腘绳肌的动态约束能力在膝关节前交叉韧带损伤和前交叉韧带重建术后具有重要的功能意义。
Dynamic restraint capacity of the hamstring muscles has important functional implications after anterior cruciate ligament injury and anterior cruciate ligament reconstruction.
作者信息
Bryant Adam L, Creaby Mark W, Newton Robert U, Steele Julie R
机构信息
Centre for Health, Exercise and Sports Medicine, School of Physiotherapy, The University of Melbourne, Melbourne, Australia.
出版信息
Arch Phys Med Rehabil. 2008 Dec;89(12):2324-31. doi: 10.1016/j.apmr.2008.04.027.
OBJECTIVE
The purpose of this study was to investigate the relation between knee functionality of anterior cruciate ligament deficient (ACLD) and anterior cruciate ligament reconstruction (ACLR) patients and hamstring antagonist torque generated during resisted knee extension.
DESIGN
Cross-sectional.
SETTING
Laboratory based.
PARTICIPANTS
Male ACLD subjects (n=10) (18-35 y) and 27 matched males who had undergone ACLR (14 patella tendon [PT] grafts and 13 combined semitendinosus/gracilis tendon grafts).
INTERVENTIONS
Not applicable.
MAIN OUTCOME MEASURES
Knee functionality was rated (0- to 100-point scale) by using the Cincinnati Knee Rating System. Using electromyography data from the semitendinosus (ST) and biceps femoris muscles, we created a mathematical model to estimate the opposing torque generated by the hamstrings during isokinetic knee extension in 10 degrees intervals from 80 degrees to 10 degrees knee flexion.
RESULTS
Pearson product-moment correlations revealed that more functional ACLD subjects generated significantly (P<.05) higher hamstring antagonist torque throughout knee extension. In contrast, more functional PT subjects produced significantly lower hamstring antagonist torque at 80 degrees to 70 degrees knee flexion, whereas no significant associations were found between hamstring antagonist torque and knee functionality for the ST/gracilis tendon subjects.
CONCLUSIONS
An increased hamstring antagonist torque generated by the more functional ACLD subjects, reflective of increased hamstring contractile force, is thought to represent a protective mechanism to compensate for mechanical instability. The restoration of anterior knee stability through ACLR negates the need for augmented hamstring antagonist torque.
目的
本研究旨在探讨前交叉韧带损伤(ACLD)患者和前交叉韧带重建(ACLR)患者的膝关节功能与抗阻伸膝过程中腘绳肌拮抗肌扭矩之间的关系。
设计
横断面研究。
地点
基于实验室。
参与者
10名年龄在18 - 35岁的男性ACLD受试者,以及27名匹配的接受ACLR手术的男性(14例髌腱[PT]移植和13例半腱肌/股薄肌腱联合移植)。
干预措施
不适用。
主要观察指标
使用辛辛那提膝关节评分系统对膝关节功能进行评分(0至100分制)。利用半腱肌(ST)和股二头肌的肌电图数据,我们创建了一个数学模型,以估计在膝关节从80度屈曲到10度屈曲以10度间隔进行等速伸膝过程中腘绳肌产生的对抗扭矩。
结果
Pearson积差相关性分析显示,功能较好的ACLD受试者在整个伸膝过程中产生的腘绳肌拮抗肌扭矩显著更高(P <.05)。相比之下,功能较好的PT受试者在膝关节屈曲80度至70度时产生的腘绳肌拮抗肌扭矩显著更低,而对于ST/股薄肌腱受试者,腘绳肌拮抗肌扭矩与膝关节功能之间未发现显著关联。
结论
功能较好的ACLD受试者产生的腘绳肌拮抗肌扭矩增加,反映了腘绳肌收缩力增加,被认为是一种补偿机械不稳定的保护机制。通过ACLR恢复膝关节前侧稳定性消除了增加腘绳肌拮抗肌扭矩的需求。