Kinetics During the Tuck Jump Assessment and Biomechanical Deficits in Female Athletes 12 Months After ACLR Surgery

Lucy S. Kember, Christopher D. Riehm, Andrew Schille, Jake A. Slaton, Jon L. Oliver, Gregory D. Myer, Rhodri S. Lloyd
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Abstract

Background:Residual interlimb deficits after anterior cruciate ligament reconstruction (ACLR) can lead to functional maladaptation and increase the risk of reinjury. The tuck jump assessment (TJA) may offer a more effective evaluation of ACLR status as compared with traditional tasks owing to increased risk of altered landing mechanics, asymmetrical landing, and increased knee valgus attributed to the cyclical nature of the task. However, it remains unclear whether altered TJA kinetics resolve over time or persist through return-to-play phases of rehabilitation.Purpose:To examine longitudinal kinetics, asymmetries, and functional performance deficits during TJA at 9 and 12 months after ACLR in female athletes at high risk of reinjury.Study Design:Cohort study; Level of evidence, 2.Methods:Female athletes (ACLR, n = 24; controls, n = 19; total, N = 43) performed a single trial of TJA on dual-force plates at 2 time points. The ACLR group (mean ± SD age, 16.8 ± 1.9 years) was tested at 9 and 12 months after surgery, and the control group (16.5 ± 3.6 years) was tested at similar time points. All athletes participated in similar sports and had comparable activity levels. Discrete time point analysis and statistical parametric mapping were used to identify deficits within each group.Results:At 9 months after surgery, the ACLR group exhibited significant interlimb differences in all kinetic variables ( P < .05), which persisted at 12 months with only small reductions in magnitude. As compared with controls, the ACLR group demonstrated a persistent offloading strategy in the involved limb by exhibiting larger interlimb asymmetries for a range of kinetic variables and a greater vertical ground-reaction force in the uninvolved limb during most of the stance phase at both time points ( P < .001). Distinct differences in functional performance of TJA were evident at both time points, characterized by lower peak vertical ground-reaction force, peak center of mass displacement, and relative vertical leg stiffness and longer ground contact times ( P < .001).Conclusion:This study revealed that young female athletes after ACLR exhibit persistent interlimb deficits and functional maladaptations up to 12 months after surgery. The TJA identified significant biomechanical impairments to both limbs, resulting in asymmetrical loading and altered movement strategies as compared with healthy controls. Despite some improvements, athletes with ACLR continued to demonstrate offloading to the uninvolved limb, indicating incomplete neuromuscular recovery.
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女运动员ACLR术后12个月的塔克跳跃评估和生物力学缺陷的动力学
背景:前交叉韧带重建(ACLR)后残留的肢间缺损可导致功能不适应,增加再损伤的风险。与传统任务相比,折叠跳跃评估(TJA)可能提供更有效的ACLR状态评估,因为该任务的周期性增加了着陆力学改变、着陆不对称和膝盖外翻的风险。然而,尚不清楚改变的TJA动力学是否会随着时间的推移而消退,还是会持续到康复的恢复阶段。目的:研究再损伤高风险女运动员ACLR后9个月和12个月TJA期间的纵向动力学、不对称性和功能表现缺陷。研究设计:队列研究;证据等级2。方法:女运动员(ACLR, n = 24;对照组,n = 19;总共,N = 43)在2个时间点对双力板进行TJA单次试验。ACLR组(平均±SD年龄,16.8±1.9岁)于术后9个月和12个月进行检测,对照组(16.5±3.6岁)在相似时间点进行检测。所有的运动员都参加了类似的运动,并且有相似的活动水平。使用离散时间点分析和统计参数映射来确定每组的缺陷。结果:术后9个月,ACLR组在所有动力学变量上均表现出显著的肢间差异(P <;.05),在12个月时持续存在,仅有微小的减少。与对照组相比,ACLR组在受累肢体中表现出持续的卸载策略,在两个时间点的站立阶段的大部分时间里,肢体间在一系列动力学变量上表现出更大的不对称性,并且在未受累肢体中表现出更大的垂直地面反作用力(P <;措施)。在两个时间点上,TJA的功能性能差异明显,其特征是垂直地面反力峰值较低,质心位移峰值较低,相对垂直腿刚度较低,接触地面次数较长(P <;措施)。结论:本研究显示,年轻女运动员在ACLR术后12个月仍表现出持续的肢间缺损和功能适应不良。与健康对照组相比,TJA发现了明显的四肢生物力学损伤,导致负荷不对称和运动策略改变。尽管有一些改善,但ACLR运动员继续表现出向未受累肢体的卸载,表明神经肌肉恢复不完全。
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