabilization of the joint in ACL injured patients, exercises stimulating the neuromuscular mechanisms are necessary. This suggests the importance of neuromuscular coordination in the rehabilitation of the lower extremity while maintaining joint stability, which represents the scientific contribution of this paper.