Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Vision and Eye Research Unit, School of Medicine, Anglia Ruskin University, Young Street 213, Cambridge, CB1 1PT, UK.
Knee Surg Sports Traumatol Arthrosc. 2019 Feb;27(2):478-490. doi: 10.1007/s00167-018-5116-y. Epub 2018 Sep 4.
Limited evidence suggests that cross-education affords clinical benefits in the initial 8 weeks after anterior cruciate ligament (ACL) reconstruction, but it is unknown if such cross-education effects are reproducible and still present in later phases of rehabilitation. We examined whether cross-education, as an adjuvant to standard therapy, would accelerate the rehabilitation up to 26 weeks after ACL reconstruction by attenuating quadriceps weakness.
ACL-reconstructed patients were randomized into experimental (n = 22) and control groups (n = 21). Both groups received standard care after ACL reconstruction. In addition, the experimental group strength trained the quadriceps of the non-operated leg during weeks 1-12 after surgery (i.e., cross-education). Self-reported knee function was assessed with the Hughston Clinic Knee score as the primary outcome. Secondary outcomes were maximal quadriceps and hamstring strength and single leg hop distance. All outcomes were measured 29 ± 23 days prior to surgery, as a reference, and at 5-week, 12-week, and 26-week post-surgery.
Both groups scored 12% worse on self-reported knee function 5-week post-surgery (95% CI 7-17) and showed 15% improvement 26-week post-surgery (95% CI - 20 to - 10). No cross-education effect was found. Interestingly, males scored 8-10% worse than females at each time point post-surgery. None of 33 secondary outcomes showed a cross-education effect. At 26-week post-surgery, both legs improved maximal quadriceps (5-14%) and hamstring strength (7-18%), and the non-injured leg improved 2% in hop distance. The ACL recovery was not affected by limb dominance and age.
26 weeks of standard care improved self-reported knee function and maximal leg strength relative to pre-surgery and adding cross-education did not further accelerate ACL recovery.
I.
This randomized controlled clinical trial is registered at the Dutch trial register ( http://www.trialregister.nl ) under NTR4395.
有限的证据表明，交叉训练在前交叉韧带（ACL）重建后 8 周内提供临床益处，但尚不清楚这种交叉训练效应是否具有再现性，并且在康复的后期阶段仍然存在。我们研究了作为标准治疗的辅助手段，交叉训练是否会通过减轻股四头肌无力来加速 ACL 重建后 26 周的康复。
ACL 重建患者被随机分为实验组（n=22）和对照组（n=21）。两组在 ACL 重建后均接受标准治疗。此外，实验组在手术后的第 1 至 12 周内对未手术的腿进行股四头肌力量训练（即交叉训练）。自我报告的膝关节功能使用 Hughston 诊所膝关节评分作为主要结果进行评估。次要结果为最大股四头肌和腘绳肌力量以及单腿跳跃距离。所有结果均在手术前 29±23 天进行测量，作为参考，并在术后 5 周、12 周和 26 周进行测量。
两组患者在术后 5 周时膝关节功能自我报告评分降低了 12%（95%CI 7-17），术后 26 周时改善了 15%（95%CI -20 至-10）。没有发现交叉训练效应。有趣的是，男性在手术后的每个时间点的评分都比女性低 8-10%。33 项次要结果均未显示出交叉训练效应。在术后 26 周时，两条腿的最大股四头肌（5-14%）和腘绳肌力量（7-18%）都有所提高，未受伤的腿在跳跃距离上提高了 2%。ACL 的恢复不受肢体优势和年龄的影响。
26 周的标准治疗与术前相比改善了自我报告的膝关节功能和最大腿部力量，而添加交叉训练并没有进一步加速 ACL 的恢复。
I。
本随机对照临床试验在荷兰临床试验注册中心（http://www.trialregister.nl）注册，注册号为 NTR4395。
