Capin Jacob J, Behrns William, Thatcher Karen, Arundale Amelia, Smith Angela Hutchinson, Snyder-Mackler Lynn
J Orthop Sports Phys Ther. 2017 May;47(5):324-333. doi: 10.2519/jospt.2017.7245. Epub 2017 Mar 29.
Synopsis The literature pertaining to the rehabilitation of ice hockey players seeking to return to sport after anterior cruciate ligament reconstruction (ACLR) is currently limited. The purpose of this clinical commentary was to present a criterion-based progression for return to ice hockey for athletes after ACLR. First, we review pertinent literature and provide previously published guidelines on general rehabilitation after ACLR. Then, we present a 4-phase, on-ice skating progression with objective criteria to initiate each phase. During the early on-ice phase, the athlete is reintroduced to specific demands, including graded exposure to forward, backward, and crossover skating. In the intermediate on-ice phase, the emphasis shifts to developing power and introducing anticipated changes of direction within a controlled environment. During the late on-ice phase, the focus progresses to developing anaerobic endurance and introducing unanticipated changes of direction, but still without other players or contact. Finally, once objective return-to-sport criteria are met, noncontact team drills, outnumbered and even-numbered drills, practices, scrimmages, and games are progressively reintroduced during the return-to-sport phase. Recommendations for off-ice strength and conditioning exercises complement the on-ice progression. Additionally, we apply the return-to-hockey progression framework to a case report of a female collegiate defensive ice hockey player who returned to sport successfully after ACLR. This criterion-based return-to-hockey progression may guide rehabilitation specialists managing athletes returning to ice hockey after ACLR. J Orthop Sports Phys Ther 2017;47(5):324-333. Epub 29 Mar 2017. doi:10.2519/jospt.2017.7245.
目前，关于前交叉韧带重建（ACLR）后寻求重返冰球运动的运动员康复的文献有限。本临床评论的目的是为ACLR后的运动员提供一个基于标准的重返冰球运动进展方案。首先，我们回顾相关文献，并提供先前发表的关于ACLR后一般康复的指南。然后，我们提出一个4阶段的冰上滑冰进展方案，并给出启动每个阶段的客观标准。在冰上早期阶段，运动员重新适应特定要求，包括逐步增加向前、向后和交叉滑冰的训练量。在冰上中期阶段，重点转向发展力量，并在可控环境中引入预期的方向变化。在冰上后期阶段，重点进一步发展到提高无氧耐力，并引入意外的方向变化，但仍不与其他球员接触或进行身体对抗。最后，一旦达到客观的重返运动标准，在重返运动阶段逐步重新引入非接触式团队训练、人数不等和人数相等的训练、练习赛、对抗赛和正式比赛。冰上力量和体能训练的建议补充了冰上进展方案。此外，我们将重返冰球运动进展框架应用于一名女子大学冰球防守队员的病例报告，该队员在ACLR后成功重返运动。这个基于标准的重返冰球运动进展方案可能会指导康复专家管理ACLR后重返冰球运动的运动员。《矫形与运动物理治疗杂志》2017年；47(5):324 - 333。2017年3月29日在线发表。doi:10.2519/jospt.2017.7245 。
