Baumgart Christian, Hoppe Matthias W, Freiwald Jürgen
Department of Movement and Training Science, University of Wuppertal, Wuppertal, Germany.
Orthop J Sports Med. 2017 Jun 20;5(6):2325967117710912. doi: 10.1177/2325967117710912. eCollection 2017 Jun.
In patients who have undergone anterior cruciate ligament (ACL) reconstruction, there is a weak correlation between subjective evaluation of knee function on questionnaires and clinical or biomechanical test results.
Patients with lower subjective knee function will demonstrate lower ground-reaction forces (GRFs) in the operated leg and greater GRF asymmetries in both phase-specific and functional data analysis (FDA) approaches compared with patients with higher subjective knee function.
Descriptive laboratory study.
The GRFs of the operated and nonoperated legs of 40 patients who previously underwent ACL reconstruction (patellar tendon) were analyzed during unilateral and bilateral countermovement jumps at a mean 2.5 years after surgery. The patients were separated into 2 groups depending on their International Knee Documentation Committee (IKDC) Subjective Form score: low IKDC and high IKDC.
Both phase-specific and FDA approaches showed lower GRF values in the operated compared with the nonoperated leg within the low-IKDC group during bilateral jumps. Moreover, lower GRF values were also present in the operated and nonoperated legs in the low-IKDC group compared with those of the high-IKDC group. Differences in GRFs were predominantly observed during the eccentric deceleration phase of jumping.
Patients with previous ACL reconstruction who have limited subjective knee function have lower GRF values and greater GRF asymmetries, suggesting the use of interlimb compensation strategies.
The study results lead to a better understanding of the motor control needed during the eccentric and concentric movement phases of unilateral and bilateral jumps in patients who have undergone ACL reconstruction.
在接受前交叉韧带(ACL)重建的患者中,问卷上对膝关节功能的主观评估与临床或生物力学测试结果之间存在微弱的相关性。
与主观膝关节功能较高的患者相比,主观膝关节功能较低的患者在患侧下肢将表现出较低的地面反作用力(GRF),并且在特定阶段和功能数据分析(FDA)方法中患侧与健侧的GRF不对称性更大。
描述性实验室研究。
对40例先前接受过ACL重建(髌腱)的患者在术后平均2.5年进行单腿和双腿反向纵跳时患侧和健侧下肢的GRF进行分析。根据国际膝关节文献委员会(IKDC)主观评分表得分将患者分为两组:低IKDC组和高IKDC组。
在双腿跳跃过程中,低IKDC组患侧下肢与健侧下肢相比,特定阶段和FDA方法均显示出较低的GRF值。此外,低IKDC组患侧和健侧下肢的GRF值也低于高IKDC组。GRF的差异主要在跳跃的离心减速阶段观察到。
既往接受过ACL重建且主观膝关节功能受限的患者GRF值较低,GRF不对称性更大,提示其采用了肢体间代偿策略。
该研究结果有助于更好地理解ACL重建患者在单腿和双腿跳跃的离心和向心运动阶段所需的运动控制。