Dauty Marc, Collon Sylvie, Dubois Charles
CHU Nantes, Hôpital Saint Jacques, Pôle MPR, Nantes Cedex, France.
Clin Physiol Funct Imaging. 2010 May;30(3):187-91. doi: 10.1111/j.1475-097X.2010.00926.x. Epub 2010 Mar 16.
The aim of this study was to compare statical postures of a knee anterior cruciate ligament reconstruction (ACLR) population with a healthy control population. Thirty-five patients (age 25.5 +/- 5.8 years) were compared at 15 days after an anterior cruciate ligament reconstruction with 35 healthy, age and sex-matched subjects. Bilateral and unilateral postures were studied according to various stances, knee extension and 20 degrees knee flexion with opened and closed eyes, using a stabilometric platform. A comparison with the non-ACLR limb and the healthy limbs of the control population was carried out. The ACLR subjects present with the following: (i) a significant change in two-legged stance, i.e. distances covered by the centre of pressure projection are significantly increased; (ii) a postural alteration during the ACLR one-legged stance with knee extension and opened eyes in comparison with the non-ACLR limb; (iii) an incapacity for certain ACLR subjects to perform one-legged stance on the non-ACLR limb when there is no visual compensation. Only 11.4% (95% CI: 0.9-21.9%) and 42.8% (95% CI: 26.3-59.3%) of ACLR subjects are capable of maintaining correctly a one-legged stance posture with closed eyes on both sides (knee extension and flexion, respectively). The identification of the ACLR knee limb is possible from the one-legged stance postural test in knee extension and opened eyes condition. Because of a change in two-legged balance and of the incapacity for certain ACLR subjects to maintain one-legged stance with closed eyes, a central origin explaining the abnormalities of postural control is suggested.
本研究的目的是比较膝关节前交叉韧带重建（ACLR）人群与健康对照人群的静态姿势。35例患者（年龄25.5±5.8岁）在进行前交叉韧带重建术后15天与35名年龄、性别匹配的健康受试者进行比较。使用稳定测力平台，根据各种站立姿势、膝关节伸展以及睁眼和闭眼时膝关节20度屈曲情况，研究双侧和单侧姿势。对ACLR人群的非手术肢体与对照人群的健康肢体进行了比较。ACLR受试者表现出以下情况：（i）双脚站立时显著变化，即压力中心投影覆盖的距离显著增加；（ii）与非ACLR肢体相比，ACLR单腿站立且膝关节伸展并睁眼时姿势改变；（iii）部分ACLR受试者在没有视觉补偿时无法在非ACLR肢体上进行单腿站立。只有11.4%（95%CI：0.9 - 21.9%）和42.8%（95%CI：26.3 - 59.3%）的ACLR受试者能够分别在双侧闭眼（膝关节伸展和屈曲）时正确保持单腿站立姿势。在膝关节伸展且睁眼的条件下，通过单腿站立姿势测试可以识别ACLR膝关节所在肢体。由于双腿平衡的改变以及部分ACLR受试者无法在闭眼时保持单腿站立，提示存在一个解释姿势控制异常的中枢起源。
