与健康对照组相比,前交叉韧带重建术后的业余运动员单腿跳跃时髋部力量与髋部运动学之间的关联。

THE ASSOCIATIONS BETWEEN HIP STRENGTH AND HIP KINEMATICS DURING A SINGLE LEG HOP IN RECREATIONAL ATHLETES POST ACL RECONSTRUCTION COMPARED TO HEALTHY CONTROLS.

作者信息

Tate Jeremiah, Suckut Tell, Wages Jensen, Lyles Heather, Perrin Benjamin

机构信息

Physical Therapy Department, University of Tennessee at Chattanooga, Chattanooga, TN.

出版信息

Int J Sports Phys Ther. 2017 Jun;12(3):341-351.

DOI:
Abstract

BACKGROUND

Only a small amount of evidence exists linking hip abductor weakness to dynamic knee valgus during static and dynamic activities. The associations of hip extensor strength and hip kinematics during the landing of a single leg hop are not known. Purpose: To determine if relationships exist between hip extensor and abductor strength and hip kinematics in both involved and uninvolved limb during the landing phase of a single leg hop in recreational athletes post anterior cruciate ligament (ACL) reconstruction. The presence of similar associations was also evaluated in healthy recreational athletes.

STUDY DESIGN

Controlled Laboratory Study; Cross-sectional.

METHODS

Twenty-four recreational college-aged athletes participated in the study (12 post ACL reconstruction; 12 healthy controls). Sagittal and frontal plane hip kinematic data were collected for five trials during the landing of a single leg hop. Hip extensor and abductor isometric force production was measured using a hand-held dynamometer and normalized to participants' height and weight. Dependent and independent t-tests were used to analyze for any potential differences in hip strength or kinematics within and between groups, respectively. Pearson's was used to demonstrate potential associations between hip strength and hip kinematics for both limbs in the ACL group and the right limb in the healthy control group.

RESULTS

Independent t-tests revealed that participants post ACL reconstruction exhibited less hip extensor strength (0.18 N/HtBW vs. 0.25 N/HtBW, p=<.01) and landed with greater hip adduction (9.0 º vs. 0.8 º, p=<.01) compared with their healthy counterparts. In the ACL group, Pearson's demonstrated a moderate and indirect relationship (=-.62, p=.03) between hip extensor strength and maximum hip abduction/adduction angle in the involved limb. A moderate and direct relationship between hip abductor strength and maximum hip flexion angle was demonstrated in the both the involved (=.62) and uninvolved limb (=.65, p=.02). No significant associations were demonstrated between hip extensor or abductor strength and hip flexion and/or abduction/adduction angles in the healthy group.

CONCLUSION

The results suggest that hip extensors may play a role in minimizing hip adduction in the involved limb while the hip abductors seem to play a role in facilitating hip flexion during the landing phase of a single leg hop for both limbs following ACL reconstruction. Researchers and clinicians alike should consider the importance of the hip extensors in playing a more prominent role in contributing to frontal plane motion.

LEVELS OF EVIDENCE

Level 2a.

摘要

背景

仅有少量证据表明在静态和动态活动中,髋外展肌无力与动态膝外翻有关。单腿跳落地时髋伸肌力量与髋部运动学之间的关联尚不清楚。目的:确定在娱乐性运动员前交叉韧带(ACL)重建术后单腿跳落地阶段,患侧和健侧肢体的髋伸肌与外展肌力量及髋部运动学之间是否存在关系。同时也评估了健康娱乐性运动员中是否存在类似关联。

研究设计

对照实验室研究;横断面研究。

方法

24名大学年龄的娱乐性运动员参与了该研究(12名ACL重建术后患者;12名健康对照者)。在单腿跳落地过程中进行5次试验,收集矢状面和额状面的髋部运动学数据。使用手持测力计测量髋伸肌和外展肌的等长肌力,并根据参与者的身高和体重进行标准化。分别使用独立样本t检验和配对样本t检验分析组内和组间髋部力量或运动学的任何潜在差异。在ACL组的双侧肢体以及健康对照组的右侧肢体中,使用Pearson相关系数来证明髋部力量与髋部运动学之间的潜在关联。

结果

独立样本t检验显示,与健康对照组相比,ACL重建术后的参与者髋伸肌力量较小(0.18N/HtBW vs. 0.25N/HtBW,p<0.01),且落地时髋内收角度更大(9.0° vs. 0.8°,p<0.01)。在ACL组中,Pearson相关系数显示患侧肢体的髋伸肌力量与最大髋外展/内收角度之间存在中度间接关系(r = -0.62,p = 0.03)。患侧(r = 0.62)和健侧肢体(r = 0.65,p = 0.02)的髋外展肌力量与最大髋屈曲角度之间均存在中度直接关系。在健康组中,髋伸肌或外展肌力量与髋部屈曲和/或外展/内收角度之间未显示出显著关联。

结论

结果表明,在ACL重建术后单腿跳落地阶段,髋伸肌可能在减少患侧肢体髋内收方面发挥作用,而髋外展肌似乎在促进双侧肢体髋部屈曲方面发挥作用。研究人员和临床医生都应考虑髋伸肌在促进额状面运动中发挥更突出作用的重要性。

证据水平

2a级。

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