前十字韧带重建术后肢体负荷和下肢力量恢复分析

IF 2.7 2区 医学 Q1 SPORT SCIENCES Sports Health-A Multidisciplinary Approach Pub Date : 2024-10-14 DOI:10.1177/19417381241285859
Amelia S Bruce Leicht, Xavier D Thompson, Robin M Queen, Jordan S Rodu, Michael J Higgins, Kevin M Cross, Brian C Werner, Jacob E Resch, Joe M Hart
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引用次数: 0

摘要

背景:前十字韧带重建术(ACLR)后,患者在下蹲任务中的大腿肌肉力量和肢体负荷(LL)在整个康复过程中如何恢复,目前还缺乏证据:假设:患者将在整个康复过程中改善下蹲负荷和力量。研究设计:前瞻性队列研究:研究设计:前瞻性队列研究:证据级别:3 级:共有 60 名参与者(28 名男性/32 名女性;年龄为 22.5 ± 9.35 岁)参加了 ACLR 后的两次访问,评估 LL 和力量。患者使用带仪器的压力垫,完成 3 组 3 次的负重深蹲。计算并记录双侧峰值力(牛顿)、单侧累积负荷(%)以及股四头肌和腿肌等速峰值扭矩(牛顿-米)。LL 和峰值扭矩随时间和肢体之间进行了比较:在 LL 峰值力(N)方面,观察到肢体与时间之间存在明显的交互作用,与对侧肢体相比,患者在第 1 次就诊时前交叉韧带复位肢体的负荷不足(P < 0.01)。患者的 ACLR LL 在各次检查中均有所增加(P = 0.04)。在股四头肌峰值扭矩(N-m)方面,观察到肢体与时间的交互作用,ACLR肢体在各次就诊时峰值扭矩均有所增加(P < 0.01);然而,与未手术肢体相比,第 2 次就诊时力量缺陷仍然存在(P < 0.01)。所有变化评分指标之间的相关性较弱(r,0.20-0.25):结论:随着时间的推移,前交叉韧带置换术后恢复期患者在下蹲任务中表现出更对称的负荷,下肢力量也有所提高。随着时间的推移,力量的变化与下蹲任务中LL的变化无关:深蹲任务安全且易于在前交叉韧带损伤恢复过程中实施。临床意义:深蹲任务在前交叉韧带重建的整个恢复过程中都很安全且易于实施。由于功能性下肢力量的变化与力量恢复无关,因此在进行更全面的功能和力量评估的术后连续测试时应同时考虑这两个因素。
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Analysis of Limb Loading and Lower Extremity Strength Recovery Across Time After Anterior Cruciate Ligament Reconstruction.

Background: Evidence as to how patient thigh muscle strength and limb loading (LL) during a squatting task recovers throughout rehabilitation after anterior cruciate ligament reconstruction (ACLR) is lacking.

Hypothesis: Patients will improve LL and strength throughout rehabilitation. Changes in LL and strength over time will be positively correlated.

Study design: Prospective cohort study.

Level of evidence: Level 3.

Methods: A total of 60 participants (28 male/32 female; age, 22.5 ± 9.35 years) participated in 2 visits post-ACLR, assessing LL and strength. Using an instrumented pressure mat, patients completed 3 sets of 3 repetitions of bodyweight squats. Peak force (N), unilateral cumulative load (%), and quadriceps and hamstring isokinetic peak torque (N·m) were calculated and recorded bilaterally. LL and peak torque were compared over time and between limbs.

Results: A significant limb-by-time interaction was observed for LL peak force (N), where patients underloaded the ACLR limb at visit 1 compared with the contralateral limb (P < 0.01). Patients increased their ACLR LL across visits (P = 0.04). A limb-by-time interaction for quadriceps peak torque (N·m) was observed where the ACLR limb increased peak torque across visits (P < 0.01); however, strength deficits persisted at visit 2 (P < 0.01) when compared with the nonoperative limb. Weak correlations were observed between all change scores metrics (r, 0.20-0.25).

Conclusion: Patients recovering from ACLR exhibited more symmetric loading during a squatting task and improved their lower extremity strength over time. Changes in strength were not related to changes in LL during a squatting task over time.

Clinical relevance: Squatting tasks are safe and easily implemented throughout ACLR recovery. As changes in functional LL and strength recovery are not related, both should be considered in serial postoperative testing for more comprehensive function and strength assessments.

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来源期刊
Sports Health-A Multidisciplinary Approach
Sports Health-A Multidisciplinary Approach Medicine-Orthopedics and Sports Medicine
CiteScore
6.90
自引率
9.10%
发文量
101
期刊介绍: Sports Health: A Multidisciplinary Approach is an indispensable resource for all medical professionals involved in the training and care of the competitive or recreational athlete, including primary care physicians, orthopaedic surgeons, physical therapists, athletic trainers and other medical and health care professionals. Published bimonthly, Sports Health is a collaborative publication from the American Orthopaedic Society for Sports Medicine (AOSSM), the American Medical Society for Sports Medicine (AMSSM), the National Athletic Trainers’ Association (NATA), and the Sports Physical Therapy Section (SPTS). The journal publishes review articles, original research articles, case studies, images, short updates, legal briefs, editorials, and letters to the editor. Topics include: -Sports Injury and Treatment -Care of the Athlete -Athlete Rehabilitation -Medical Issues in the Athlete -Surgical Techniques in Sports Medicine -Case Studies in Sports Medicine -Images in Sports Medicine -Legal Issues -Pediatric Athletes -General Sports Trauma -Sports Psychology
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