MĚKKÉ STRUKTURY KOLENNÍHO KLOUBUA PORUCHY MOTORICKÉ KONTROLY

Soft Structures of the Knee Joint and Disordersof Motor Control

The incidence and severity of consequences of the damage to soft structures of the knee jointrepresent even growing problem in the population of the most productive age. The development andapplication of modern technologies, especially computing-assisted polyelectromyography, three-dimensionalkinematics, tensometric kinetics and functional imaging, bring about a completely newinsight into pathogenesis of locomotion system. Increasing numbers of studies have shown that oneof the key factors in the origin of lesions of soft structures of the knee joint is the disorder of neuromotor(neuromuscular) control of dynamic stabilization of the knee joint and its feed-back control. There isa bilateral close relationship between the conditions of soft tissues of the knee joint and proprioception– each damage to soft structures becomes immediately manifest in a disorder of proprioceptionand this condition further deteriorates the control of dynamic stabilization of the joint.One of the mostimportant factors, related to the damage of anterior cruciate ligament, is the time distribution ofstabilization in posterior-anterior and mediolateral direction, especially in the standing phase of thewalking cycle, during landing, in correcting force moments acting in anterior translation of tibia. Theetiology of inclination of the female knee joint for damage to soft tissues is of complex character.Themain causes may be divided into anatomical and biomechanical, hormonal and neuromotor in nature.Each training of dynamic stabilization (e.g. also lumbar spine, shoulder, etc.) originates from theimage of interrelationship between proprioception, neuromotoric, condition of soft tissues and joint structures in general. The projects of ortheses presently investigate the biomechanic stabilization ofthe segment (knee joint), but also the consequences of the remedy for neuromotorics – timing of themuscles in specific tasks and sensoric afferentation from the segment. Interdisciplinary and borderlinearea, where the orthopedic, traumatologic, orthetic (to mention just few) problems is evolvingdramatically due to technical and technological progress as well as due to changes in intellectualparadigms and concepts. Further knowledge extending our knowledge and immediately serving thebenefit of the patient may be expected.

Key words:
knee, injury, motor control, anterior cruciate ligament, rehabilitation