Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Samanpazari, 06100, Ankara, Turkey.
Department of Physiotherapy and Rehabilitation, Karatekin University, Çankırı, Turkey.
Knee Surg Sports Traumatol Arthrosc. 2019 Jan;27(1):68-75. doi: 10.1007/s00167-018-5040-1. Epub 2018 Jun 29.
The aim of this study was to investigate the effects of concentric and eccentric cross-education (CE) on quadriceps strength and knee function recoveries after anterior cruciate ligament (ACL) reconstruction.
Forty-eight patients (age: 29.5 ± 6.8 years, body mass index: 26.1 ± 3.2 kg/m) who had undergone ACL reconstruction with hamstring tendon autograft were included in the study. The patients were randomly divided into three groups when they reached four weeks post surgery: (1) concentric CE (n = 16); (2) eccentric CE (n = 16); and (3) control (n = 16). All groups followed the same post-surgical rehabilitation program for their reconstructed limb. Additionally, the two experimental groups followed eight weeks of isokinetic training for the uninjured knee at 60°/s for 3 days per week. Quadriceps maximum voluntary isometric strength (MVIC) was measured during the 4th week (pre-training), 12th week (post training), and 24th week post surgery. The single-leg hop distance and International Knee Documentary Committee (IKDC) scores were also evaluated during the 24th week post surgery. Analysis of variance was used for statistical analysis.
Group-by-time interaction was significant for quadriceps MVICs for reconstructed and healthy limbs (p = 0.02). Quadriceps strength of both knees was greater in concentric and eccentric CE groups compared to control group during the 12th- and 24th weeks post surgery (p < 0.05). Strength gain was 28% and 31% in concentric and eccentric CE groups, respectively, when compared with the control group. Concentric and eccentric CE had similar effects on quadriceps strength recovery (n.s.). IKDC score, and single-leg hop distances were not significantly different among groups (n.s.).
Concentric and eccentric quadricep strengthening of healthy limbs in early phases of ACL rehabilitation improved post-surgical quadriceps strength recovery of the reconstructed limb. CE should be integrated into ACL reconstruction rehabilitation, especially in the early rehabilitative phases to restore quadriceps strength.
Randomized controlled trial, Level I.
本研究旨在探讨同心和偏心交叉教育（CE）对前交叉韧带（ACL）重建后股四头肌力量和膝关节功能恢复的影响。
48 名患者（年龄：29.5±6.8 岁，体重指数：26.1±3.2kg/m²）接受了 ACL 重建伴腘绳肌腱自体移植物。当患者术后 4 周时，他们被随机分为三组：（1）同心 CE 组（n=16）；（2）偏心 CE 组（n=16）；和（3）对照组（n=16）。所有组都遵循相同的术后康复方案进行重建肢体的康复。此外，两个实验组在 8 周内每周 3 天以 60°/s 的速度对未受伤的膝盖进行等速训练。在第 4 周（训练前）、第 12 周（训练后）和第 24 周手术后测量股四头肌最大等长等速力量（MVIC）。在手术后 24 周还评估了单腿跳跃距离和国际膝关节文献委员会（IKDC）评分。使用方差分析进行统计分析。
重建和健康肢体的股四头肌 MVICs 存在组间时间交互作用（p=0.02）。与对照组相比，在手术后 12 周和 24 周时，同心和偏心 CE 组的双膝股四头肌力量均较大（p<0.05）。与对照组相比，同心和偏心 CE 组的力量增益分别为 28%和 31%。同心和偏心 CE 对股四头肌力量恢复的影响相似（无统计学差异）。IKDC 评分和单腿跳跃距离在各组之间无显著差异（无统计学差异）。
在 ACL 康复的早期阶段对健康肢体的股四头肌进行同心和偏心强化可以改善重建肢体的术后股四头肌力量恢复。CE 应整合到 ACL 重建康复中，尤其是在早期康复阶段，以恢复股四头肌力量。
随机对照试验，一级。
