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manuelletherapie 2017; 21(01): 27-35
DOI: 10.1055/s-0042-120933
Originalia
Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Haben Patienten mit einer langwierigen Kreuzbandverletzung eine Veränderung der Neurodynamik des N. tibialis?

QuerschnittstudieDo Patients with a Long-Lasting Anterior Cruciate Ligament Rupture Have a Change in Tibial Nerve Neurodynamics?Cross-Sectional Study
F. Moll
1   Hochschule Osnabrück, Abt. Rehabilitation und Physiotherapie
,
S. Gunschera
1   Hochschule Osnabrück, Abt. Rehabilitation und Physiotherapie
,
C. Zalpour
1   Hochschule Osnabrück, Abt. Rehabilitation und Physiotherapie
,
H. von Piekartz
1   Hochschule Osnabrück, Abt. Rehabilitation und Physiotherapie
› Author Affiliations
Further Information

Publication History

13 September 2016

13 October 2016

Publication Date:
17 February 2017 (online)

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Zusammenfassung

Kreuzbandrisse (Rupturen des vorderen Kreuzbands, VKB) ziehen oft eine langwierige Rehabilitation und Wiedereingliederung nach sich. Die physiotherapeutische Nachbehandlung beinhaltet aktive und passive Maßnahmen. Bislang existieren keine Studien zu neurodynamischen Aspekten der Rehabilitation von Kreuzbandrissen. Das Ziel der vorliegenden Studie bestand darin, die Veränderung der Bewegung des N. tibialis des betroffenen und nicht betroffenen Beins bei Probanden nach einer VKB-Ruptur zu untersuchen.

Bestandteil der verblindeten Untersuchung der 19 Probanden waren der Knee Outcome Survey für alltägliche Aktivitäten (KOS) und verschiedene Funktionsuntersuchungen (Slump-Test mit passiver Knieextension, Long Sitting Slump Test mit passiver Dorsalextension des oberen Sprunggelenks, Straight Leg Raise Test, belastete Dorsalextension im Stand). Die longitudinale Nervenexkursion des N. tibialis wurde mit bildgebendem Ultraschall in sitzender Slump-Position untersucht. Die Auswertung der Ultraschallvideos erfolgte mit einer Frame-by-frame Cross Correlation Software.

Die Ergebnisse zeigten eine signifikant geringere Nervenexkursion des N. tibialis am betroffenen Knie. Allerdings fand sich kein klinisch signifikanter Zusammenhang zu den Funktionsuntersuchungen.

Abstract

Anterior cruciate ligament ruptures (ACL) often lead to lengthy rehabilitation and reintegration. Physiotherapeutic postoperative treatment includes active and passive interventions. To date there are no studies concerning neurodynamic aspects of rehabilitation following ACL rupture. The aim of this study was to determine changes in tibial nerve movement of the affected and non-affected leg in subjects with ACL rupture.

Components of the blinded examination of 19 subjects were the Knee Outcome Survey for Daily Activities (KOS) and multiple functional assessments (slump test with passive knee extension, long sitting slump test with passive dorsiflexion of the ankle, straight leg raise test, weight-bearing standing dorsiflexion). The longitudinal nerve excursion of the tibial nerve was examined using ultrasound in sitting slump position. The ultrasound videos were evaluated using a frame-to-frame cross correlation software.

The results showed a significant nerve excursion of the tibial nerve of the affected knee. There was, however, no clinically significant correlation with the functional examination.

Schlüsselwörter

vorderes Kreuzband - N. tibialis - Sonografie - diagnostischer Ultraschall - bildgebender Ultraschall - Neurodynamik

Keywords

anterior cruciate ligament - tibial nerve - sonography - diagnostic ultrasound - imaging ultrasound - neurodynamics
 

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