RETURN TO SPORT AFTER ACL INJURY AND SURGERY: AN EDUCATIONAL MATTER?

Valeria Agosti

Abstract


Return to sport after an anterior cruciate ligament (ACL) injury has always been considered a purely rehabilitative matter. Such approach has been supported by a culture that views the body and the movement from a merely clinical and mechanistic perspective. Scientific evidence suggests that in an ACL injury, in addition to peripheral anatomical damage, a modification in the activation of the cortical areas - in which the injured ACL is represented - is evident. It follows that, to ensure a full movement recovery, the standard surgical and rehabilitation process is not enough, and that there is the need for a sport-specific re-learning intervention. Therefore, the proposed study monitors, through a Motion Analysis System, an ACL injured élite volleyball athlete’s return to sport, according to a neurocognitive approach where the sport recovery is also an educational matter.

Ritornare alla pratica sportiva dopo aver subito una lesione legamento crociato anteriore (LCA) è da sempre considerata una questione puramente riabilitativa. Questo approccio è sostenuto da una cultura che osserva il corpo e il movimento da una prospettiva meramente clinica e meccanicistica. Evidenze scientifiche suggeriscono che in una lesione del LCA, oltre al danno anatomico periferico, è evidente anche una modificazione nell'attivazione delle aree corticali - in cui il LCA è rappresentato. Ne consegue che, per garantire un pieno recupero dell’organizzazione motoria, il normale percorso chirurgico e riabilitativo non è sufficiente ma che è invece necessario un intervento di ri-apprendimento del gesto sport specifico. Pertanto, lo studio che proponiamo monitora, attraverso un Sistema di Motion Analysis, il ritorno allo sport di un atleta pallavolista professionista dopo lesione del LCA che è stata coinvolta in un percorso che segue un approccio neurocognitivo dove il recupero sportivo è considerato anche una questione educativa.


Keywords


Sport - Pedagogy – Education - Motion Analysis – Anterior Cruciate Ligament

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References


Adachi, N., Ochi, M., Uchio, Y., Iwasa, J., Ryoke, K., & Kuriwaka, M. (2002). Mechanoreceptors in the anterior cruciate ligament contribute to the joint position sense. Acta orthopaedica Scandinavica, 73(3), 330–334. https://doi.org/10.1080/000164702320155356 259

Ageberg, E., Björkman, A., Rosén, B., & Roos, E. M. (2012). Principles of brain plasticity in improving sensorimotor function of the knee and leg in patients with anterior cruciate ligament injury: a double-blind randomized exploratory trial. BMC musculoskeletal disorders, 13, 68. https://doi.org/10.1186/1471-2474-13-68

Agosti, V. (2019). The proposal of a new educational-pedagogical training program to prevent muscle strain in élite fencers: a case study. Italian Journal of Health Education, Sports and Inclusive Didactics, 3 (2), 50-56. doi: https://doi.org/10.32043/gsd.v3i2.145

Agosti, V., & Autuori M. (2020). Fencing functional training system (ffts): a new pedagogical-educational training project. Sport Science, 13(1), 118-122.

Banios, K., Raoulis, V., Fyllos, A., Chytas, D., Mitrousias, V., & Zibis, A. (2022). Anterior and Posterior Cruciate Ligaments Mechanoreceptors: A Review of Basic Science. Diagnostics (Basel, Switzerland), 12(2), 331. https://doi.org/10.3390/diagnostics12020331

Beynnon, B. D., Vacek, P. M., Newell, M. K., Tourville, T. W., Smith, H. C., Shultz, S. J., Slauterbeck, J. R., & Johnson, R. J. (2014). The Effects of Level of Competition, Sport, and Sex on the Incidence of First-Time Noncontact Anterior Cruciate Ligament Injury. The American journal of sports medicine, 42(8), 1806–1812. https://doi.org/10.1177/0363546514540862

Cappellino, F., Paolucci, T., Zangrando, F., Iosa, M., Adriani, E., Mancini, P., Bellelli, A., & Saraceni, V. M. (2012). Neurocognitive rehabilitative approach effectiveness after anterior cruciate ligament reconstruction with patellar tendon. A randomized controlled trial. European journal of physical and rehabilitation medicine, 48(1), 17–30.

Courtney, C., Rine, R. M., & Kroll, P. (2005). Central somatosensory changes and altered muscle synergies in subjects with anterior cruciate ligament deficiency. Gait & posture, 22(1), 69–74. https://doi.org/10.1016/j.gaitpost.2004.07.002

Dauty, M., Crenn, V., Louguet, B., Grondin, J., Menu, P., & Fouasson-Chailloux, A. (2022). Anatomical and Neuromuscular Factors Associated to Non-Contact Anterior Cruciate Ligament Injury. Journal of clinical medicine, 11(5), 1402. https://doi.org/10.3390/jcm11051402

