Arcamedica Institution, L’Aquila, Italy.
J Orthop Sports Phys Ther. 2012 Sep;42(9):772-80. doi: 10.2519/jospt.2012.3780. Epub 2012 Jul 19.
Descriptive, prospective, longitudinal single-cohort study.
To investigate the rate of force development to 30% (RFD(30)), 50% (RFD(50)), and 90% (RFD(90)) of maximal voluntary isometric contraction (MVIC) as an adjunct outcome measure for determining readiness for return to sport following an anterior cruciate ligament (ACL) reconstruction.
One criterion of full recovery following an ACL reconstruction is the ability to achieve 85% or 90% of the maximal strength of the contralateral limb. However, the time required to develop muscular strength in many types of daily and sports activities is considerably shorter than that required to achieve maximal strength. Therefore, in addition to maximal strength, neuromuscular functions such as RFD should also be considered in the definition of recovery.
Forty-five male professional soccer players who underwent an ACL reconstruction were recruited. Assessment with the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Tegner score, and KT1000 instrumented arthrometer was performed postinjury/prereconstruction and at 6 and 12 months after ACL reconstruction. MVIC, RFD(30), RFD(50), and RFD(90) testing was performed preinjury, as part of standard preseason assessment, and at 6 and 12 months post-ACL reconstruction.
The average MVIC value 6 months postreconstruction was 97% of the preinjury average value. In contrast, at 6 months, the RFD(30), RFD(50), and RFD(90) values were 80% (P = .04), 77% (P = .03), and 63% (P = .007), respectively, of the preinjury values. The mean RFD values for the reconstructed knee attained or exceeded 90% of the preinjury mean values only at the 12-month post-ACL reconstruction assessment (RFD(30), P = .86; RFD(50), P = .51; RFD(90), P = .56).
Despite the near recovery of MVIC strength to preinjury levels, there were still significant deficits in RFD at 6 months post-ACL reconstruction. An RFD similar to the preinjury RFD was achieved at 12 months post-ACL reconstruction, following a rehabilitation program focusing on muscle power. These results suggest that, following an ACL reconstruction, RFD criteria may be a useful adjunct outcome measure for the decision to return athletes to sports. J Orthop Sports Phys Ther 2012;42(9):772-780, Epub 19 July 2012. doi:10.2519/jospt.2012.3780.
描述性、前瞻性、纵向单队列研究。
研究在进行前交叉韧带（ACL）重建后，30%（RFD(30)）、50%（RFD(50)）和 90%（RFD(90)）最大等长收缩（MVIC）的力发展率作为确定重返运动准备状态的辅助结果测量指标。
ACL 重建后完全恢复的一个标准是能够达到对侧肢体最大力量的 85%或 90%。然而，在许多类型的日常和运动活动中，发展肌肉力量所需的时间要比达到最大力量所需的时间长得多。因此，除了最大力量外，RFD 等神经肌肉功能也应在恢复的定义中加以考虑。
招募了 45 名接受 ACL 重建的男性职业足球运动员。在受伤/重建前、ACL 重建后 6 个月和 12 个月进行国际膝关节文献委员会（IKDC）主观膝关节评估表、Tegner 评分和 KT1000 仪器关节测径器评估。MVIC、RFD(30)、RFD(50)和 RFD(90)测试在受伤前进行，作为标准赛前评估的一部分，以及 ACL 重建后 6 个月和 12 个月进行。
重建后 6 个月的平均 MVIC 值为受伤前平均水平的 97%。相比之下，在 6 个月时，RFD(30)、RFD(50)和 RFD(90)的值分别为 80%（P =.04）、77%（P =.03）和 63%（P =.007），低于受伤前的值。只有在 ACL 重建后 12 个月的评估中，重建侧的平均 RFD 值达到或超过受伤前的平均水平（RFD(30)，P =.86；RFD(50)，P =.51；RFD(90)，P =.56）。
尽管 MVIC 力量几乎恢复到受伤前的水平，但 ACL 重建后 6 个月时 RFD 仍存在显著缺陷。在专注于肌肉力量的康复计划后，在 ACL 重建后 12 个月时，达到了与受伤前相似的 RFD。这些结果表明，在 ACL 重建后，RFD 标准可能是决定运动员重返运动的有用辅助结果测量指标。《美国骨科运动物理治疗杂志》2012 年；42(9)：772-780，2012 年 7 月 19 日在线发表。doi：10.2519/jospt.2012.3780。
