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前交叉韧带重建术后 5 周康复训练中胫骨平移和肌肉激活情况

Tibial translation and muscle activation during rehabilitation exercises 5 weeks after anterior cruciate ligament reconstruction.

机构信息

Department of Medical and Health Sciences, Division of Physiotherapy, Linköping, Sweden.

出版信息

Scand J Med Sci Sports. 2010 Feb;20(1):154-64. doi: 10.1111/j.1600-0838.2009.00903.x.

Abstract

The aim of this study was to compare different rehabilitation exercises with respect to dynamic anterior tibial translation and muscle activation 5 weeks after an anterior cruciate ligament (ACL) reconstruction. Another aim was to compare the ACL-reconstructed knee with the ACL-injured and the uninjured knees for differences in anterior tibial translation and muscle activation during the exercises. Sagittal tibial translation and muscle activation were measured during the Lachman test (static translation) and during seven rehabilitation exercises (dynamic translation) in 19 patients. Results obtained 5 weeks after ACL reconstruction were compared with those obtained before the ACL reconstruction (ACL-deficient and uninjured knee). After ACL reconstruction the seated knee extension produced more anterior tibial translation than the straight leg raise and standing on one leg. The ACL reconstruction reduced the static and the dynamic tibial translation and the tibial translations measured in ACL-reconstructed knees were similar to those measured in uninjured knees. After ACL reconstruction, the patients used a joint stiffening strategy that used more hamstring activation and reduced the dynamic tibial translation. Although all exercises tested are suitable for rehabilitation after ACL reconstruction, to protect the graft from excessive strain, the straight leg raise and squat on one leg are preferable for quadriceps training in the early phase of rehabilitation.

摘要

本研究旨在比较不同的康复训练方法在 ACL 重建后 5 周时对胫骨前向动态平移和肌肉激活的影响。此外,本研究还旨在比较 ACL 重建膝关节与 ACL 损伤和未损伤膝关节在这些运动中胫骨前向平移和肌肉激活的差异。19 名患者在进行 Lachman 试验(静态平移)和 7 项康复训练(动态平移)时测量了矢状面胫骨平移和肌肉激活。ACL 重建 5 周后获得的结果与 ACL 缺失(ACL 损伤和未损伤膝关节)时获得的结果进行了比较。ACL 重建后,坐位伸膝比直腿抬高和单腿站立产生更大的胫骨前向平移。ACL 重建减少了静态和动态胫骨平移,ACL 重建膝关节测量的胫骨平移与未损伤膝关节相似。ACL 重建后,患者采用了一种关节僵硬策略,增加了腘绳肌的激活,减少了动态胫骨平移。尽管所有测试的运动都适合 ACL 重建后的康复,但为了防止移植物过度受力,在康复的早期阶段,直腿抬高和单腿蹲起更适合股四头肌训练。

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