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竞技运动员前交叉韧带重建后与对照组的静态和动态姿势控制。

Static and dynamic postural control in competitive athletes after anterior cruciate ligament reconstruction and controls.

机构信息

Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Koodakyar St, Daneshjou Blvd, Evin, Tehran, Iran.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2012 Aug;20(8):1603-10. doi: 10.1007/s00167-011-1806-4. Epub 2011 Nov 29.

Abstract

PURPOSE

To evaluate the test-retest reliability and compare the static and dynamic postural control values in competitive athletes following anterior cruciate ligament (ACL) reconstruction and controls.

METHODS

Thirty athletes, 8.4 ± 1.8 months after ACL reconstruction, and thirty healthy matched controls were asked to execute single-leg stance and single-legged drop jump tests onto a force plate. Amplitude and velocity in anteroposterior and mediolateral directions, and mean total velocity were measured for static evaluation. Peak vertical ground reaction force (PVGRF) during landing and takeoff and loading rate were measured for dynamic evaluation. To evaluate test-retest reliability, 15 participants of each group repeated the tests 6-8 days after the first session. Mixed model of analysis of variance was used to determine differences between the involved, uninvolved, and control limbs. The test-retest reliability was measured using intraclass correlation coefficient and standard error of measurement.

RESULTS

Greater postural sway has been observed in the operated leg of ACL-reconstructed athletes compared with the non-operated side (P < 0.01) and the matched limb of the control group (P < 0.01). During landing, PVGRF and loading rate on the uninvolved limb of the athletes who had undergone ACL reconstruction were greater in comparison with those of the control group (P < 0.001). Both static and dynamic postural measures have high test-retest reliability, ranging from 0.73 to 0.88.

CONCLUSIONS

Static and dynamic postural measures are reliable tests to evaluate functional performance of athletes following ACL reconstruction. Eight months postsurgery, competitive athletes still demonstrated postural asymmetries, compared to matched controls, which might result in their susceptibility to future ACL injury.

LEVEL OF EVIDENCE

Prognostic study, case-control, Level III.

摘要

目的

评估前交叉韧带(ACL)重建后竞技运动员的测试-重测信度,并比较其静态和动态姿势控制值与对照组的差异。

方法

招募 30 名 ACL 重建后 8.4±1.8 个月的运动员和 30 名健康匹配的对照组,让他们在测力板上执行单腿站立和单腿跳落测试。测量静态评估的前后和左右方向的振幅和速度,以及平均总速度。测量动态评估的落地和离地时的垂直地面反作用力峰值(PVGRF)和加载率。为了评估测试-重测信度,每组有 15 名参与者在第一次测试后 6-8 天重复测试。采用混合模型方差分析来确定实验组、对照组和未受伤组之间的差异。使用组内相关系数和测量标准误差来评估测试-重测信度。

结果

与未受伤侧(P<0.01)和对照组的匹配肢体(P<0.01)相比,ACL 重建运动员的手术侧的姿势摆动更大。与对照组相比,ACL 重建运动员未受伤侧的落地时的 PVGRF 和加载率更大(P<0.001)。静态和动态姿势测量均具有较高的测试-重测信度,范围为 0.73 至 0.88。

结论

静态和动态姿势测量是评估 ACL 重建后运动员功能表现的可靠测试。手术后 8 个月,与匹配的对照组相比,竞技运动员仍表现出姿势不对称,这可能导致他们易受未来 ACL 损伤的影响。

证据等级

预后研究、病例对照、III 级。

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