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ACL Injuries and Rehabilitation

October 4, 2018

The nervous system is a complex network of nerves that carry messages to and from the brain and spinal cord to various parts of the body. This is essential

 

 

to our existence as we would not even be able to stand up and walk without the neurological messages being passed on to our physical body. 

But what effect does a physical injury have on our neurological pathways and how can we consider this in helping an individual rehabilitate an injury?

Researchers out of the Ohio State University found that to regain full function of an anterior cruciate ligament injury (ACL) requires more than just physical rehab - it require re-training the brain and neural pathways. Previous studies have identified that the parts of the brain responsible for leg movements, have lagged during recovery from ACL injury. Comparing brain scans, the researches could see differences in brain activity in healthy adults versus those recovering from ACL injury, when flexing and extending the knee.

The brain fundamentally changes the way it processes information from the injured knee. In the healthy adults, the brains scans determined the individuals would rely on spatial awareness - somatosensory feedback/proprioception. In contrast, the individuals recovering from ACL injury would rely more on their visual senses - meaning they were unable to move as naturally or instinctively as their uninjured counterparts.

So how would this affect an injured athlete who is trying to return to sport?

These athletes may look like they are doing the same in training or in play, but they may not be moving with the same confidence, and constantly using their visual feedback from the world around them. Having to rely heavy on the visual senses can cause complications in more complex sports, though a way to overcome this in a rehab setting may be using the strobe effect to include motor learning and visual-motor compensations. 

The idea of using the strobe effect would be to pre-occupy the individuals vision, whilst completing rehab and sports specific exercises , in an aim to rewire their brains to an original state. This may help the individual once again move their knee based on natural instinct rather than visual feedback.

Individuals post ACL injury who return to sport or activity are up to 30-40 times more likely to sustain a second ACL injury when compared to athletes in the same sport or activity who have never experienced an ACL injury.

How can this be applied to other demographics outside of injury rehabilitation?

To maintain balance, the brain must rapidly and continuously integrate and process sensory information received from vision, vesicular (inner ear) and somatosensory (joints i.e. Knees, ankles, spine). As humans become older, this integration seems to deteriorate, leaving us more prone to falls. Often the joints become quite stiff and without mobility, come with a loss in somatosensory feedback from these joints too, meaning the ageing individual too relies more on their visual, observed with the shuffling steps and constantly looking at the ground when walking around - the joints are less likely to adjust to uneven ground the way they used to.

So maybe, we can take the evidence from above and apply it to balance and falls prevention, pre-occupying their visual sensory system, and force them to use and rewire their proprioceptive feedback systems, in an aim to prevent falls.

SMLXL

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