Department of Kinesiology, College of Education, Michigan State University, East Lansing, Michigan.
Department of Kinesiology, University of Connecticut, Storrs, Connecticut.
Sports Health. 2019 Mar/Apr;11(2):163-179. doi: 10.1177/1941738118822739. Epub 2019 Jan 14.
: Quadriceps function is a significant contributor to knee joint health that is influenced by central and peripheral factors, especially after anterior cruciate ligament reconstruction (ACLR).
: To assess differences of unilateral quadriceps isometric strength and activation between the involved limb and contralateral limb of individuals with ACLR and healthy controls.
: Web of Science, SportDISCUS, PubMed, CINAHL, and the Cochrane Database were all used during the search.
: A total of 2024 studies were reviewed. Twenty-eight studies including individuals with a unilateral history of ACLR, isometric knee extension strength normalized to body mass, and quadriceps activation measured by central activation ratios (CARs) through a superimposed burst technique were identified for meta-analysis. The methodological quality of relevant articles was assessed using a modified Downs and Black scale. Results of methodological quality assessment ranged from low to high quality (low, n = 10; moderate, n = 8; high, n = 10).
: Meta-analysis.
: Level 2.
: Means, standard deviations, and sample sizes were extracted from articles, and magnitude of between-limb and between-group differences were evaluated using a random-effects model meta-analysis approach to calculate combined pooled effect sizes (ESs) and 95% CIs. ESs were classified as weak ( d < 0.19), small ( d = 0.20-0.49), moderate ( d = 0.50-0.79), or large ( d > 0.80).
: The involved limb of individuals with ACLR displayed lower knee extension strength compared with the contralateral limb (ES, -0.78; lower bound [LB], -0.99; upper bound [UB], -0.58) and healthy controls (ES, -0.76; LB, -0.98; UB, -0.53). The involved limb displayed a lower CAR compared with healthy controls (ES, -0.84; LB, -1.18; UB, -0.50) but not compared with the contralateral limb (ES, -0.15; LB, -0.37; UB, 0.07). The ACLR contralateral limb displayed a lower CAR (ES, -0.73; LB, -1.39; UB, -0.07) compared with healthy control limbs but similar knee extension strength (ES, -0.24; LB, -0.68; UB, -0.19).
: Individuals with ACLR have bilateral CAR deficits and involved limb strength deficits that persist years after surgery. Deficits in quadriceps function may have meaningful implications for patient-reported and objective outcomes, risk of reinjury, and long-term joint health after ACLR.
股四头肌功能是膝关节健康的重要贡献因素，受中枢和外周因素的影响，尤其是在前交叉韧带重建（ACL 重建）之后。
评估 ACL 重建患者和健康对照者患侧和健侧股四头肌等长力量和激活的差异。
在检索过程中使用了 Web of Science、SportDISCUS、PubMed、CINAHL 和 Cochrane 数据库。
共综述了 2024 项研究。确定了 28 项研究，这些研究包括单侧 ACLR 病史的个体、通过叠加爆发技术通过中央激活比（CAR）测量的标准化体重的膝关节等长伸展力量和股四头肌激活。使用改良的 Downs 和 Black 量表评估相关文章的方法学质量。方法学质量评估结果从低到高（低，n = 10；中，n = 8；高，n = 10）。
荟萃分析。
2 级。
从文章中提取平均值、标准差和样本量，并使用随机效应模型荟萃分析方法评估双侧和组间差异的幅度，以计算合并的 pooled 效应量（ES）和 95%置信区间（CI）。ES 被分类为弱（d < 0.19）、小（d = 0.20-0.49）、中（d = 0.50-0.79）或大（d > 0.80）。
ACL 重建患者的患侧与健侧（ES，-0.78；下限 [LB]，-0.99；上限 [UB]，-0.58）和健康对照组（ES，-0.76；LB，-0.98；UB，-0.53）相比，膝关节伸展力量较低。患侧与健康对照组相比（ES，-0.84；LB，-1.18；UB，-0.50），但与健侧相比（ES，-0.15；LB，-0.37；UB，0.07），CAR 较低。ACL 重建的对侧肢体（ES，-0.73；LB，-1.39；UB，-0.07）与健康对照组相比，CAR 较低，但膝关节伸展力量相似（ES，-0.24；LB，-0.68；UB，-0.19）。
ACL 重建患者存在双侧 CAR 缺陷和患侧力量缺陷，这些缺陷在手术后多年仍然存在。股四头肌功能缺陷可能对患者报告和客观结果、再受伤风险以及 ACL 重建后的长期关节健康具有重要意义。
