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Srpski arhiv za celokupno lekarstvo
2016, vol. 144, br. 3-4, str. 151-157
Jačine i odnosi jačina mišića ekstenzora i fleksora kolena kod sportista nakon rekonstrukcije prednjeg ukrštenog ligamenta
Kadija Markoa, Knežević Olivera M.b ORCID, Milovanović Darkoa, Nedeljković Aleksandarc, Mirkov Dragan M.c ORCID
aKlinički centar Srbije, Klinika za ortopedsku hirurgiju i traumatologiju, Beograd
bUniverzitet u Beogradu, Institut za medicinska istraživanja
cUniverzitet u Beogradu, Fakultet sporta i fizičkog vaspitanja

e-adresa: kadija.marko@kcs.ac.rs
Projekat:
Neinvazivna modulacija kortikalne ekscitabilnosti i plasticiteta – Razvoj metoda neinvazivne neuromodulacije centralnog nervnog sistema u ispitivanja fizioloških mehanizama, dijagnostici i terapiji (MPNTR - 175012)
Mišićni i neuralni faktori humane lokomocije i njihove adaptivne promene (MPNTR - 175037)

Ključne reči: lig. cruciatum anterius (LCA); kvadpiceps; hamstrings; izometpija
Sažetak
Uvod Maksimalne jačine ekstenzora i fleksora kolena, njihov međusobni odnos (eng. hamstrings-to-quadriceps ratio; HQ), kao i indeks simetrije operisane i neoperisane noge (eng. limb symmetry index; LSI) važni su pokazatelji pomoću kojih se prati oporavak nakon rekonstrukcije LCA. Iako je za izvođenje brojnih funkcionalnih zadataka eksplozivna jačina važnija od maksimalne, ova sposobnost generalno je zanemarena u praćenju oporavka mišićne funkcije. Cilj rada bio je da se uporede odnosi (maksimalne jačine (Fmax) i odnosi eksplozivne jačine (eng. Rate of Force Development - RFD) kod sportista sa rekonstrukcijom LCA. Metode rada U studiju je uključeno 15 sportista, kojima je testirana maksimalna voljna izometrijska kontrakcija (MBK) ekstenzora i fleksora kolena (4,0 ± 0,1 meseca postoperativno). Pored Fmax, procenjivan je i RFD (RFDmax, kao i RFD na 50, 100 i 200 ms od početka kontrakcije) i računati odnosi jačine (LSI i HQ odnos). Rezultati Maksimalna jačina i ekstenzora i fleksora operisane noge bila je značajno niža nego kod neoperisane noge (p < 0,01). Deficiti su bili posebno izraženi kod ekstenzora operisane noge, usled čega su i HQ odnosi na toj strani (prosečno 0,63) bili veći nego kod neoperisane noge (0,44). Indeks simetrije je bio značajno niži za varijable RFD (prosečno 55%) nego za Fmax (66%). Zaključak Procena eksplozivne jačine može biti još jedan objektivni pokazatelj oporavka i spremnosti za izlaganje specifičnim opterećenjima i kretnjama, zbor čega bi trebalo da bude deo standardnog protokola za praćenje sportista nakon rekonstpukcije LCA. Štaviše, kombinacija indeksa izvedenih iz maksimalne i eksplozivne jačine morala bi dati kompletniji uvid u balans jačine mišića za kretnje koje zahtevaju maksimalne i eksplozivne akcije, kao i jasnu sliku o funkcionalnim implikacijama.
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