A randomized crossover trial was designed to investigate the influence of muscle activation and strength on functional stability/control of the knee joint, to determine whether bilateral imbalances still occur six months after successful anterior cruciate ligament reconstruction (ACLR), and to analyze whether the use of orthotic devices changes the activity onset of these muscles. Furthermore, conclusions on the feedforward and feedback mechanisms are highlighted. Therefore, twenty‑eight patients will take part in a modified Back in Action (BIA) test battery at an average of six months after a primary unilateral ACLR, which used an autologous ipsilateral semitendinosus tendon graft. This includes double‑leg and single‑leg stability tests, double‑leg and single‑leg countermovement jumps, double‑leg and single‑leg drop jumps, a speedy jump test, and a quick feet test. During the tests, gluteus medius and semitendinosus muscle activity are analyzed using surface electromyography (sEMG). Motion analysis is conducted using Microsoft Azure DK and 3D force plates. The tests are performed while wearing knee rigid orthosis, soft brace, and with no aid, in random order. Additionally, the range of hip and knee motion and hip abductor muscle strength under isometric conditions are measured. Furthermore, patient‑rated outcomes will be assessed.
Multiple sclerosis is the most common neurological disease of young adults leading to permanent disability and early retirement. There are currently about 224,000 people affected in Germany. The disease is an inflammatory autoimmune disease with a broad spectrum of symptoms. The most common symptoms are fatigue and walking disabilities. Approximately 75% of patients suffer from difficulties in movement and balance, which lead to postural stability, walking ability and an increased risk of falling. 80 - 97% of those affected also suffer from fatigue symptoms. Both gait disorders and fatigue have the greatest negative effects on the quality of life and activities of daily life. The review shows, how treadmill training of different types affects the gait parameters stride length and walking speed; gait capacity and fatigue in patients with multiple sclerosis of all types and disability rates compared to no intervention, other treadmill training or conventional physiotherapy and how it should be dosed. Nine studies with a total of 294 participants will be evaluated in this systematic review. The study results are categorized according to their type of training. Compared to no intervention, conventional treadmill training shows significant improvements in walking speed and partial in fatigue and gait capacity. Furthermore, it indicates that treadmill training with negative slope achieves significantly better results in gait capacity and fatigue. The comparison of treadmill training with Virtual Reality shows no advantage over conventional treadmill
training and a robot-supported treadmill training does not show any superiority over conventional gait training. Treadmill training is an adequate alternative to conventional gait training in physiotherapy. The study situation is very rare and is not sufficient to completely determine the effects of treadmill training in multiple sclerosis. Further high-quality studies will be needed to investigate the effects of treadmill training on a larger sample size compared to conventional gait training or other treadmill training in patients with impaired walking ability and to examine the effects of training on a more homogeneous group of participants. Thus, possible interindividual differences between the different types of MS and disabilities could be identified and more specific conclusions could be drawn.