Davis Kylie, Williams John L, Sanford Brooke A, Zucker-Levin Audrey
University of Tennessee Health Science Center, Memphis, TN 38163, United States.
University of Memphis, Memphis, TN 38152, United States.
Gait Posture. 2019 Jan;67:154-159. doi: 10.1016/j.gaitpost.2018.10.010. Epub 2018 Oct 10.
Despite our knowledge of several biomechanical risk factors related to anterior cruciate ligament (ACL) injury, such as decreased knee flexion, increased knee abduction, and increased hip flexion, adduction and internal rotation during walking, jogging, and landing from a jump, the incidence of ACL tears remains high. Quantifying variability in the lower extremity provides a continuous measure of joint coordination and function that may elicit an additional aspect of ACL injury mechanisms.
The aim of this study was to assess joint coordination patterns and variability in individuals following ACL reconstruction (ACLR).
Twenty participants with unilateral ACLR and twenty uninjured participants matched by sex and body mass index (BMI) walked over-ground at self-selected speed. Two force plates embedded in the walking platform recorded ground reaction forces (GRF), and a motion capture system collected kinematic data. Vector coding was used to describe coordination patterns and measure coordination variability in hip-knee and knee-ankle coupled motion.
Individuals with ACLR had greater variability in hip-knee coordination compared to their healthy counterparts for both the reconstructed and contralateral limbs. The individuals with ACLR also exhibited altered coordination patterns, one of which was characterized by constrained hip motion.
These results are evidence that differences in joint coordination exist between individuals with and without ACLR, even after the former are cleared to return to sport. This new insight into coordinative function after ACLR may be useful for improving rehabilitation strategies as well as identifying those at risk of injury during return to sport testing.
尽管我们了解与前交叉韧带（ACL）损伤相关的几种生物力学风险因素，如在行走、慢跑和从跳跃落地过程中膝关节屈曲减少、膝关节外展增加以及髋关节屈曲、内收和内旋增加，但ACL撕裂的发生率仍然很高。量化下肢的变异性提供了一种对关节协调和功能的连续测量方法，这可能揭示ACL损伤机制的一个额外方面。
本研究的目的是评估ACL重建（ACLR）后个体的关节协调模式和变异性。
20名单侧ACLR患者和20名性别及体重指数（BMI）相匹配的未受伤参与者以自我选择的速度在地面行走。嵌入行走平台的两个测力板记录地面反作用力（GRF），运动捕捉系统收集运动学数据。矢量编码用于描述协调模式并测量髋膝和膝踝耦合运动中的协调变异性。
与健康对照组相比，ACLR患者重建肢体和对侧肢体的髋膝协调变异性更大。ACLR患者还表现出改变的协调模式，其中一种模式的特征是髋关节运动受限。
这些结果证明，即使ACLR患者在获准恢复运动后，有和没有ACLR的个体之间在关节协调方面仍存在差异。这种对ACLR后协调功能的新见解可能有助于改进康复策略，以及识别在恢复运动测试期间有受伤风险的个体。
