Chmielewski Terese L, Hurd Wendy J, Rudolph Katherine S, Axe Michael J, Snyder-Mackler Lynn
Department of Physical Therapy, University of Florida, Gainsville, FL, USA.
Phys Ther. 2005 Aug;85(8):740-9; discussion 750-4.
Dynamic knee stabilization strategies of people who successfully compensate for the absence of an anterior cruciate ligament (ACL) ("copers") are different from those of people who do not compensate well for the injury ("noncopers"). Early after injury, certain patients ("potential copers") can increase the likelihood of successfully compensating for the injury by participating in 10 sessions of perturbation training. The purpose of this study was to determine how perturbation training alters muscle co-contraction and knee kinematics in potential copers.
Seventeen individuals with acute, unilateral ACL rupture who were categorized as potential copers and 17 subjects without injuries who were matched by age, sex, and activity level were recruited for this study.
Motion analysis and electromyographic data were collected as subjects walked across a stationary or moving platform (horizontal translation) before and after perturbation training.
Before training, potential copers had higher co-contraction indexes and lower peak knee flexion angles than subjects without injuries. After training, potential copers' movement patterns more closely resembled those of subjects without injuries (ie, they showed reduced co-contraction indexes and increased peak knee flexion angles during stance).
Perturbation training reduced quadriceps femoris-hamstring muscle and quadriceps femoris-gastrocnemius muscle co-contractions and normalized knee kinematics in individuals with ACL rupture who were classified as potential copers. Findings from this study provide evidence for a mechanism by which perturbation training acts as an effective intervention for promoting coordinated muscle activity in a select population of people with ACL rupture.
成功代偿前交叉韧带(ACL)缺失的人群(“代偿者”)的动态膝关节稳定策略与代偿不佳的人群(“非代偿者”)不同。在受伤后早期,某些患者(“潜在代偿者”)通过参加10次扰动训练可增加成功代偿损伤的可能性。本研究的目的是确定扰动训练如何改变潜在代偿者的肌肉协同收缩和膝关节运动学。
本研究招募了17名急性单侧ACL断裂且被归类为潜在代偿者的个体,以及17名年龄、性别和活动水平相匹配的未受伤受试者。
在扰动训练前后,当受试者走过固定或移动平台(水平平移)时,收集运动分析和肌电图数据。
训练前,潜在代偿者的协同收缩指数较高,膝关节屈曲峰值角度低于未受伤的受试者。训练后,潜在代偿者的运动模式更接近未受伤的受试者(即,他们在站立期的协同收缩指数降低,膝关节屈曲峰值角度增加)。
扰动训练减少了股四头肌 - 腘绳肌以及股四头肌 - 腓肠肌的协同收缩,并使被归类为潜在代偿者的ACL断裂个体的膝关节运动学正常化。本研究结果为扰动训练作为一种有效干预措施促进特定ACL断裂人群的肌肉协调活动提供了机制证据。