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A Journal on Sports Medicine

Official Journal of the Italian Sports Medicine Federation
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Medicina dello Sport 2003 December;56(4):317-22


language: Italian

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”.

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