在接受前交叉韧带重建手术的患者中，术前股四头肌激活与术后激活相关，而非与力量相关。
Pre-operative quadriceps activation is related to post-operative activation, not strength, in patients post-ACL reconstruction.
作者信息
Lepley Lindsey K, Palmieri-Smith Riann M
机构信息
Department of Rehabilitation Sciences, University of Kentucky, Lexington, KY, USA.
School of Kinesiology, University of Michigan, 4745G Central Campus Recreational Building, 401 Washtenaw Ave., Ann Arbor, MI, 48109, USA.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2016 Jan;24(1):236-46. doi: 10.1007/s00167-014-3371-0. Epub 2014 Oct 15.
PURPOSE
Quadriceps activation failure is considered to contribute to the weakness that lingers following anterior cruciate ligament (ACL) reconstruction. Importantly, the impact of pre-operative quadriceps activation on post-operative quadriceps function is unknown. Understanding this relationship is clinically important; as the counteractive approach clinicians should employ pre-operatively to mitigate post-operative quadriceps weakness is unclear. Accordingly, the primary purpose of this study was to investigate the relationship between pre-operative quadriceps activation and post-operative quadriceps strength and activation.
METHODS
Fifty-four individuals post-ACL injury reported for testing on two occasions: prior to surgery and post-surgery once they returned to activity. Quadriceps activation was assessed using the burst superimposition technique and quantified using the central activation ratio. Quadriceps strength was assessed using isometric contractions that were performed at 90° of knee flexion. Multiple linear regressions were utilized to detect the relationships between pre-operative activation and strength and post-operative activation and strength.
RESULTS
Pre-operative activation was not associated with post-operative strength (R(2) = 0.064, P = 0.186). Pre-operative quadriceps activation and strength were associated with post-operative activation (R(2) = 0.383, P ≤ 0.001) and strength (R(2) = 0.465, P ≤ 0.001), respectively.
CONCLUSIONS
Individuals with better pre-operative quadriceps activation demonstrated greater post-operative activation. Similarly, individuals with better pre-operative strength demonstrated better post-operative strength. Pre-operative quadriceps activation was not a predictor of post-operative strength. From a clinical perspective, our work indicates that clinicians should utilize therapies targeting both quadriceps activation and strength prior to ACL reconstruction in order to maximize these factors post-ACL reconstruction, as pre-operative activation and strength are related to post-operative activation and strength, respectively at return-to-activity.
目的
股四头肌激活失败被认为是导致前交叉韧带（ACL）重建后持续存在的肌肉无力的原因。重要的是，术前股四头肌激活对术后股四头肌功能的影响尚不清楚。了解这种关系具有临床重要性；因为临床医生术前应采用何种对抗方法来减轻术后股四头肌无力尚不清楚。因此，本研究的主要目的是探讨术前股四头肌激活与术后股四头肌力量及激活之间的关系。
方法
54例ACL损伤患者分两次接受测试：手术前以及术后恢复活动时。使用爆发叠加技术评估股四头肌激活情况，并通过中枢激活率进行量化。在膝关节屈曲90°时进行等长收缩来评估股四头肌力量。采用多元线性回归来检测术前激活与力量以及术后激活与力量之间的关系。
结果
术前激活与术后力量无关（R² = 0.064，P = 0.186）。术前股四头肌激活和力量分别与术后激活（R² = 0.383，P≤0.001）和力量（R² = 0.465，P≤0.001）相关。
结论
术前股四头肌激活较好的个体术后激活程度更高。同样，术前力量较好的个体术后力量也更好。术前股四头肌激活不是术后力量的预测指标。从临床角度来看，我们的研究表明，临床医生在ACL重建术前应采用针对股四头肌激活和力量的治疗方法，以便在ACL重建术后使这些因素最大化，因为术前激活和力量分别与恢复活动时的术后激活和力量相关。
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