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前交叉韧带重建术后的跳跃着陆力学:一项着陆误差评分系统研究。

Jump-landing mechanics after anterior cruciate ligament reconstruction: a landing error scoring system study.

作者信息

Bell David Robert, Smith Mason D, Pennuto Anthony P, Stiffler Mikel R, Olson Matthew E

机构信息

Departments of Kinesiology and Orthopedics and Rehabilitation, University of Wisconsin, Madison.

出版信息

J Athl Train. 2014 Jul-Aug;49(4):435-41. doi: 10.4085/1062-6050-49.3.21. Epub 2014 Jun 6.

Abstract

CONTEXT

The Landing Error Scoring System (LESS) is a clinical evaluation of jump-landing mechanics and may provide useful information in assisting with return-to-sport decisions in patients after anterior cruciate ligament reconstruction (ACLR). However, it is currently unknown how patients with ACLR perform on the LESS compared with healthy controls.

OBJECTIVE

To determine if the total LESS score differed between individuals with ACLR and healthy controls and to determine the types of errors that differ between groups.

DESIGN

Cross-sectional study.

SETTING

Research laboratory.

PATIENTS OR OTHER PARTICIPANTS

A total of 27 individuals with unilateral ACLR (age = 19.8 ± 1.8 years, height = 170 ± 5.5 cm, mass = 68.8 ± 11.9 kg) and 27 controls (age = 20.5 ± 1.7 years, height = 169 ± 8.4 cm, mass = 66.6 ± 9.0 kg) with no history of ACLR.

INTERVENTION(S): Each participant completed 3 trials of a standardized jump-landing task.

MAIN OUTCOME MEASURE(S): Each jump landing was assessed for specific postures using standardized LESS criteria by a blinded evaluator. Individual LESS items were summed to create a total LESS score. The dominant limb was assessed in the control group, and the reconstructed limb was assessed in the ACLR group.

RESULTS

The ACLR group had higher LESS scores compared with controls (ACLR: 6.7 ± 2.1 errors, control: 5.6 ± 1.5 errors, P = .04). Additionally, the ACLR group was more likely to err when landing with lateral trunk flexion (Fisher exact test, P = .002).

CONCLUSIONS

Individuals with ACLR had worse landing mechanics as measured by the LESS. Lateral trunk deviation may be related to quadriceps avoidance in the reconstructed limb or poor trunk neuromuscular control. The LESS is useful for evaluating landing errors in patients with ACLR and may help to identify areas of focus during rehabilitation and before return to sport.

摘要

背景

落地误差评分系统(LESS)是对跳跃落地力学的临床评估,可能为协助前交叉韧带重建(ACLR)术后患者恢复运动的决策提供有用信息。然而,目前尚不清楚与健康对照组相比,ACLR患者在LESS上的表现如何。

目的

确定ACLR患者与健康对照组之间的LESS总分是否存在差异,并确定两组之间存在差异的错误类型。

设计

横断面研究。

地点

研究实验室。

患者或其他参与者

共有27名单侧ACLR患者(年龄=19.8±1.8岁,身高=170±5.5厘米,体重=68.8±11.9千克)和27名无ACLR病史的对照组(年龄=20.5±1.7岁,身高=169±8.4厘米,体重=66.6±9.0千克)。

干预措施

每位参与者完成3次标准化跳跃落地任务的试验。

主要观察指标

由一名不知情的评估者使用标准化的LESS标准对每次跳跃落地的特定姿势进行评估。将各个LESS项目相加得出LESS总分。对照组评估优势肢体,ACLR组评估重建肢体。

结果

与对照组相比,ACLR组的LESS得分更高(ACLR组:6.7±2.1个错误,对照组:5.6±1.5个错误,P = 0.04)。此外,ACLR组在侧躯干屈曲落地时更易出错(Fisher精确检验,P = 0.002)。

结论

以LESS衡量,ACLR患者的落地力学较差。侧躯干偏差可能与重建肢体的股四头肌规避或躯干神经肌肉控制不佳有关。LESS有助于评估ACLR患者的落地误差,并可能有助于确定康复期间和恢复运动前的关注重点。

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