Shands Rehabilitation, UF & Shands Orthopaedics and Sports Medicine Institute.
Sports Health. 2009 Jan;1(1):47-53. doi: 10.1177/1941738108326700.
BACKGROUND: Many individuals do not resume unrestricted, preinjury sports participation after anterior cruciate ligament reconstruction, thus a better understanding of factors associated with function is needed. The purpose of this study was to investigate the association of knee impairment and psychological variables with function in subjects with anterior cruciate ligament reconstruction. HYPOTHESIS: After controlling for demographic variables, knee impairment and psychological variables contribute to function in subjects with anterior cruciate ligament reconstruction. STUDY DESIGN: Cross-sectional study; Level of evidence, 4a. METHODS: Fifty-eight subjects with a unilateral anterior cruciate ligament reconstruction completed a standardized testing battery for knee impairments (range of motion, effusion, quadriceps strength, anterior knee joint laxity, and pain intensity), kinesiophobia (shortened Tampa Scale for Kinesiophobia), and function (International Knee Documentation Committee subjective form and single-legged hop test). Separate 2-step regression analyses were conducted with International Knee Documentation Committee subjective form score and single-legged hop index as dependent variables. Demographic variables were entered into the model first, followed by knee impairment measures and Tampa Scale for Kinesiophobia score. RESULTS: A combination of pain intensity, quadriceps index, Tampa Scale for Kinesiophobia score, and flexion motion deficit contributed to the International Knee Documentation Committee subjective form score (adjusted r(2) = 0.67; P < .001). Only effusion contributed to the single-legged hop index (adjusted r(2) = 0.346; P = .002). CONCLUSION: Knee impairment and psychological variables in this study were associated with self-report of function, not a performance test. CLINICAL RELEVANCE: The results support focusing anterior cruciate ligament reconstruction rehabilitation on pain, knee motion deficits, and quadriceps strength, as well as indicate that kinesiophobia should be addressed. Further research is needed to reveal which clinical tests are associated with performance testing.
背景：许多人在前交叉韧带重建后无法恢复无限制的、受伤前的运动参与，因此需要更好地了解与功能相关的因素。本研究的目的是调查前交叉韧带重建患者的膝关节损伤和心理变量与功能的关系。
假设：在控制人口统计学变量后，膝关节损伤和心理变量对前交叉韧带重建患者的功能有贡献。
研究设计：横断面研究；证据水平，4a。
方法：58 名单侧前交叉韧带重建患者完成了膝关节损伤（关节活动度、关节积液、股四头肌力量、前膝关节松弛度和疼痛强度）、运动恐惧（缩短坦帕运动恐惧量表）和功能（国际膝关节文献委员会主观评分和单腿跳跃测试）的标准化测试组合。以国际膝关节文献委员会主观评分和单腿跳跃指数为因变量，分别进行了 2 步回归分析。首先将人口统计学变量输入模型，然后是膝关节损伤测量和坦帕运动恐惧量表评分。
结果：疼痛强度、股四头肌指数、坦帕运动恐惧量表评分和屈曲运动缺陷的组合与国际膝关节文献委员会主观评分相关（调整后的 r(2) = 0.67；P <.001）。只有关节积液对单腿跳跃指数有贡献（调整后的 r(2) = 0.346；P =.002）。
结论：本研究中的膝关节损伤和心理变量与功能的自我报告相关，而不是与表现测试相关。
临床相关性：研究结果支持将前交叉韧带重建康复的重点放在疼痛、膝关节运动缺陷和股四头肌力量上，并表明应解决运动恐惧。需要进一步的研究来揭示哪些临床测试与表现测试相关。
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