Lion Alexis, Gette Paul, Meyer Christophe, Seil Romain, Theisen Daniel
Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Luxembourg.
Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Luxembourg.
Gait Posture. 2018 Feb;60:251-257. doi: 10.1016/j.gaitpost.2017.12.013. Epub 2017 Dec 15.
Our study aimed to evaluate the effect of cognitive challenge on double-leg postural control under visual and surface perturbations of patients with anterior cruciate ligament reconstruction (ACLR) cleared to return to sport. Double-leg stance postural control of 19 rehabilitated patients with ACLR (age: 24.8 ± 6.7 years, time since surgery: 9.2 ± 1.6 months) and 21 controls (age: 24.9 ± 3.7 years) was evaluated in eight randomized situations combining two cognitive (with and without silent backward counting in steps of seven), two visual (eyes open, eyes closed) and two surface (stable support, foam support) conditions. Sway area and sway path of the centre of foot pressure were measured during three 20-s recordings for each situation. Higher values indicated poorer postural control. Generally, postural control of patients with ACLR and controls was similar for sway area and sway path (p > 0.05). The lack of visual anchorage and the disturbance of the plantar input by the foam support increased sway area and sway path (p < 0.001) similarly in both groups. The addition of the cognitive task decreased sway area and sway path (p < 0.001) similarly in both groups. Patients with ACLR who recently completed their rehabilitation have normalized postural control during double-leg stance tests. The use of a dual task paradigm under increased task complexity modified postural control, but in a similar way in patients with ACLR than in healthy controls. Double-leg stance tests, even under challenging conditions, are not sensitive enough to reveal postural control differences between rehabilitated patients with ACLR and controls.
我们的研究旨在评估认知挑战对前交叉韧带重建（ACLR）后已获准恢复运动的患者在视觉和表面扰动下双腿姿势控制的影响。对19名接受康复治疗的ACLR患者（年龄：24.8±6.7岁，术后时间：9.2±1.6个月）和21名对照组（年龄：24.9±3.7岁）的双腿站立姿势控制进行了评估，评估在八种随机情况下进行，这些情况结合了两种认知条件（有和没有以七为步长的无声倒数）、两种视觉条件（睁眼、闭眼）和两种表面条件（稳定支撑、泡沫支撑）。在每种情况下的三次20秒记录期间测量足底压力中心的摆动面积和摆动路径。值越高表明姿势控制越差。一般来说，ACLR患者和对照组在摆动面积和摆动路径方面的姿势控制相似（p>0.05）。两组中，缺乏视觉锚定和泡沫支撑对足底输入的干扰同样增加了摆动面积和摆动路径（p<0.001）。添加认知任务同样降低了两组的摆动面积和摆动路径（p<0.001）。最近完成康复的ACLR患者在双腿站立测试期间的姿势控制已恢复正常。在任务复杂性增加的情况下使用双任务范式改变了姿势控制，但ACLR患者与健康对照组的方式相似。双腿站立测试，即使在具有挑战性的条件下，也不够敏感，无法揭示康复后的ACLR患者与对照组之间的姿势控制差异。
