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Strength and Proprioception Monitorization of a Male Basketball Player after ACL
Surgery: A Case Study
İsmail BAYRAM1 Ali Onur CERRAH1, Deniz ŞİMŞEK1, Hayri ERTAN1
1
Anadolu University, Faculty of Sport Sciences, Eskişehir, Turkey
Introduction: Athletes who practice contact sports such as soccer, football and basketball are
more susceptible to injure their Anterior Cruciate Ligaments (ACL) due to instantaneous loads on
the knee joint. This loads generally occur while changing direction rapidly, stopping suddenly,
deceleration, incorrectly landing from a jump, direct contact or collusion. When the biomechanical
limits of the knee are exceeded, a tear or rupture of the ligament is inevitable.
Purpose: This study intents to give a brief information about a university level basketball player’s
rehabilitation process after an ACL reconstruction surgery. Our main aim was to monitorize the
strength and proprioception differences as well as expected improvements during rehabilitation
process between injured and non-injured legs. Two parameters have been evaluated mainly; a)
isokinetic strength, b) proprioception.
Method: The athlete was 23 years old and his descriptive statistics were the following ones;
height: 172 cm, weight: 76 kg and training age: 13 years. He had a 3rd grade sprain which means
a total rupture. For the reconstruction of his ACL, 1/3 part of the tendons of musculuc gracilis and
musculus semitendinosus have been harvested from him by making a small incision on tibial
tuberosity. The two tendons were then looped to create a stranded graft structure. The athlete was
able to walk without support ten days after surgery. He performed some functional movements,
stretching and massage. After the fifth week, the athlete was performing some pool activities, after
the seventh week, all daily activities were normal and he started to perform low intensity jogs,
BOSU ball activities and low intensity strength training. Measurements were taken within a month
interval. Isokinetic strength values (concentric/concentric) were measured for knee
flexion/extension by using ‘‘Isomed2000 isokinetic dynamometer’’ (D&R Ferstl GmbH, Hemau,
Germany). Both legs of athlete were tested in 600.s-1 (5 repetitions), 1800.s-1 (10 repetitions) and
2400.s-1 (10 repetitions) angular velocities. For proprioception evaluation, a simple angle
reproduction test made for a 650 of target knee angle while flexion and extension. Comparisons
were made between first/second measurement and injured/non-injured legs.
Results and Discussion: Maximum flex/ex torques of injured leg were 63/114 Nm for 600.s-1 in
the first test and increased to 100/186 Nm in the second test. Similarly, it increased from 73/94 to
103/130 Nm for 1800.s-1, and from 67/93 to 96/127 Nm for 2400.s-1. For proprioception
evaluation, it was 130 away from target angle during flexion and 180 away during extension in the
first test. There was not a considerable improvement in the second measurement and it was still 90
away from target angle during flexion and 160 away during extension. Unlikely, proprioception
sense was better on non-injured leg with a 50 of deviation during flexion and 70 during extension.
Strength values of non-injured leg were 144/238 Nm for 600.s-1, 117/165 for 1800.s-1 and 124/145
for 2400.s-1. Low strength values of injured leg flexors could indicate a muscle rehabilitation
process of the gracilis and semitendinosus due to tendon harvest. It is also thought that
proprioception sense was not significantly different due to reconstructed joint integrity.