Morrissey M C, Hudson Z L, Drechsler W I, Coutts F J, Knight P R, King J B
Department of Health Sciences, University of East London, Romford Road, London E15 4LZ, UK.
Knee Surg Sports Traumatol Arthrosc. 2000;8(6):343-8. doi: 10.1007/s001670000161.
Knee extensor resistance training using open kinetic chain (OKC) exercise for patients recovering from anterior cruciate ligament reconstruction (ACLR) surgery has lost favour mainly because of research indicating that OKC exercise causes greater ACL strain than closed kinetic chain (CKC) exercise. In this prospective, randomized clinical trial the effects of these two regimes on knee laxity were compared in the early period after ACLR surgery. Thirty-six patients recovering from ACLR surgery (29 males, 7 females; age mean = 30) were tested at 2 and 6 weeks after ACLR with knee laxity measured using the Knee Signature System arthrometer. Between tests subjects trained using either OKC or CKC resistance of their knee and hip extensors in formal physical therapy sessions three times per week. Following adjustment for site of treatment, pretraining injured knee laxity, and untreated knee laxity at post-training, the use of OKC exercise, when compared to CKC exercise, was found to lead to a 9% increase in looseness with a 95% confidence interval of -8% to +29%. These results indicate that the great concern about the safety of OKC knee extensor training in the early period after ACLR surgery may not be well founded.
对于前交叉韧带重建（ACLR）手术后正在康复的患者，使用开链运动（OKC）进行膝关节伸肌阻力训练已不再受青睐，主要是因为研究表明，与闭链运动（CKC）相比，OKC运动会导致更大的前交叉韧带应变。在这项前瞻性随机临床试验中，比较了这两种训练方式在ACLR手术后早期对膝关节松弛度的影响。对36例ACLR手术后正在康复的患者（29例男性，7例女性；平均年龄 = 30岁）在ACLR术后2周和6周进行测试，使用膝关节特征系统关节测量仪测量膝关节松弛度。在两次测试之间，受试者在正式的物理治疗课程中每周三次对其膝关节和髋关节伸肌进行OKC或CKC阻力训练。在对治疗部位、训练前受伤膝关节松弛度以及训练后未治疗膝关节松弛度进行调整后，发现与CKC运动相比，使用OKC运动导致松弛度增加9%，95%置信区间为 -8%至 +29%。这些结果表明，对ACLR手术后早期OKC膝关节伸肌训练安全性的高度关注可能没有充分依据。
