Trainingssteuerung des rehabilitativen Krafttrainings: Eine Funktionsanalyse während einer Trainingseinheit und ihre Konsequenzen

摘要

Controlling rehabilitative strength training after orthopedic/traumatologic injuries closely follow programs known from competitive sports training. The different muscle functions were analysed on 13 rehabilitation patients after ACL reconstruction (patellar tendon autograft) being examined in a concentric maximum strength and strength endurance training (60%, 90%, and 180%, each training unit comprising 5 or 6 sets for both legs) on an isokinetic system linked with EMG and lactate measurements. The selected, controlled group showed increasing recruitment (EMG-amplitudes and -median frequencies) of the involved atrophic M. quadriceps femoris within each training unit. So an average improvement of 25% in peak torque was measured in the course of one training unit. Increasing myoelectrical activity of the knee joint extensors combined with better endurance indices and less increasing lactate values suggests a preferential activation of small motor units (type 1 fibers) at the beginning of the training. The knee joint flexors however did not show bilateral differences. In comparison to conventional training methods rehabilitative strength training programs have to be changed. In this case progression of intensity with- in one training unit is necessary to adapt the load to the increasing ability to mobilize muscle power and to ensure a high training threshold and training effort. The reason for the missing power of the involved muscle must not be seen in the atrophy of the muscle only. The existing deficit of strength is due to the disturbed capability to activate available muscle potential. Especially the sense of training local strength endurance in rehabilitation on the basis of conventional training methods has to be reconsidered critically.