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前交叉韧带重建术后活动范围减小患者在步态中胫股关节前向滑动对膝关节伸展的影响

Effect of Anterior Tibiofemoral Glides on Knee Extension during Gait in Patients with Decreased Range of Motion after Anterior Cruciate Ligament Reconstruction.

作者信息

Hunt Michael A, Di Ciacca Stephen R, Jones Ian C, Padfield Beverley, Birmingham Trevor B

机构信息

Michael A. Hunt, MPT, PhD: Assistant Professor, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia.

出版信息

Physiother Can. 2010 Summer;62(3):235-41. doi: 10.3138/physio.62.3.235. Epub 2010 Jul 23.

Abstract

PURPOSE

The purpose of this preliminary investigation was to evaluate the effect of anterior tibiofemoral glides on maximal knee extension and selected spatiotemporal characteristics during gait in patients with knee extension deficits after anterior cruciate ligament (ACL) reconstruction.

METHODS

Twelve patients with knee-extension deficits after recent ACL reconstructions underwent quantitative gait analyses immediately before and after 10 minutes of repeated anterior tibiofemoral glides on the operative limb, and again after a 10-minute seated rest period.

RESULTS

Maximum knee extension during stance phase of the operative limb significantly increased immediately after the treatment (mean increase: 2.0°±4.1°, 95% CI: 0.6°-3.3°). Maximum knee extension decreased after the 10-minute rest period (mean decrease: 0.9°±1.8°, 95% CI: -0.1°-1.8°), although the decrease was not statistically significant. Small increases in operative limb step length, stride length, and gait speed were observed after the rest period compared to baseline values only.

CONCLUSIONS

A single session of anterior tibiofemoral glides increases maximal knee extension during the stance phase of gait in patients with knee-extension deficits. Increases in knee extension are small and short-lived, however, suggesting that continued activity is required to maintain the observed improvements.

摘要

目的

本初步研究的目的是评估在前交叉韧带(ACL)重建术后存在膝关节伸展功能障碍的患者中,胫股关节前向滑动对最大膝关节伸展度以及步态中选定的时空特征的影响。

方法

12例近期接受ACL重建术后存在膝关节伸展功能障碍的患者,在对手术肢体进行10分钟重复胫股关节前向滑动之前和之后立即进行定量步态分析,并在10分钟坐位休息后再次进行分析。

结果

治疗后,手术肢体站立期的最大膝关节伸展度立即显著增加(平均增加:2.0°±4.1°,95%可信区间:0.6°-3.3°)。10分钟休息期后,最大膝关节伸展度有所下降(平均下降:0.9°±1.8°,95%可信区间:-0.1°-1.8°),尽管这种下降没有统计学意义。与基线值相比,仅在休息期后观察到手术肢体步长、步幅和步态速度有小幅增加。

结论

单次胫股关节前向滑动可增加存在膝关节伸展功能障碍患者步态站立期的最大膝关节伸展度。然而,膝关节伸展度的增加幅度小且持续时间短,这表明需要持续活动以维持所观察到的改善效果。

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本文引用的文献

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Gait patterns before and after anterior cruciate ligament reconstruction.前交叉韧带重建前后的步态模式。
Knee Surg Sports Traumatol Arthrosc. 2004 Jan;12(1):7-14. doi: 10.1007/s00167-003-0440-1. Epub 2003 Oct 29.
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Gait mechanics in chronic ACL deficiency and subsequent repair.慢性前交叉韧带损伤及其修复后的步态力学
Clin Biomech (Bristol). 2002 May;17(4):274-85. doi: 10.1016/s0268-0033(02)00016-5.

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