Di Stasi, S. L., Logerstedt, D., Gardinier, E. S., & Snyder-Mackler, L. (2013). Gait patterns differ between ACL-reconstructed athletes who pass return-to-sport criteria and those who fail. The American journal of sports medicine, 41(6), 1310–1318. https://doi.org/10.1177/0363546513482718

Doege, J., Ayres, J. M., Mackay, M. J., Tarakemeh, A., Brown, S. M., Vopat, B. G., & Mulcahey, M. K. (2021). Defining Return to Sport: A Systematic Review. Orthopaedic journal of sports medicine, 9(7), 23259671211009589. https://doi.org/10.1177/23259671211009589

Flosadottir, V., Frobell, R., Roos, E. M., & Ageberg, E. (2018). Impact of treatment strategy and physical performance on future knee-related self-efficacy in individuals with ACL injury. BMC musculoskeletal disorders, 19(1), 50. https://doi.org/10.1186/s12891-018-1973-2

Fort-Vanmeerhaeghe, A., Arboix-Alió, J., Montalvo, A.M. (2021). Return-to-sport following anterior cruciate ligament reconstruction in team sport athletes. Part I: From initial injury to return-to-competition. Apunts Sports Medicine. 56(212), 100362. https://doi.org/10.1016/j.apunsm.2021.100362.

Fort-Vanmeerhaeghe, A., Arboix-Alió, J., Montalvo, A.M. (2022). Return-to-sport following anterior cruciate ligament reconstruction in team sport athletes. Part II: Progressive framework. Apunts Sports Medicine. 57(213), 100261. 100361. 10.1016/j.apunsm.2021.100361.

Gao, B., & Zheng, N. N. (2010). Alterations in three-dimensional joint kinematics of anterior cruciate ligament-deficient and -reconstructed knees during walking. Clinical biomechanics (Bristol, Avon), 25(3), 222–229. https://doi.org/10.1016/j.clinbiomech.2009.11.006

Gao, F., Zhou, J., He, C., Ding, J., Lou, Z., Xie, Q., Li, H., Li, F., & Li, G. (2016). A Morphologic and Quantitative Study of Mechanoreceptors in the Remnant Stump of the Human Anterior Cruciate Ligament. Arthroscopy: the journal of arthroscopic & related surgery: official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 32(2), 273–280. https://doi.org/10.1016/j.arthro.2015.07.010

Gokeler, A., Dingenen, B., & Hewett, T. E. (2022). Rehabilitation and Return to Sport Testing After Anterior Cruciate Ligament Reconstruction: Where Are We in 2022?. Arthroscopy, sports medicine, and rehabilitation, 4(1), e77–e82. https://doi.org/10.1016/j.asmr.2021.10.025

Griffin, L. Y., Agel, J., Albohm, M. J., Arendt, E. A., Dick, R. W., Garrett, W. E., Garrick, J. G., Hewett, T. E., Huston, L., Ireland, M. L., Johnson, R. J., Kibler, W. B., Lephart, S., Lewis, J. L., Lindenfeld, T. N., Mandelbaum, B. R., Marchak, P., Teitz, C. C., & Wojtys, E. M. (2000). Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. The Journal of the American Academy of Orthopaedic Surgeons, 8(3), 141–150. https://doi.org/10.5435/00124635-200005000-00001

Hewett, T. E., Myer, G. D., Ford, K. R., Heidt, R. S., Jr, Colosimo, A. J., McLean, S. G., van den Bogert, A. J., Paterno, M. V., & Succop, P. (2005). Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. The American journal of sports medicine, 33(4), 492–501. https://doi.org/10.1177/0363546504269591

Kakavas, G., Malliaropoulos, N., Pruna, R., Traster, D., Bikos, G., & Maffulli, N. (2020). Neuroplasticity and Anterior Cruciate Ligament Injury. Indian journal of orthopaedics, 54(3), 275–280. https://doi.org/10.1007/s43465-020-00045-2

Kapreli, E., & Athanasopoulos, S. (2006). The anterior cruciate ligament deficiency as a model of brain plasticity. Medical hypotheses, 67(3), 645–650. https://doi.org/10.1016/j.mehy.2006.01.063

Kapreli, E., Athanasopoulos, S., Gliatis, J., Papathanasiou, M., Peeters, R., Strimpakos, N., Van Hecke, P., Gouliamos, A., & Sunaert, S. (2009). Anterior cruciate ligament deficiency causes brain plasticity: a functional MRI study. The American journal of sports medicine, 37(12), 2419–2426. https://doi.org/10.1177/0363546509343201

Laughlin, W. A., Weinhandl, J. T., Kernozek, T. W., Cobb, S. C., Keenan, K. G., & O'Connor, K. M. (2011). The effects of single-leg landing technique on ACL loading. Journal of biomechanics, 44(10), 1845–1851. https://doi.org/10.1016/j.jbiomech.2011.04.010

Minino, R., Belfiore, P., & Liparoti, M. (2020). Neuroplasticity and motor learning in sport activity. J. Phys. Educ. Sport, 20, 2354-2359.

