Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, OH, United States.
Gait Posture. 2013 May;38(1):136-40. doi: 10.1016/j.gaitpost.2012.11.001. Epub 2012 Dec 7.
Postural sway is defined as the movement of a body's center of mass within the base of support to maintain postural equilibrium. Deficits in postural sway are present after ACL injury; however, current evidence linking it to future injury risk is unclear. The purpose of this study was to determine if postural sway deficits persist after ACL reconstruction (ACLR). The hypothesis tested was that after ACLR, patients who return to sport (RTS) would demonstrate differences in postural sway compared to control (CTRL) subjects. Fifty-six subjects with unilateral ACLR released to RTS, and 42 uninjured CTRL subjects participated. Dynamic postural sway was assessed and 3-way (2×2×2) ANOVA was used to analyze the variables. A side×group×sex (p=0.044) interaction in postural sway was observed. A side×group analysis also revealed an interaction (p=0.04) however, no effect of sex was observed (p=0.23). Analysis within the ACLR cohort showed less (p=0.001) postural sway on the involved side (1.82±0.84°) versus the uninvolved side (2.07±0.96°). No side-to-side differences (p=0.73) were observed in the CTRL group. The involved limb of subjects after ACLR demonstrated the least postural sway. In conclusion, these findings indicate that dynamic postural sway may be significantly altered in a population of athletes after ACLR and RTS compared to CTRL subjects. Further investigation is needed to determine if deficits in postural sway can be used as an effective criterion to assist in the decision to safely RTS after ACLR.
姿势摆动是指身体质心在支撑基础内的运动，以维持姿势平衡。ACL 损伤后存在姿势摆动缺陷；然而，将其与未来损伤风险联系起来的现有证据尚不清楚。本研究的目的是确定 ACLR 后是否存在姿势摆动缺陷。测试的假设是，ACL 重建后，重返运动（RTS）的患者与对照组（CTRL）患者相比，姿势摆动会存在差异。56 名单侧 ACLR 患者获准重返运动，42 名未受伤的对照组患者参与。评估动态姿势摆动，并使用 3 因素（2×2×2）方差分析来分析变量。观察到姿势摆动的侧×组×性别（p=0.044）交互作用。侧×组分析还显示存在交互作用（p=0.04），但未观察到性别的影响（p=0.23）。ACL 重建队列内的分析显示，患侧（1.82±0.84°）的姿势摆动明显小于健侧（2.07±0.96°）（p=0.001）。对照组中未观察到侧间差异（p=0.73）。ACL 重建后患者的患侧肢体表现出最小的姿势摆动。总之，这些发现表明，与对照组相比，ACL 重建和 RTS 后运动员群体的动态姿势摆动可能会发生显著改变。需要进一步研究以确定姿势摆动缺陷是否可以用作协助 ACLR 后安全 RTS 决策的有效标准。
