Sports Surgery Clinic, Dublin, Ireland.
University of Roehampton, London, United Kingdom.
J Athl Train. 2018 Jul;53(7):687-695. doi: 10.4085/1062-6050-480-16. Epub 2018 Aug 15.
Despite an increase in the literature, few definitive guidelines are available to determine when an athlete has been fully rehabilitated after anterior cruciate ligament reconstruction (ACLR).
To examine countermovement jump and isokinetic dynamometry measures to (1) identify which measures can best distinguish between ACLR and control participants and (2) provide normative values for identified measures in young adult male multidirectional field-sport athletes.
Cross-sectional study.
Orthopaedic hospital.
Young adult male multidirectional field-sport athletes (n = 118) who had undergone unilateral patellar-tendon graft ACLR at least 6 months earlier and healthy male participants (n = 44) with no previous knee injury.
INTERVENTION(S): Single-legged countermovement jump (SL CMJ).
MAIN OUTCOME MEASURE(S): Three-dimensional biomechanical analysis of the SL CMJ and mean peak concentric knee-extension and -flexion torque using isokinetic dynamometry (ISO) were compared in the 2 groups. A stepwise logistic regression was carried out to identify the best predictors of ACLR- or control-group membership (SL CMJ height, limb symmetry index, peak power, joint power contribution, ISO peak torque, limb symmetry index variables).
The control group differed strongly from the ACLR group in isokinetic knee-extension peak torque (d = -1.33), SL CMJ performance (d > 0.4), and limb symmetry measures in both ISO and jump outcomes (d > 1.1). The combination of measures from both ISO and SL CMJ identified group membership with an accuracy of 89%.
Rehabilitation of ACLR patients may be complete when they achieve isokinetic knee-extension peak torque of 260% (±40%) body mass, SL CMJ performance of >17 cm (±4 cm), and reach-limb symmetry measures of >90% in both strength and jump outcomes. The outcomes in the control group can inform return-to-play criteria for young adult male multidirectional field-sport athletes after ACLR.
尽管文献不断增加,但对于前交叉韧带重建(ACLR)后运动员何时已完全康复,仍缺乏明确的指导。
通过测试反跳和等速测力评估,(1)确定哪些指标最能区分 ACLR 和对照组,(2)为年轻男性多向运动项目运动员提供确定指标的正常值。
横断面研究。
骨科医院。
接受过单侧髌腱移植物 ACLR 且至少 6 个月前的年轻男性多向运动项目运动员(n=118)和无既往膝关节损伤的健康男性参与者(n=44)。
单腿反跳(SL CMJ)。
比较两组的三维生物力学分析和等速测力(ISO)的单腿伸膝和屈膝的平均峰值等速力矩。采用逐步逻辑回归确定 ACLR 或对照组的最佳预测指标(SL CMJ 高度、肢体对称性指数、峰值功率、关节功率贡献、ISO 峰值扭矩、肢体对称性指数变量)。
与 ACLR 组相比,对照组在等速伸膝峰值扭矩(d=-1.33)、SL CMJ 表现(d>0.4)以及 ISO 和跳跃结果的肢体对称性测量(d>1.1)方面差异明显。来自 ISO 和 SL CMJ 的组合测量指标可识别出 89%的组内成员。
当 ACLR 患者达到 260%(±40%)体重的等速伸膝峰值扭矩、>17 厘米(±4 厘米)的 SL CMJ 表现和在力量和跳跃结果中均达到>90%的达到肢体对称性测量时,康复可能已完成。对照组的结果可以为 ACLR 后的年轻男性多向运动项目运动员提供重返比赛的标准。