University of Delaware Department of Physical Therapy, 301 McKinly Lab, Newark, DE 19716, USA.
J Biomech. 2011 Jul 7;44(10):1948-53. doi: 10.1016/j.jbiomech.2011.04.037. Epub 2011 May 17.
The anterior cruciate ligament (ACL) is the most commonly-injured knee ligament during sporting activities. After injury, most individuals experience episodes of the knee giving way during daily activities (non-copers). Non-copers demonstrate asymmetrical quadriceps strength and movement patterns, which could have long-term deleterious effects on the integrity of the knee joint. The purpose of this study was to determine if non-copers resolve their strength and movement asymmetries within two years after surgery. 26 Non-copers were recruited to undergo pre-operative quadriceps strength testing and 3-dimensional gait analysis. Subjects underwent surgery to reconstruct the ligament followed by physical therapy focused on restoring normal range of motion, quadriceps strength, and function. Subjects returned for quadriceps strength testing and gait analysis six months and two years after surgery. Acutely after injury, quadriceps strength was asymmetric between limbs, but resolved six months after surgery. Asymmetric knee angles, knee moments, and knee and hip power profiles were also observed acutely after injury and persisted six months after surgery despite subjects achieving symmetrical quadriceps strength. Two years after surgery, quadriceps strength in the involved limb continued to improve and most kinematic and kinetic asymmetries resolved. These findings suggest that adequate quadriceps strength does not immediately resolve gait asymmetries in non-copers. They also suggest that non-copers have the capacity to improve their quadriceps strength and gait symmetry long after ACL reconstruction.
前交叉韧带（ACL）是运动中最常受伤的膝关节韧带。受伤后，大多数人在日常活动中（非适应者）会出现膝关节不稳定的情况。非适应者表现出股四头肌力量和运动模式的不对称性，这可能对膝关节的完整性产生长期的有害影响。本研究旨在确定非适应者在手术后两年内是否能够解决其力量和运动的不对称性。招募了 26 名非适应者进行术前股四头肌力量测试和三维步态分析。研究对象接受了重建韧带的手术，随后进行了物理治疗，重点是恢复正常的活动范围、股四头肌力量和功能。研究对象在手术后 6 个月和 2 年时返回进行股四头肌力量测试和步态分析。在受伤后，股四头肌力量在肢体之间是不对称的，但在手术后 6 个月得到了恢复。在受伤后也观察到膝关节角度、膝关节力矩以及膝关节和髋关节功率谱的不对称性，尽管研究对象实现了股四头肌力量的对称，但这些不对称性在手术后 6 个月仍持续存在。手术后 2 年，受累肢体的股四头肌力量继续改善，大多数运动学和动力学的不对称性得到了缓解。这些发现表明，足够的股四头肌力量并不能立即解决非适应者的步态不对称性。它们还表明，非适应者在 ACL 重建后很长时间内都有能力提高其股四头肌力量和步态对称性。
