J Orthop Sports Phys Ther. 2018 Jan;48(1):34-43. doi: 10.2519/jospt.2018.7684. Epub 2017 Oct 26.
Study Design Cross-sectional laboratory study. Background Asymmetrical knee loading during jogging and hopping has been reported in individuals who have ruptured their Achilles tendon. No studies have examined knee loads in individuals post Achilles tendon rupture during high-demand tasks, such as single-limb landings. Objectives We sought to determine whether individuals post Achilles tendon rupture demonstrated asymmetrical knee loads and impact forces during drop countermovement jumps (CMJs). Methods Achilles tendon length and the single-leg heel-rise test for endurance were assessed in 34 individuals (31 male) 6.1 ± 2.0 years post Achilles tendon rupture. Movement patterns were assessed during a drop CMJ. Data were analyzed via repeated-measures analyses of variance, with comparisons between limbs and prior treatment history (surgery versus nonsurgery). Results An 8.6% longer Achilles tendon (P<.001) was found in the involved limb. During the single-leg heel-rise test, the involved limb demonstrated 22.4% less endurance and 14.6% lower heel-rise height (all, P<.001). During the landing phase of the drop CMJ, the involved limb exhibited 39.6% greater loading rate (P<.001), 16.8% greater eccentric knee power (P = .048), but 21.6% lower eccentric ankle power (P<.001). During the take-off phase, the involved limb exhibited 12.1% lower jump height and 19.9% lower concentric ankle power (both, P<.001). Conclusion Elevated eccentric knee joint power and higher loading rates during a drop CMJ in individuals who experienced Achilles tendon rupture several years earlier may be a compensation pattern for reduced plantar flexor function. This movement pattern may place individuals who have had an Achilles tendon rupture at greater risk for knee injuries. J Orthop Sports Phys Ther 2018;48(1):34-43. Epub 26 Oct 2017. doi:10.2519/jospt.2018.7684.
横断面实验室研究。背景：在跟腱断裂的个体中，已经报道了在慢跑和单足跳跃时膝关节出现不对称性负荷。没有研究检查过跟腱断裂后个体在高需求任务（如单足着地）期间的膝关节负荷。目的：我们旨在确定跟腱断裂后个体在进行单足跳落反向跳跃（CMJ）时是否表现出膝关节负荷和冲击力量的不对称性。方法：34 名（31 名男性）跟腱断裂后 6.1 ± 2.0 年的个体接受了跟腱长度和单腿跟腱抬高试验（耐力）评估。在单足跳落反向跳跃中评估运动模式。通过重复测量方差分析对数据进行分析，并比较肢体之间以及既往治疗史（手术与非手术）。结果：患侧的跟腱长 8.6%（P<.001）。在单腿跟腱抬高试验中，患侧的耐力减少 22.4%，跟腱抬高高度降低 14.6%（均 P<.001）。在单足跳落反向跳跃的着地阶段，患侧的负荷率增加 39.6%（P<.001），离心膝关节功率增加 16.8%（P =.048），但离心踝关节功率降低 21.6%（P<.001）。在起跳阶段，患侧的跳跃高度降低 12.1%，向心踝关节功率降低 19.9%（均 P<.001）。结论：跟腱断裂后数年的个体在进行单足跳落反向跳跃时，其膝关节的离心关节功率升高和负荷率增加，这可能是对跖屈肌功能降低的一种代偿模式。这种运动模式可能会使跟腱断裂的个体面临更大的膝关节损伤风险。
