St Clair Gibson A, Lambert M I, Durandt J J, Scales N, Noakes T D
Department of Physiology, University of Cape Town, South Africa.
J Orthop Sports Phys Ther. 2000 Jul;30(7):418-27. doi: 10.2519/jospt.2000.30.7.418.
Cross-sectional analytical study in which subjects served as their own controls.
To assess the concentric and eccentric peak torque in the hamstrings and quadriceps muscles, hamstrings/quadriceps amplitude ratios, and lean thigh volume differences in the involved and uninvolved limb of subjects with anterior cruciate ligament (ACL) deficiency.
[corrected] Although the hamstrings/quadriceps ratios for concentric and eccentric activity have been studied, the more functional eccentric hamstings/concentric quadriceps ratio has not been previously described in chronic ACL deficient individuals.
Eighteen subjects (36 +/- 11 years; 12 men, 6 women) with unilateral chronic ACL deficiency were recruited. Changes in activities of daily living, lean thigh volume (LTV) and isokinetic peak torque and total work capacity of both the quadriceps and hamstring muscles were investigated. The uninvolved limb served as control.
Eccentric quadriceps peak torque in the ACL deficient limb was reduced by 38% compared with the 16% reduction of concentric quadriceps peak torque. Eccentric hamstrings peak torque was reduced by 15% compared with an 8% reduction in concentric hamstrings peak torque. LTV in the ACL deficient limb was 11% smaller than the uninvolved limb (3,541 +/- 899 vs 3,161 +/- 742 cc, uninvolved versus ACL deficient limb). The relation between LTV and eccentric peak torque was stronger in the uninvolved (r = 0.82) compared with the ACL deficient limb (r = 0.66). The eccentric hamstrings/quadriceps ratio was significantly higher in the ACL deficient (0.80 +/- 0.26) compared with the uninvolved limb (0.55 +/- 0.13). However, the eccentric hamstrings/concentric quadriceps ratio was similar between ACL deficient (0.75 +/- 0.17) and uninvolved (0.77 +/- 0.20) limbs, while the concentric hamstrings/eccentric quadriceps ratio was significantly higher in the ACL deficient (0.79 +/- 0.26) compared with the uninvolved (0.50 +/- 0.14) limb.
Quadriceps and hamstrings peak torque values were significantly decreased in ACL deficient compared with the uninvolved limb. Eccentric muscle activity was affected to a greater degree than concentric muscle activity in the quadriceps muscle after ACL injury. The eccentric hamstrings/concentric quadriceps ratios were similar in ACL deficient and normal limbs, indicating that muscular co-ordination strategies may have been altered to maintain normal limb activity despite the strength losses particularly evident in quadriceps muscle function.
横断面分析研究，受试者自身作为对照。
评估前交叉韧带（ACL）损伤患者患侧与未患侧下肢腘绳肌和股四头肌的向心和离心峰值扭矩、腘绳肌/股四头肌幅度比以及大腿瘦体量差异。
虽然已经对向心和离心活动的腘绳肌/股四头肌比率进行了研究，但之前尚未描述慢性ACL损伤个体中更具功能性的离心腘绳肌/向心股四头肌比率。
招募了18名单侧慢性ACL损伤患者（年龄36±11岁；男性12名，女性6名）。研究日常生活活动、大腿瘦体量（LTV）以及股四头肌和腘绳肌的等速峰值扭矩和总工作能力的变化。未患侧下肢作为对照。
ACL损伤侧股四头肌离心峰值扭矩比未患侧降低了38%，而股四头肌向心峰值扭矩降低了16%。腘绳肌离心峰值扭矩比未患侧降低了15%，而腘绳肌向心峰值扭矩降低了8%。ACL损伤侧的LTV比未患侧小11%（未患侧为3541±899立方厘米，ACL损伤侧为3161±742立方厘米）。与ACL损伤侧（r = 0.66）相比，未患侧LTV与离心峰值扭矩之间的关系更强（r = 0.82）。ACL损伤侧的离心腘绳肌/股四头肌比率（0.80±0.26）显著高于未患侧（未患侧为0.55±0.13）。然而，ACL损伤侧（0.75±0.17）与未患侧（0.77±0.20）的离心腘绳肌/向心股四头肌比率相似，而ACL损伤侧（0.79±0.26）的向心腘绳肌/离心股四头肌比率显著高于未患侧（0.50±0.14）。
与未患侧下肢相比，ACL损伤患者的股四头肌和腘绳肌峰值扭矩值显著降低。ACL损伤后，股四头肌的离心肌肉活动比向心肌肉活动受到的影响更大。ACL损伤侧与正常侧的离心腘绳肌/向心股四头肌比率相似，这表明尽管股四头肌功能明显下降，但肌肉协调策略可能已发生改变以维持正常的肢体活动。
