解释 ACL 重建后慢性膝关节伸肌力量缺陷的因素。

Factors explaining chronic knee extensor strength deficits after ACL reconstruction.

机构信息

Searle Laboratory, Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, Illinois, USA.

出版信息

J Orthop Res. 2011 May;29(5):633-40. doi: 10.1002/jor.21316. Epub 2011 Jan 18.

Abstract

Persistent quadriceps muscle weakness is common after anterior cruciate ligament (ACL) reconstruction. The mechanisms underlying these chronic strength deficits are not clear. This study examined quadriceps strength in people 2-15 years post-ACL reconstruction and tested the hypothesis that chronic quadriceps weakness is related to levels of voluntary quadriceps muscle activation, antagonistic hamstrings moment, and peripheral changes in muscle. Knee extensor strength and activation were evaluated in 15 ACL reconstructed and 15 matched uninjured control subjects using an interpolated triplet technique. Electrically evoked contractile properties were used to evaluate peripheral adaptations in the quadriceps muscle. Antagonistic hamstrings moments were predicted using a practical mathematical model. Knee extensor strength and evoked torque at rest were significantly lower in the reconstructed legs (p < 0.05). Voluntary activation and antagonistic hamstrings activity were similar across legs and between groups (p > 0.05). Regression analyses indicated that side-to-side differences in evoked torque at rest explained 71% of the knee extensor strength differences by side (p < 0.001). Voluntary activation and antagonistic hamstrings moment did not contribute significantly (p > 0.05). Chronic quadriceps weakness in this sample was primarily related to peripheral changes in the quadriceps muscle, not to levels of voluntary activation or antagonistic hamstrings activity.

摘要

前交叉韧带(ACL)重建后,股四头肌持续无力很常见。这些慢性力量缺陷的机制尚不清楚。本研究检查了 ACL 重建后 2-15 年人群的股四头肌力量,并验证了以下假设:慢性股四头肌无力与自愿性股四头肌肌肉激活水平、拮抗腘绳肌力矩和肌肉的外周变化有关。使用插值三重技术评估了 15 名 ACL 重建患者和 15 名匹配的未受伤对照组的膝关节伸肌力量和激活情况。使用实用的数学模型预测拮抗腘绳肌力矩。在重建腿中,膝关节伸肌力量和静息时的电诱发扭矩明显较低(p < 0.05)。自愿激活和拮抗腘绳肌活动在两腿之间和两组之间相似(p > 0.05)。回归分析表明,静息时电诱发扭矩的双侧差异解释了 71%的膝关节伸肌力量差异(p < 0.001)。自愿激活和拮抗腘绳肌力矩的贡献不显著(p > 0.05)。该样本中的慢性股四头肌无力主要与股四头肌的外周变化有关,而与自愿激活或拮抗腘绳肌活动水平无关。

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