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Rehabilitation after a Complete Avulsion of the Proximal Rectus Femoris Muscle: Considerations from a Case Report

Background: A complete avulsion of the proximal rectus femoris muscle is a rare but severity injury. There is a lack of substantial information for its operative treatment and rehabilitation; in particular there is a lack of biomechanical data to evaluate long-term outcomes. Case presentation: The c...

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Autores principales: Baumgart, Christian, Grim, Casper, Heiss, Rafael, Ehrenstein, Philipp, Freiwald, Jürgen, Hoppe, Matthias Wilhelm
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8392792/
https://www.ncbi.nlm.nih.gov/pubmed/34444475
http://dx.doi.org/10.3390/ijerph18168727
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author Baumgart, Christian
Grim, Casper
Heiss, Rafael
Ehrenstein, Philipp
Freiwald, Jürgen
Hoppe, Matthias Wilhelm
author_facet Baumgart, Christian
Grim, Casper
Heiss, Rafael
Ehrenstein, Philipp
Freiwald, Jürgen
Hoppe, Matthias Wilhelm
author_sort Baumgart, Christian
collection PubMed
description Background: A complete avulsion of the proximal rectus femoris muscle is a rare but severity injury. There is a lack of substantial information for its operative treatment and rehabilitation; in particular there is a lack of biomechanical data to evaluate long-term outcomes. Case presentation: The case report presents the injury mechanism and surgical treatment of a complete avulsion of the proximal rectus femoris muscle in a 41-year-old recreational endurance athlete. Moreover, within a one-year follow-up period, different biomechanical tests were performed to get more functional insights into changes in neuromuscular control, structural muscle characteristics, and endurance performance. Within the first month post-surgery, an almost total neuromuscular inhibition of the rectus femoris muscle was present. A stepwise reduction in inter-limb compensations was observable (e.g., in crank torque during cycling) during the rehabilitation. Muscular intra-limb compensations were shown at six months post-surgery and even one year after surgery, which were also represented in the long-term adaption of the muscle characteristics and leg volumes. A changed motor control strategy was shown by asymmetric muscle activation patterns during ergometer cycling, while the power output was almost symmetric. During rehabilitation, there might be a benefit to normalizing neuromuscular muscle activation in ergometer cycling using higher loads. Conclusions: While the endurance performance recovered after six months, asymmetries in neuromuscular control and structural muscle characteristics indicate the long-term presence of inter- and intra-limb compensation strategies.
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spelling pubmed-83927922021-08-28 Rehabilitation after a Complete Avulsion of the Proximal Rectus Femoris Muscle: Considerations from a Case Report Baumgart, Christian Grim, Casper Heiss, Rafael Ehrenstein, Philipp Freiwald, Jürgen Hoppe, Matthias Wilhelm Int J Environ Res Public Health Case Report Background: A complete avulsion of the proximal rectus femoris muscle is a rare but severity injury. There is a lack of substantial information for its operative treatment and rehabilitation; in particular there is a lack of biomechanical data to evaluate long-term outcomes. Case presentation: The case report presents the injury mechanism and surgical treatment of a complete avulsion of the proximal rectus femoris muscle in a 41-year-old recreational endurance athlete. Moreover, within a one-year follow-up period, different biomechanical tests were performed to get more functional insights into changes in neuromuscular control, structural muscle characteristics, and endurance performance. Within the first month post-surgery, an almost total neuromuscular inhibition of the rectus femoris muscle was present. A stepwise reduction in inter-limb compensations was observable (e.g., in crank torque during cycling) during the rehabilitation. Muscular intra-limb compensations were shown at six months post-surgery and even one year after surgery, which were also represented in the long-term adaption of the muscle characteristics and leg volumes. A changed motor control strategy was shown by asymmetric muscle activation patterns during ergometer cycling, while the power output was almost symmetric. During rehabilitation, there might be a benefit to normalizing neuromuscular muscle activation in ergometer cycling using higher loads. Conclusions: While the endurance performance recovered after six months, asymmetries in neuromuscular control and structural muscle characteristics indicate the long-term presence of inter- and intra-limb compensation strategies. MDPI 2021-08-18 /pmc/articles/PMC8392792/ /pubmed/34444475 http://dx.doi.org/10.3390/ijerph18168727 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Baumgart, Christian
Grim, Casper
Heiss, Rafael
Ehrenstein, Philipp
Freiwald, Jürgen
Hoppe, Matthias Wilhelm
Rehabilitation after a Complete Avulsion of the Proximal Rectus Femoris Muscle: Considerations from a Case Report
title Rehabilitation after a Complete Avulsion of the Proximal Rectus Femoris Muscle: Considerations from a Case Report
title_full Rehabilitation after a Complete Avulsion of the Proximal Rectus Femoris Muscle: Considerations from a Case Report
title_fullStr Rehabilitation after a Complete Avulsion of the Proximal Rectus Femoris Muscle: Considerations from a Case Report
title_full_unstemmed Rehabilitation after a Complete Avulsion of the Proximal Rectus Femoris Muscle: Considerations from a Case Report
title_short Rehabilitation after a Complete Avulsion of the Proximal Rectus Femoris Muscle: Considerations from a Case Report
title_sort rehabilitation after a complete avulsion of the proximal rectus femoris muscle: considerations from a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8392792/
https://www.ncbi.nlm.nih.gov/pubmed/34444475
http://dx.doi.org/10.3390/ijerph18168727
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