Dauty M, Huguet D, Tortellier L, Potiron-Josse M, Dubois C
Pôle de MPR et médecine du sport, hôpital Saint-Jacques, CHU de Nantes, 44035 Nantes cedex 01, France.
Ann Readapt Med Phys. 2006 Jun;49(5):218-25. doi: 10.1016/j.annrmp.2006.03.006. Epub 2006 Apr 17.
To study the effect of cycling or running retraining between 4 and 6 months after patients underwent anterior cruciate ligament reconstruction with hamstring grafting (Semitendinosus-Gracilis) compared with that in patients who had the same surgery but were untrained.
Patients who had undergone surgery for an anterior cruciate ligament reconstruction by the same surgeon who used hamstring grafting were included if they were free of knee pain 4 months after the surgery. After giving consent, patients were randomized to receive controlled retraining (cycling or running 3 times a week) or not. The effect of retraining was measured by the evolution of the knee isokinetic peak torque at 60 degrees/s and 180 degrees/s 6 months after surgery.
Fifteen patients were retrained with cycling (GI), 17 with running (GII) and 15 patients did not retrain (GIII). Before retraining, the 3 groups had the same peak torque deficit, measured at an angular speed of 60 degrees/s and 180 degrees/s, for knee extensors (GI: 33+/-11% and 27+/-8%; GII: 30+/-13% and 24+/-10%; GIII: 31+/-15% and 24+/-13%, respectively) and knee flexors (GI: 26+/-11% and 20+/-13%; GII: 20+/-14% and 17+/-13%; GIII: 19+/-15% and 14+/-15%, respectively). After retraining, progress measured at 60 degrees /s of knee extensors and flexors on the operated knees was 18+/-9% and 16+/-10% for GI, 16+/-9% and 11+/-11% for GII and 12+/-15% and 8+/-12 for GIII, respectively. Progress measured at 180 degrees /s followed the same evolution. After comparison of the 3 groups, any significant difference was put in relief according to the type of retraining.
Retraining after anterior cruciate ligament reconstruction is necessary for patients to practice their previous sport. In our study, aerobic cycling or running between 4 and 6 months after surgery did not improve peak torque in the operated knee extensors and flexors. However, these 2 types of retraining are well-tolerated.
研究在接受腘绳肌肌腱移植（半腱肌-股薄肌）重建前交叉韧带的患者术后4至6个月进行骑自行车或跑步再训练的效果，并与接受相同手术但未进行训练的患者进行比较。
纳入由同一位使用腘绳肌肌腱移植进行前交叉韧带重建手术的外科医生实施手术且术后4个月无膝关节疼痛的患者。在获得患者同意后，将患者随机分为接受控制性再训练组（每周骑自行车或跑步3次）或不接受再训练组。通过测量术后6个月时膝关节在60度/秒和180度/秒时等速峰值扭矩的变化来评估再训练的效果。
15例患者接受骑自行车再训练（第一组），17例接受跑步再训练（第二组），15例未接受再训练（第三组）。再训练前，三组在60度/秒和180度/秒角速度下测量的膝关节伸肌（第一组：分别为33±11%和27±8%；第二组：30±13%和24±10%；第三组：31±15%和24±13%）和屈肌（第一组：分别为26±11%和20±13%；第二组：20±14%和17±13%；第三组：19±15%和14±15%）的峰值扭矩 deficit相同。再训练后，第一组手术侧膝关节伸肌和屈肌在60度/秒时的进展分别为18±9%和16±10%，第二组为16±9%和11±11%，第三组为12±15%和8±12%。在180度/秒时测量的进展情况也呈现相同变化趋势。对三组进行比较后，未发现根据再训练类型存在任何显著差异。
前交叉韧带重建术后进行再训练对于患者恢复之前的运动是必要的。在我们的研究中，术后4至6个月进行有氧骑自行车或跑步训练并未改善手术侧膝关节伸肌和屈肌的峰值扭矩。然而，这两种再训练方式耐受性良好。
