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前交叉韧带重建术后,双腿之间的协调性稳定性降低。

Coordination stability between the legs is reduced after anterior cruciate ligament reconstruction.

作者信息

Armitano Cortney N, Morrison Steven, Russell Daniel M

机构信息

School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA, USA.

School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA, USA.

出版信息

Clin Biomech (Bristol). 2018 Oct;58:28-33. doi: 10.1016/j.clinbiomech.2018.07.003. Epub 2018 Jul 4.

Abstract

BACKGROUND

The study was designed to examine coordination differences in walking between individuals with an anterior cruciate ligament reconstruction compared with healthy matched controls. Predictions from the extended Haken, Kelso, and Bunz coupled oscillator model were tested in these populations.

METHODS

Seventeen persons with anterior cruciate ligament reconstruction and 17 matched controls participated in the study. Sagittal plane angular knee displacement was recorded using electrogoniometers over the lateral right and left knee joints while participants walked at five walking speeds overground. Coordination pattern and stability between the knees were quantified by mean and standard deviation of relative phase, respectively.

FINDINGS

Mean relative phase was not influenced by walking speed or group. For both groups, coordination stability was maximal when individual's walked at their preferred gait speed. However, the anterior cruciate ligament reconstruction group demonstrated reduced coordination stability compared with healthy controls across the five speeds. Multiple regression analyses found that people with anterior cruciate ligament reconstruction who deviated more from antiphase coordination had decreased coordination stability.

INTERPRETATION

Anterior cruciate ligament reconstruction results in decreased coordination stability, indicative of reduced coupling strength between the legs. This change in gait coordination, which has not previously been found in the literature, may contribute to the increased rate of re-injury and degeneration in individuals who have had this reconstructive surgery. Application of a motor control model enhances our understanding of the influence of an injury on coordination during gait.

摘要

背景

本研究旨在比较前交叉韧带重建患者与健康对照者在行走时的协调性差异。在这些人群中测试了扩展的哈肯、凯尔索和邦兹耦合振子模型的预测结果。

方法

17名前交叉韧带重建患者和17名匹配的对照者参与了本研究。当参与者在地面上以五种步行速度行走时,使用电子测角仪记录右膝和左膝外侧矢状面的角位移。通过相对相位的均值和标准差分别量化膝关节之间的协调模式和稳定性。

结果

平均相对相位不受步行速度或组别影响。对于两组而言,当个体以其偏好的步态速度行走时,协调稳定性最大。然而,在前交叉韧带重建组中,在五种速度下与健康对照组相比,协调稳定性均降低。多元回归分析发现,前交叉韧带重建患者中与反相协调偏差越大,协调稳定性越低。

解读

前交叉韧带重建导致协调稳定性降低,表明双腿之间的耦合强度降低。这种步态协调性的变化在以往文献中未曾发现,可能导致接受该重建手术的个体再次受伤和退变的发生率增加。运动控制模型的应用增强了我们对损伤对步态协调影响的理解。

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