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MEDICINA DELLO SPORT
A Journal on Sports Medicine
Official Journal of the Italian Sports Medicine Federation
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,163
Medicina dello Sport 2003 December;56(4):317-22
The sensomotor replanning in the recurrence prevention of sprained ankle: six months-evalutation in basket-ball players
Francavilla V. C., La Sala F., Palmeri F., Pancucci G., Parisi A., Francavilla G.
Cattedra di Medicina dello Sport, Università degli Studi di Palermo, Palermo
Aim. The performance of an athlete is based upon 2 factors: the 1st depends on his physiool condition and is linked to his own training, the 2nd is structural and in relation to the neuromotor organization of the myoarticular system. In the economy of the general “system” of a man, the “posture” represents the changeable data which is modified when particular musculo-skeleton pathologies arise: among these we have studied the traumas of the sprained ankle. This functional central complex, modulated by a passive system, constituted by the medial and lateral ligamental apparatus together with an active stabilising system formed by varied and valgus muscles, is governed by proprioceptive reflexes which leave from nervous centres staying in the encephalon and in the cerebellum. Our recovery and rehabilitation register has a neurophysiological base, the “proprioceptive system” which is connected to 3 systems: the “afferent”, the “efferent” and the “integrative” system. The “proprioceptive circuit” may be interrupted by compressive, torsional and tractional traumas which determines some degenerative or ischemic damages, responsible for a distorted or a delayed information; the simple rehabilitation of the strength of the muscular power, without a contemporaneous recovery of the proprioceptive control and of the kinaesthesia, delay the athlete’s cure.
Methods. Since we were confident in this result, we have applied a rigid system of inclusion to 20 basketball agonists, who, after 40 days of rehabilitation with a traditional treatment, showed a relapse of the ankle pathology. The results have confirmed the absolute reliability of the “proprioceptive rehabilitation” because any pathology hasn’t been verified in a sprain ankle; only some accidental traumas occurred, but they haven’t damaged the sporting season of the athlete.
Results. At least, the data of the research showed the validity of the sensomotor reprogramming, giving a close correlation between the anatomic-functional conditions and the rehabilitating and progressive tactics which is the fruit of a particular “training” based on 3 main activities: the recovery of the specific gestural expressiveness, of the muscular system and of the workload.
Conclusion. The inactivity modifies the functional capsule-ligamental and muscle-tendinous unity, acting on the structure and on the information and control centres and hiding itself as “proprioceptive stupor” in the anatomic damage. The biological recovery does not guarantee the right working of the kinetic chains which hold up the equilibrium between the agonist and antagonist muscles, the chronometrical sequences peculiar to the sports practice and the essential automatism to the articular economy. The complicated recovery, due to the persistence fof this “half-light of proprioception” justifies the finding of our research which privileges “the sensomotor replanning through a correct proprioceptive rehabilitation”.