Hatton Anna L, Crossley Kay M, Clark Ross A, Whitehead Timothy S, Morris Hayden G, Culvenor Adam G
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
School of Allied Health, La Trobe University, Bundoora, Australia.
Gait Posture. 2017 Feb;52:22-25. doi: 10.1016/j.gaitpost.2016.11.013. Epub 2016 Nov 11.
Following anterior cruciate ligament (ACL) rupture, reconstructive surgery (ALCR) is often performed to mechanically stabilise the knee, however functional deficits often persist long after surgery. Impaired single-limb standing balance has been observed in the ACLR limb compared to healthy individuals. However, it remains inconclusive as to whether these same balance deficits exist between the injured and contralateral uninjured limbs, during challenging balance tasks, and at a time when patients are permitted to return to sport. 100 adults who had undergone a primary hamstring-tendon ACLR 12 months previously (68 male; median[IQR] age: 28.1[14.1] years) performed tests of single-limb standing with the knee in a functional position of 20-30° flexion, with their eyes closed, over 20s (Nintendo Wii Balance Board). Two repetitions were performed on the ACLR and uninjured limb. Measures of postural control included centre of pressure (CoP) path velocity, anterior-posterior and mediolateral range and standard deviation, and were averaged across the two trials. Wilcoxon signed-rank tests showed no significant between-leg differences in single-limb balance for any of the CoP measures of interest (all P values>0.686). Further, multiple linear regression analyses showed no significant associations between concomitant meniscectomy or chondral lesions noted at the time of ACLR and measures of single-limb balance on the ACLR limb one year later (all P values>0.213). In the context of prior research, these findings suggest bilateral balance deficits may exist prior to ACL injury, or appear post ACL-injury or ACLR. Treatment of balance deficits should therefore consider both limbs after ACLR.
在前交叉韧带(ACL)断裂后,通常会进行重建手术(ALCR)以机械稳定膝关节,然而功能缺陷往往在手术后很长时间仍然存在。与健康个体相比,在ACL重建(ACLR)肢体中观察到单腿站立平衡受损。然而,在具有挑战性的平衡任务期间以及患者被允许恢复运动时,受伤肢体和对侧未受伤肢体之间是否存在相同的平衡缺陷仍尚无定论。100名12个月前接受了原发性绳肌腱ACLR的成年人(68名男性;年龄中位数[四分位间距]:28.1[14.1]岁)在膝关节处于20 - 30°屈曲功能位、闭眼的情况下进行单腿站立测试,持续20秒(使用任天堂Wii平衡板)。在ACLR肢体和未受伤肢体上各进行两次重复测试。姿势控制的测量指标包括压力中心(CoP)路径速度、前后和内外侧范围及标准差,并在两次试验中进行平均。Wilcoxon符号秩检验显示,对于任何感兴趣的CoP测量指标,单腿平衡的两腿间差异均无统计学意义(所有P值>0.686)。此外,多元线性回归分析显示,ACLR时记录的半月板切除术或软骨损伤与一年后ACLR肢体的单腿平衡测量指标之间无显著相关性(所有P值>0.213)。结合先前的研究,这些发现表明双侧平衡缺陷可能在ACL损伤之前就已存在,或者在ACL损伤或ACLR后出现。因此,ACLR后平衡缺陷的治疗应考虑双下肢。
J Orthop Sports Phys Ther. 2016-3-21
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