Estimation of vastus medialis’ excitability in cases of lateral patellar instability in children Kinga Kaczmarek , Aleksandra Wysokińska , Andrzej Żytkowski Ortop Traumatol Rehabil 2008; 10(6):583-592 ICID: 877716
Article type: Original article
IC™ Value: 7.16
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Introduction: Lateral patellar instability is a common disorder of functional patellofemoral joint. It affects mainly young people, more often it is observed in female. From among anatomical causes of instability we can mention changes in musculo-ligamentous system which embrace pathologic tension and elasticity of passive and active restraints of patella what influences its functioning. The aim of this study is to estimate excitability of vastus medialis muscle in children with lateral patellar instability. It seems that despite restoring elasticity of passive lateral restraints, the main thing in rehabilitation of this disorder is strengthening of vastus medialis muscle, particularly its oblique fibers, the only active medial stabilizer of patella. Materials and methods: Research was conducted in patients from Rehabilitation of Locomotion Organs Clinic in Warsaw’s Hospital for Children. They were divided into two groups: children with patellar instability and healthy one who were control group. The study were carried out from October 2006 to April 2007. The Bioethics Board of Medical University in Łódź gave its consent for this investigation. To explore neuro-muscular excitability rheobasis measurement was taken. This parameter was marked with use of Sonopuls 992, two electrodes of dimension 4x5 cm were used for the measurement. Results: In the study group there were taken 72 measurements, mean value of rheobasis was 15,31mA (+/- 4,94). 47 measurements were taken from girls, where mean value of rheobasis was 14,44mA (+/- 4,36) and 25 measurements among boys, where mean value of rheobasis was 17,004mA (+/- 5,62). In the control group 76 measurements were taken and mean value of rheobasis was 11,53mA (+/- 4,08), in this group 46 measurement were taken from girls, where mean value of rheobasis was 12,30mA (+/- 4,35) and 30 taken from boys, where mean value of vastus medialis excitability was 10,34mA (+/- 3,35). Muscles in the study group display substantially higher values of rheobasis, that means they are less excitable than those from control group. Conclusions: Measuring rheobasis among children with lateral patellar instability, before and during rehabilitation and also before or after surgical treatment can help to adapt process of rehabilitation and method of operation to individual patient. Strengthening vastus medialis muscle, especially it’s oblique fibers, the only active medial stabilizer of patella, is one of the most important elements of rehabilitation in children with symptoms of lateral patellar instability.
ICID 877716 PMID 19153547 - click here to show this article in PubMed