Motor control after anterior cruciate ligament reconstruction
01 / 2005 - 03 / 2015
Almost every week, there is a report in the media that a well-known athlete has torn the anterior cruciate ligament (ACL) of the knee. Although often regarded necessary, ACL reconstruction does not guarantee a normal knee function. Many patients do not return to competitive sports, have a higher risk of re-injury and develop degeneration of the cartilage of the knee joint at a young age. The first aim of this research was to examine how the knee moves after surgery. The results showed that patients put less weight on the knee during walking and jumping. Unfortunately, patients who do not move the knee in a normal way, have an increased risk to tear the ACL again. Therefore, the second and most important purpose of this study, was to find an explanation for this behaviour. A theory was developed that patients have an increased attention on movement (internal focus) of the knee which affects the learning process to regain normal movements. An external focus means that attention is directed toward the results of the movement. To further test this theory, patients were placed in a virtual reality setting in order to distract them from their conscious control of the knee. The results showed that movement of the knee in patients can be favourably influenced. This thesis indicates room for a paradigm change to guide rehabilitation. Future rehabilitation that incorporates instructions with an external attentional focus may decrease the risk of tearing the ACL again and delay the onset of wear and tear of the knee.