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  Česky / Czech version Rehab. fyz. Lék., 11, 2004, No. 3, p. 111–117
 
Soft Structures of the Knee Joint and Disorders of Motor Control 
Mayer M.1,2, Smékal D.1 

1Katedra fyzioterapie a algoterapie Fakulty tělesné kultury UP, Olomouc, přednosta doc. MUDr. J. Opavský, Csc. 2Klinika rehabilitačního a tělovýchovného lékařství LF UP a FN, Olomouc, přednostka MUDr. J. Malinčíková, Ph.D.
 


Summary:

       The incidence and severity of consequences of the damage to soft structures of the knee joint represent even growing problem in the population of the most productive age. The development and application of modern technologies, especially computing-assisted polyelectromyography, three-dimensional kinematics, tensometric kinetics and functional imaging, bring about a completely new insight into pathogenesis of locomotion system. Increasing numbers of studies have shown that one of the key factors in the origin of lesions of soft structures of the knee joint is the disorder of neuromotor (neuromuscular) control of dynamic stabilization of the knee joint and its feed-back control. There is a bilateral close relationship between the conditions of soft tissues of the knee joint and proprioception – each damage to soft structures becomes immediately manifest in a disorder of proprioception and this condition further deteriorates the control of dynamic stabilization of the joint.One of the most important factors, related to the damage of anterior cruciate ligament, is the time distribution of stabilization in posterior-anterior and mediolateral direction, especially in the standing phase of the walking cycle, during landing, in correcting force moments acting in anterior translation of tibia. The etiology of inclination of the female knee joint for damage to soft tissues is of complex character.The main causes may be divided into anatomical and biomechanical, hormonal and neuromotor in nature. Each training of dynamic stabilization (e.g. also lumbar spine, shoulder, etc.) originates from the image of interrelationship between proprioception, neuromotoric, condition of soft tissues and joint structures in general. The projects of ortheses presently investigate the biomechanic stabilization of the segment (knee joint), but also the consequences of the remedy for neuromotorics – timing of the muscles in specific tasks and sensoric afferentation from the segment. Interdisciplinary and borderline area, where the orthopedic, traumatologic, orthetic (to mention just few) problems is evolving dramatically due to technical and technological progress as well as due to changes in intellectual paradigms and concepts. Further knowledge extending our knowledge and immediately serving the benefit of the patient may be expected.

        Key words: knee, injury, motor control, anterior cruciate ligament, rehabilitation
       

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