Clark Ross A, Bell Stuart W, Feller Julian A, Whitehead Timothy S, Webster Kate E
School of Health and Sports Science, University of the Sunshine Coast, Australia.
OrthoSport Victoria Research Unit, Deakin University and Epworth Richmond, Australia.
Gait Posture. 2017 Feb;52:318-324. doi: 10.1016/j.gaitpost.2016.12.016. Epub 2016 Dec 16.
BACKGROUND: Static standing balance can be safely assessed early following anterior cruciate ligament reconstruction (ACLR), and deficits may have important implications for long-term outcomes. This study includes a large cohort of people post-ACLR and has the primary aim of establishing whether inter-limb and sex differences exist, with a secondary aim of assessing the association between static balance variables and other outcome measures. METHODS: A total of 414 patients with a primary ACLR performed a 30-s static single leg balance test. Centre of pressure (COP) path length, antero-posterior (AP) and medio-lateral (ML) sway range and slow and fast speed COP path-length were examined. Additional measures included single and triple hop distance and symmetry, knee flexion range of motion, ligament laxity and the International Knee Documentation Committee (IKDC) subjective knee evaluation form. RESULTS: No significant inter-limb balance differences were present in females. Significant, yet small to negligible effect size (ES) differences were present in males for ML range (ES=0.19), and AP and ML axis slow speed path length (ES=0.11 and 0.23 respectively). Significant, negligible to moderate effect size (ES range=<0.01 to 0.60) sex differences were observed, with females showing reduced sway compared to males. No balance variables had associations with any other variable that were greater than weak. DISCUSSION: Our findings provide evidence that primary ACLR does not appear to negatively impact single leg standing balance on the operated limb more than the non-operated side. The lack of association with other outcome measures warrants further longitudinal examination into the utility of static standing balance assessment.
背景:在前交叉韧带重建术(ACLR)后可早期安全地评估静态站立平衡,且平衡缺陷可能对长期预后有重要影响。本研究纳入了一大群ACLR术后患者,主要目的是确定双侧肢体及性别差异是否存在,次要目的是评估静态平衡变量与其他预后指标之间的关联。 方法:共有414例初次行ACLR的患者进行了30秒单腿静态平衡测试。检测了压力中心(COP)路径长度、前后(AP)和内外侧(ML)摆动范围以及慢速和快速速度下的COP路径长度。其他测量指标包括单跳和三跳距离及对称性、膝关节活动度、韧带松弛度以及国际膝关节文献委员会(IKDC)主观膝关节评估表。 结果:女性双侧肢体平衡无显著差异。男性在ML范围(效应量ES = 0.19)以及AP和ML轴慢速路径长度(效应量ES分别为0.11和0.23)方面存在显著但微小至可忽略不计的效应量差异。观察到显著的、可忽略不计至中等效应量(效应量范围<0.01至0.60)的性别差异,女性比男性摆动更小。没有平衡变量与任何其他变量的关联大于弱相关。 讨论:我们的研究结果表明,初次ACLR似乎对患侧单腿站立平衡的负面影响并不比非患侧更大。与其他预后指标缺乏关联,这值得对静态站立平衡评估的效用进行进一步的纵向研究。
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