The Role of Eccentric Training and Pain Neuroscience Education (PNE) to Improve Quadriceps Muscle Strength, and Function in Post ACL Repair: A Case Report

Dhiraj Tatiya, Tajuddin Chitapure, Amreen Shaikh, Ankita Jaju

Abstract


Background: A 19-year-old man presented with right knee pain while bearing weight on the right leg and difficulty bending the right knee. He was diagnosed with a complete -tear of the anterior cruciate ligament. After ACL reconstruction this individual was referred to physical therapy treatment. Objective: To investigate if neuroscience pain education, and eccentric training, have any therapeutic significance in post-ACL reconstructive patients. Method: After assessment, the first day of the first week, introduced a treatment protocol consisting of basic range of motion (ROM) and isometric exercises for three sets of 10–30 sec hold. From first to fourth week eccentric exercises along with pain neuroscience education (PNE) sessions were given on alternate days, with three sessions for PNE and eccentric exercises until fourth week. Result: As shown in this study, treatment with a combination of PNE and eccentric training results in improved quadriceps muscle strength, range of motion, and overall function. Conclusion: This report suggested that PNE in conjunction with eccentric exercise has clinical merit. Clinical implication of study is examining the effectiveness of this approach should be conducted in the form of well-designed, clinical studies.

Keywords


Pain, Anterior Cruciate Ligament Injuries, Quadriceps Muscle, Exercise Therapy

Full Text:

PDF

References


Arumugam, H. H., Balaraman, T., Bains, B. S., & Sadeghi, H. (2017). The Prevalence Of Upper Limb Pain Among Veena Players: A Cross-Sectional Survey. Revista Pesquisa Em Fisioterapia, 7(3), 326–331. https://doi.org/10.17267/2238-2704rpf.v7i3.1423

Carlson, K. (2020). Assessment of Post-Rehabilitation ACL Reconstructed Knees. International Journal of Kinesiology and Sports Science, 8(2), 33–39. https://doi.org/10.7575//aiac.ijkss.v.8n.2p.33

Daneshjoo, A., Tavakol, A., & Sadeghi, H. (2020). Effect of Twelve Sessions of Tai Chi Exercise on Static and Dynamic Balance in Young Girls. International Journal of Kinesiology and Sports Science, 8(1), 26–30. https://doi.org/10.7575/aiac.ijkss.v.8n.1p.26

Evans, J., & Nielson, J. l. (2020). Anterior Cruciate Ligament Knee Injurie. https://www.ncbi.nlm.nih.gov/books/NBK499848

Galan-Martin, M. A., Montero-Cuadrado, F., Lluch-Girbes, E., Coca-López, M. C., Mayo-Iscar, A., & Cuesta-Vargas, A. (2020). Pain Neuroscience Education and Physical Therapeutic Exercise for Patients with Chronic Spinal Pain in Spanish Physiotherapy Primary Care: A Pragmatic Randomized Controlled Trial. Journal of Clinical Medicine, 9(4), 1201. https://doi.org/10.3390/jcm9041201

Gerber, J. P., Marcus, R. L., Dibble, L. E., Greis, P. E., Burks, R. T., & Lastayo, P. C. (2007). Safety, Feasibility, and Efficacy of Negative Work Exercise Via Eccentric Muscle Activity Following Anterior Cruciate Ligament Reconstruction. Journal of Orthopaedic & Sports Physical Therapy, 37(1), 10–18. https://doi.org/10.2519/jospt.2007.2362

Gerber, J. P., Marcus, R. L., Dibble, L. E., Greis, P. E., & LaStayo, P. C. (2006). Early Application of Negative Work via Eccentric Ergometry Following Anterior Cruciate Ligament Reconstruction: A Case Report. Journal of Orthopaedic & Sports Physical Therapy, 36(5), 298–307. https://doi.org/10.2519/jospt.2006.2197

Larsen, J. B., Skou, S. T., Arendt-Nielsen, L., Simonsen, O., & Madeleine, P. (2020). Neuromuscular exercise and pain neuroscience education compared with pain neuroscience education alone in patients with chronic pain after primary total knee arthroplasty: Study protocol for the NEPNEP randomized controlled trial. Trials, 21(1), 218. https://doi.org/10.1186/s13063-020-4126-5

Lepley, L. K., & Palmieri-Smith, R. M. (2013). Effect of Eccentric Strengthening After Anterior Cruciate Ligament Reconstruction on Quadriceps Strength. Journal of Sport Rehabilitation, 22(2), 150–156. https://doi.org/10.1123/jsr.22.2.150

Lepley, L. K., Wojtys, E. M., & Palmieri-Smith, R. M. (2015). Combination of eccentric exercise and neuromuscular electrical stimulation to improve quadriceps function post-ACL reconstruction. The Knee, 22(3), 270–277. https://doi.org/10.1016/j.knee.2014.11.013

Louw, A., Puentedura, E. J., Zimney, K., & Schmidt, S. (2016). Know Pain, Know Gain? A Perspective on Pain Neuroscience Education in Physical Therapy. Journal of Orthopaedic & Sports Physical Therapy, 46(3), 131–134. https://doi.org/10.2519/jospt.2016.0602

Maguire, N., Chesterton, P., & Ryan, C. (2019). The Effect of Pain Neuroscience Education on Sports Therapy and Rehabilitation Students’ Knowledge, Attitudes, and Clinical Recommendations Toward Athletes With Chronic Pain. Journal of Sport Rehabilitation, 28(5), 438–443. https://doi.org/10.1123/jsr.2017-0212

Vidmar, M. F., Baroni, B. M., Michelin, A. F., Mezzomo, M., Lugokenski, R., Pimentel, G. L., & Silva, M. F. (2020). Isokinetic eccentric training is more effective than constant load eccentric training for quadriceps rehabilitation following anterior cruciate ligament reconstruction: A randomized controlled trial. Brazilian Journal of Physical Therapy, 24(5), 424–432. https://doi.org/10.1016/j.bjpt.2019.07.003




DOI: https://doi.org/10.7575/aiac.ijkss.v.9n.3p40

Refbacks

  • There are currently no refbacks.


Bookmark and Share


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

2013-2023 (CC-BY) Australian International Academic Centre PTY.LTD.

International Journal of Kinesiology and Sports Science

You may require to add the 'aiac.org.au' domain to your e-mail 'safe list’ If you do not receive e-mail in your 'inbox'. Otherwise, you may check your 'Spam mail' or 'junk mail' folders.