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前交叉韧带重建术后4年多时间里,两种速度下整个步态周期中的下肢关节力矩。

Lower extremity joint moments throughout gait at two speeds more than 4 years after ACL reconstruction.

作者信息

Stoelben Karine Josibel Velasques, Pappas Evangelos, Mota Carlos Bolli

机构信息

Federal University of Pampa - Laboratory of Applied Neuromechanics, BR 472 km 592 - Po box 118 - ZIP 97500-970, Uruguaiana, RS, Brazil.

The University of Sydney, Faculty of Health Sciences, 75 East str, Lidcombe, NSW 2141, Australia.

出版信息

Gait Posture. 2019 May;70:347-354. doi: 10.1016/j.gaitpost.2019.02.025. Epub 2019 Feb 25.

Abstract

BACKGROUND

Long-term gait adaptations after anterior cruciate ligament reconstruction (ACLR) have been reported. However, it is still unclear if they persist more than 4 years after surgery and if they are affected by gait speed.

RESEARCH QUESTION

To investigate differences between groups, legs and walking speeds for ankle, knee and hip joint moments in three planes throughout the stance phase of gait.

METHODS

Reconstructed participants (n = 20 males, 32.5 years, 5.5 years post-ACLR) and healthy controls (n = 20 males, 30.6 years) took part in the study. Gait analysis was performed in two different speeds (self-selected and 30% faster). Sagittal, frontal and transverse plane external moments were measured for ankle, knee and hip and compared throughout the stance phase using 95% confidence intervals. Significant differences were established as a consecutive 5% of gait cycle in which 95% confidence interval did not overlap.

RESULTS

The reconstructed leg did not demonstrate higher joint moments; there were largely no differences while there was lower knee external rotation moment compared to the non-preferred leg of the control group. Higher joint moments were observed during fast speed walking on sagittal plane for knee and hip moments in both groups, and in the frontal and transverse plane for ankle moments.

SIGNIFICANCE

Gait kinetics appear to be largely normalized at a minimum of 4 years after ACLR. Faster walking speed increase lower extremity joint moments.

摘要

背景

已有报道称前交叉韧带重建术(ACLR)后存在长期步态适应性变化。然而,目前仍不清楚这些变化在手术后4年以上是否依然存在,以及是否会受到步态速度的影响。

研究问题

研究在步态站立期的三个平面上,踝关节、膝关节和髋关节力矩在不同组、不同腿以及不同步行速度之间的差异。

方法

重建组参与者(n = 20名男性,32.5岁,ACLR术后5.5年)和健康对照组(n = 20名男性,30.6岁)参与了本研究。以两种不同速度(自选速度和快30%的速度)进行步态分析。测量踝关节、膝关节和髋关节在矢状面、额状面和横断面的外力矩,并在整个站立期使用95%置信区间进行比较。当95%置信区间在连续5%的步态周期内不重叠时,则确定存在显著差异。

结果

重建腿并未表现出更高的关节力矩;与对照组非优势腿相比,膝关节外旋力矩较低,但总体上差异不大。两组在快速步行时,矢状面上膝关节和髋关节力矩以及额状面和横断面上踝关节力矩均观察到更高的关节力矩。

意义

ACLR术后至少4年,步态动力学似乎在很大程度上已恢复正常。更快的步行速度会增加下肢关节力矩。

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