Curry School of Education, University of Virginia, Charlottesville, VA 22903.
J Athl Train. 1998 Jul;33(3):233-7.
Clinicians may obtain false-negative Lachman tests for tibial displacement when the trunk position of the athlete varies as the anterior cruciate ligament injury is assessed on the field, on the sideline, and in the clinic. We examined the influence of supine, semireclined, and sitting trunk positions on arthrometric laxity measurements of the knee.
Subjects in the 3 trunk-thigh test positions (15 degrees , 45 degrees , and 90 degrees of hip flexion) were passively supported and tested in a counterbalanced order. The right knee was maintained at 29.0 degrees +/- 3.1 degrees of flexion. A 133-N (30-1b) anterior force was applied to the right knee using a modified KT-1000 knee arthrometer equipped with a strain gauge that allowed for digital display of the displacement force.
Ten males and 5 females without present knee injury or history of knee ligament repair to the right lower extremity.
Three tibial displacement (mm) trials at each trunk position were averaged and used for analysis.
A 1-factor (trunk-thigh position) repeated-measures analysis of variance revealed no significant difference in anterior tibial displacement values among the 3 trunk-thigh positions (P > .05). Group means for displacement were 7.9 +/- 2.3 mm (supine), 8.1 +/- 2.5 mm (semireclined), and 8.3 +/- 2.6 mm (sitting).
These findings suggest that alterations in trunk position are not a problem in the instrumented assessment of anterior tibial displacement in an uninjured population. Further research should determine the relevance of these findings, as well as "end-feel" (ie, stiffness) in subjects with injury to the anterior cruciate ligament. Further research should also determine if these findings can be applied when comparing passive versus active (eg, propped on elbows or hands) trunk support in subjects with anterior cruciate ligament-injured knees.
当运动员的躯干位置在场上、场边和诊所评估前交叉韧带损伤时发生变化时，临床医生可能会对胫骨位移获得假阴性的拉赫曼试验。我们研究了仰卧、半倾斜和坐姿躯干位置对膝关节关节测量松弛度的影响。
在 3 种躯干-大腿测试位置（15 度、45 度和 90 度髋关节屈曲）中，受试者被动支撑并以平衡的顺序进行测试。右膝保持在 29.0 度 +/- 3.1 度的屈曲。使用配备应变计的改良 KT-1000 膝关节关节测量仪对右膝施加 133-N（30-1b）的前向力，该应变计允许数字显示位移力。
10 名男性和 5 名女性，右下肢无当前膝关节损伤或膝关节韧带修复史。
在每个躯干位置进行 3 次胫骨位移（mm）试验，取平均值进行分析。
1 因素（躯干-大腿位置）重复测量方差分析显示，3 种躯干-大腿位置的胫骨前位移值无显著差异（P >.05）。位移的组平均值分别为 7.9 +/- 2.3 毫米（仰卧位）、8.1 +/- 2.5 毫米（半倾斜位）和 8.3 +/- 2.6 毫米（坐位）。
这些发现表明，在未受伤人群中，对胫骨前位移的仪器评估中，躯干位置的改变不是问题。进一步的研究应确定这些发现以及“末端感觉”（即僵硬）在患有前交叉韧带损伤的受试者中的相关性。进一步的研究还应确定这些发现是否可用于比较前交叉韧带损伤膝关节受试者的被动与主动（例如，肘部或手支撑）躯干支撑。