Murphy, D. F., Connolly, D. A., & Beynnon, B. D. (2003). Risk factors for lower extremity injury: a review of the literature. British journal of sports medicine, 37(1), 13–29. https://doi.org/10.1136/bjsm.37.1.13

Neto, T., Sayer, T., Theisen, D., & Mierau, A. (2019). Functional Brain Plasticity Associated with ACL Injury: A Scoping Review of Current Evidence. Neural plasticity, 2019, 3480512. https://doi.org/10.1155/2019/3480512

Piskin, D., Benjaminse, A., Dimitrakis, P., & Gokeler, A. (2021). Neurocognitive and Neurophysiological Functions Related to ACL Injury: A Framework for Neurocognitive Approaches in Rehabilitation and Return-to-Sports Tests. Sports health, 19417381211029265. Advance online publication. https://doi.org/10.1177/19417381211029265

Quatman, C. E., Quatman-Yates, C. C., & Hewett, T. E. (2010). A 'plane' explanation of anterior cruciate ligament injury mechanisms: a systematic review. Sports medicine (Auckland, N.Z.), 40(9), 729–746. https://doi.org/10.2165/11534950-000000000-00000

Robbins, S. M., Clark, J. M., & Maly, M. R. (2011). Longitudinal gait and strength changes prior to and following an anterior cruciate ligament rupture and surgical reconstruction: a case report. The Journal of orthopaedic and sports physical therapy, 41(3), 191–199.

Rucco, R., Liparoti, M., Agosti, V. (2020) A new technical method to analyse the kinematics of the human movements and sports gesture. Journal of Physical Education and Sport (JPES), 20 (suppl 4), 2360 – 2363. https://doi.org/10.7752/jpes.2020.s4319

Rucco, R., Liparoti, M., Jacini, F., Baselice, F., Antenora, A., De Michele, G., Criscuolo, C., Vettoliere, A., Mandolesi, L., Sorrentino, G., & Sorrentino, P. (2019). Mutations in the SPAST gene causing hereditary spastic paraplegia are related to global topological alterations in brain functional networks. Neurological sciences: official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 40(5), 979–984. https://doi.org/10.1007/s10072-019-3725-y

Shabani, B., Bytyqi, D., Lustig, S., Cheze, L., Bytyqi, C., & Neyret, P. (2015). Gait knee kinematics after ACL reconstruction: 3D assessment. International orthopaedics, 39(6), 1187–1193. https://doi.org/10.1007/s00264-014-2643-0

Slater, L. V., Hart, J. M., Kelly, A. R., & Kuenze, C. M. (2017). Progressive Changes in Walking Kinematics and Kinetics After Anterior Cruciate Ligament Injury and Reconstruction: A Review and Meta-Analysis. Journal of athletic training, 52(9), 847–860. https://doi.org/10.4085/1062-6050-52.6.06

Sorrentino, P., Lardone, A., Pesoli, M., Liparoti, M., Montuori, S., Curcio, G., Sorrentino, G., Mandolesi, L., & Foti, F. (2019). The Development of Spatial Memory Analyzed by Means of Ecological Walking Task. Frontiers in psychology, 10, 728. https://doi.org/10.3389/fpsyg.2019.00728

Swanik, C. B., Covassin, T., Stearne, D. J., & Schatz, P. (2007). The relationship between neurocognitive function and noncontact anterior cruciate ligament injuries. The American journal of sports medicine, 35(6), 943–948. https://doi.org/10.1177/0363546507299532

Tashman, S., Kopf, S., & Fu, F. H. (2008). The Kinematic Basis of ACL Reconstruction. Operative techniques in sports medicine, 16(3), 116–118. https://doi.org/10.1053/j.otsm.2008.10.005

Troisi Lopez, E., Cusano, P., Sorrentino P. (2020). The relationship between sports activity and emotions in the formation of cognitive processes. Journal of Physical Education and Sport (JPES), 20 (Supp 4), 2349-2353. https://doi.org/10.7752/jpes.2020.s4317

Valeriani, M., Restuccia, D., Di Lazzaro, V., Franceschi, F., Fabbriciani, C., & Tonali, P. (1999). Clinical and neurophysiological abnormalities before and after reconstruction of the anterior cruciate ligament of the knee. Acta neurologica Scandinavica, 99(5), 303–307. https://doi.org/10.1111/j.1600-0404.1999.tb00680.x

Valeriani, M., Restuccia, D., Di Lazzaro, V., Franceschi, F., Fabbriciani, C., & Tonali, P. (1996). Central nervous system modifications in patients with lesion of the anterior cruciate ligament of the knee. Brain: a journal of neurology, 119(Pt5), 1751–1762. https://doi.org/10.1093/brain/119.5.1751

Zimny, M. L., Schutte, M., & Dabezies, E. (1986). Mechanoreceptors in the human anterior cruciate ligament. The Anatomical record, 214(2), 204–209. https://doi.org/10.1002/ar.1092140216




DOI: https://doi.org/10.32043/gsd.v6i1.555

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