Nawasreh Zakariya, Failla Mathew, Marmon Adam, Logerstedt David, Snyder-Mackler Lynn
Biomechanics and Movement Science program, College of Health Sciences, University of Delaware, Newark, DE, USA; Division of Physical Therapy, Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan.
Biomechanics and Movement Science program, College of Health Sciences, University of Delaware, Newark, DE, USA.
Gait Posture. 2018 Jul;64:43-49. doi: 10.1016/j.gaitpost.2018.05.027. Epub 2018 May 23.
Performing physical activities on a compliant surface alters joint kinematics and increases joints stiffness. However, the effect of compliant surface on joint kinematics after ACL-rupture is yet unknown.
To compare the effects of mechanical perturbation training with a compliant surface to manual perturbation training on joint kinematics after ACL-rupture.
Sixteen level I/II athletes with ACL-rupture participated in this preliminary study. Eight patients received mechanical perturbation with compliant surface (Mechanical) and 8 patients received manual perturbation training (Manual). Patients completed standard gait analysis before (Pre) and after (Post) training.
Significant group-by-time interactions were found for knee flexion angle at initial contact (IC) and peak knee flexion (PKF) (p<0.004), with manual group significantly increased knee flexion angle at IC and PKF (p<0.03). Main effects of group were found for hip flexion angle at IC (Manual:34.34+3.51°, Mechanical:27.68+4.08°, p = 0.011), hip rotation angle at PKE (Manual:-3.40+4.78°, Mechanical:5.43+4.78°, p < 0.0001), and knee adduction angle at PKE (Manual:-2.00+2.23°, Mechanical:0.55+2.23°, p = 0.039). Main effects of time were found for hip adduction angle at PKE (Pre:6.98+4.48°, Post:8.41+4.91°, p = 0.04), knee adduction angle at IC (Pre:-2.90+3.50°, Post:-0.62+2.58°, p = 0.03), ankle adduction angle at IC (Pre:2.16+3.54, Post:3.8+3.68, p = 0.008), and ankle flexion angle at PKF (Pre:-4.55+2.77°, Post:-2.39+3.48°, p = 0.01).
Training on a compliant surface induces different effects on joint kinematics compared to manual perturbation training after ACL-rupture. Manual perturbation improved hip alignment and increased knee flexion angles, while mechanical training decreased knee flexion angles throughout the stance phase. Administering training on a compliant surface after ACL-rupture may help improving dynamic knee stability, however, long-term effects on knee health needs to be determined.
在顺应性表面上进行体育活动会改变关节运动学并增加关节刚度。然而，顺应性表面对前交叉韧带断裂后关节运动学的影响尚不清楚。
比较顺应性表面机械扰动训练与手动扰动训练对前交叉韧带断裂后关节运动学的影响。
16名前交叉韧带断裂的I/II级运动员参与了这项初步研究。8名患者接受顺应性表面的机械扰动训练（机械组），8名患者接受手动扰动训练（手动组）。患者在训练前（Pre）和训练后（Post）完成标准步态分析。
在初始接触（IC）时的膝关节屈曲角度和膝关节最大屈曲角度（PKF）方面发现了显著的组×时间交互作用（p<0.004），手动组在IC和PKF时膝关节屈曲角度显著增加（p<0.03）。在IC时的髋关节屈曲角度（手动组：34.34+3.51°，机械组：27.68+4.08°，p = 0.011）、PKE时的髋关节旋转角度（手动组：-3.40+4.78°，机械组：5.43+4.78°，p < 0.0001）以及PKE时的膝关节内收角度（手动组：-2.00+2.23°，机械组：0.55+2.23°，p = 0.039）方面发现了组的主效应。在PKE时的髋关节内收角度（训练前：6.98+4.48°，训练后：8.41+4.91°，p = 0.04）、IC时的膝关节内收角度（训练前：-2.90+3.50°，训练后：-0.62+2.58°，p = 0.03）、IC时的踝关节内收角度（训练前：2.16+3.54，训练后：3.8+3.68，p = 0.008）以及PKF时的踝关节屈曲角度（训练前：-4.55+2.77°，训练后：-2.39+3.48°，p = 0.01）方面发现了时间的主效应。
与前交叉韧带断裂后的手动扰动训练相比，在顺应性表面上进行训练对关节运动学有不同的影响。手动扰动改善了髋关节对线并增加了膝关节屈曲角度，而机械训练在整个站立期降低了膝关节屈曲角度。前交叉韧带断裂后在顺应性表面上进行训练可能有助于改善膝关节动态稳定性，然而，对膝关节健康的长期影响有待确定。
