在 ACL 重建术后一年进行功能测试，以确定是否准备好停止使用支具。
Functional testing to determine readiness to discontinue brace use, one year after acl reconstruction.
作者信息
Goodstadt Noel M, Hunter-Giordano Airelle, Axe Michael J, Snyder-Mackler Lynn
机构信息
Drexel University, Philadelphia, PA, USA.
出版信息
Int J Sports Phys Ther. 2013 Apr;8(2):91-6.
BACKGROUND
While the use of functional knee braces for return to sports or high level physical activity after ACL reconstruction (ACLR) is controversial, brace use is still prevalent.(1,2,3,4,5) All active patients in the practice are braced after ACLR and must pass a battery of sports tests before they return to play in their brace. Criteria include a 90% score on 4 one-legged hop tests(9) burst superimposition strength test,(10) Knee Outcome Survey Activities of Daily Living Scale,(8) and a global rating of knee function.
PURPOSE
The purpose of this study was to describe the use of criterion-based guidelines to determine if athletes who had undergone an ACLR function better with or without their functional brace, one year after surgery.
STUDY DESIGN
Cross-Sectional Study.
METHODS
Sixty-four patients post ACLR performed 4 one-legged hop tests,(9) burst superimposition strength test,(10) and completed the Knee Outcome Survey Activities of Daily Living Scale,(8) and a global rating of knee function one year after surgery with and without their brace.
RESULTS
Participants included 35 men and 29 women with a mean age of 25 years. The Mean Knee Outcome Survey Activities of Daily Living score was 98%, and the global rating was 97%. Of the subjects, one patient failed hop testing by at least one criterion with and without the brace. Three additional patients failed the test while braced but passed un-braced, and one patient passed with the brace, but failed without the brace. Subjects performed significantly better un-braced than braced in all hop tests: single leg hop braced = 101%; un-braced = 107% (p<0.001); cross-over hop braced = 100%; un-braced = 105% (p<0.001); triple hop braced = 99%; un-braced = 101% (p=0.003); timed hop braced = 98%; un-braced = 103% (p = 0.004).
CONCLUSIONS
Sixty-two of 64 patients continued to score above return to play criteria one year after ACLR. All but two subjects in the cohort performed better un-braced than braced. Based on the criterion set for this testing session, 62/64 individuals performed well enough to discontinue use of their brace.
LEVEL OF EVIDENCE
2b.
背景
虽然在 ACL 重建术（ACLR）后使用功能性膝关节支具以恢复运动或进行高水平体育活动存在争议，但支具的使用仍然很普遍。（1,2,3,4,5）该诊所所有活跃的患者在 ACLR 后都佩戴支具，并且在佩戴支具恢复运动之前必须通过一系列运动测试。标准包括四项单腿跳测试（9）、爆发叠加力量测试（10）、膝关节结果调查日常生活量表（8）以及膝关节功能的整体评分达到 90%。
目的
本研究的目的是描述基于标准的指南的使用情况，以确定接受 ACLR 的运动员在术后一年佩戴或不佩戴功能性支具时功能是否更好。
研究设计
横断面研究。
方法
64 例 ACLR 术后患者在术后一年分别佩戴和不佩戴支具时进行了四项单腿跳测试（9）、爆发叠加力量测试（10），并完成了膝关节结果调查日常生活量表（8）以及膝关节功能的整体评分。
结果
参与者包括 35 名男性和 29 名女性，平均年龄 25 岁。膝关节结果调查日常生活量表的平均得分是 98%，整体评分为 97%。在这些受试者中，有一名患者在佩戴和不佩戴支具的情况下至少一项标准的单腿跳测试未通过。另外三名患者在佩戴支具时测试未通过，但不佩戴支具时通过了，还有一名患者佩戴支具时通过了测试，但不佩戴支具时未通过。在所有单腿跳测试中，受试者不佩戴支具时的表现明显优于佩戴支具时：单腿跳佩戴支具 = 101%；不佩戴支具 = 107%（p<0.001）；交叉跳佩戴支具 = 100%；不佩戴支具 = 105%（p<0.001）；三级跳佩戴支具 = 99%；不佩戴支具 = 101%（p = 0.003）；定时跳佩戴支具 = 98%；不佩戴支具 = 103%（p = 0.004）。
结论
64 例患者中有 62 例在 ACLR 术后一年继续达到恢复运动的标准得分。该队列中除两名受试者外，其他所有受试者不佩戴支具时的表现均优于佩戴支具时。根据本次测试设定的标准，64 人中有 62 人表现良好，足以停止使用支具。
证据级别
2b。
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