Tengman E, Grip H, Stensdotter Ak, Häger C K
Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
Faculty of Health Education and Social Work, Physiotherapy, Sør-Trøndelag University College, Trondheim, Norway.
Scand J Med Sci Sports. 2015 Dec;25(6):818-27. doi: 10.1111/sms.12434. Epub 2015 Feb 28.
Reduced dynamic knee stability, often evaluated with one-leg hops (OLHs), is reported after anterior cruciate ligament (ACL) injury. This may lead to long-standing altered movement patterns, which are less investigated. 3D kinematics during OLH were explored in 70 persons 23 ± 2 years after ACL injury; 33 were treated with physiotherapy in combination with ACL reconstruction (ACL(R)) and 37 with physiotherapy alone (ACL(PT)). Comparisons were made to 33 matched controls. We analyzed (a) maximal knee joint angles and range of motion (flexion, abduction, rotation); (b) medio-lateral position of the center of mass (COM) in relation to knee and ankle joint centers, during take-off and landing phases. Unlike controls, ACL-injured displayed leg asymmetries: less knee flexion and less internal rotation at take-off and landing and more lateral COM related to knee and ankle joint of the injured leg at landing. Compared to controls, ACL(R) had larger external rotation of the injured leg at landing. ACL(PT) showed less knee flexion and larger external rotation at take-off and landing, and larger knee abduction at Landing. COM was more medial in relation to the knee at take-off and less laterally placed relative to the ankle at landing. ACL injury results in long-term kinematic alterations during OLH, which are less evident for ACL(R).
据报道，前交叉韧带（ACL）损伤后，动态膝关节稳定性会降低，通常通过单腿跳（OLH）来评估。这可能会导致长期的运动模式改变，但对此研究较少。对70名ACL损伤后23±2岁的患者进行了OLH期间的三维运动学研究；其中33人接受了物理治疗并结合ACL重建（ACL(R)），37人仅接受了物理治疗（ACL(PT)）。并与33名匹配的对照组进行了比较。我们分析了：（a）最大膝关节角度和运动范围（屈曲、外展、旋转）；（b）在起跳和着陆阶段，质心（COM）相对于膝关节和踝关节中心的中外侧位置。与对照组不同，ACL损伤患者表现出腿部不对称：起跳和着陆时膝关节屈曲和内旋较少，着陆时受伤腿的COM相对于膝关节和踝关节更偏外侧。与对照组相比，ACL(R)患者受伤腿在着陆时的外旋更大。ACL(PT)患者在起跳和着陆时膝关节屈曲较少，外旋较大，着陆时膝关节外展较大。起跳时COM相对于膝关节更偏内侧，着陆时相对于踝关节更不偏外侧。ACL损伤会导致OLH期间长期的运动学改变，这在ACL(R)患者中不太明显。
