Department of Physical Therapy and Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA.
Am J Sports Med. 2019 Sep;47(11):2608-2616. doi: 10.1177/0363546519864688. Epub 2019 Aug 2.
While between-limb landing asymmetries after anterior cruciate ligament reconstruction (ACLR) are linked with poor function and risk of additional injury, it is not currently understood how landing symmetry changes over time after ACLR.
PURPOSE/HYPOTHESIS: The purpose was to investigate how double-legged drop vertical jump (DVJ) landing and single-legged drop-landing symmetry changed from the time of return-to-sport (RTS) clearance to 2 years later in a prospective cohort of young athletes after ACLR. It was hypothesized that double-legged DVJ landing and single-legged drop-landing symmetry would improve from the time of RTS to 2 years later.
Descriptive laboratory study.
The authors followed 64 young athletes with primary, unilateral ACLR for 2 years after RTS clearance. At the time of RTS and 2 years later, between-limb symmetry values for biomechanical variables of interest (VOIs) were calculated with 3-dimensional motion analysis during double-legged DVJ and single-legged drop-landing tasks. VOIs included knee flexion excursion, peak internal knee extension moment, peak vertical ground-reaction force, and peak trunk flexion (for single-legged task only). Symmetry values and proportions of participants meeting 90% symmetry cutoffs were compared between time points.
For double-legged DVJ landing, symmetry values for all VOIs and the proportions meeting 90% cutoffs for peak internal knee extension moment and peak vertical ground-reaction force were higher at 2 years after RTS as compared with RTS. For single-legged drop-landing, symmetry values were higher for knee flexion excursion and lower for peak trunk flexion at 2 years after RTS as compared with RTS, but the proportions meeting 90% cutoffs for all VOIs did not differ between time points.
Double-legged DVJ landing symmetry improved across VOIs over the 2 years after RTS following ACLR, while single-legged drop-landing did not improve as consistently. The implications of longitudinal landing asymmetry after ACLR should be further studied.
尽管前交叉韧带重建 (ACLR) 后肢体间的着陆不对称与功能不佳和额外受伤的风险有关，但目前尚不清楚 ACLR 后着陆对称性随时间的变化情况。
目的/假设：本研究旨在探讨 ACLR 后年轻运动员从重返运动 (RTS) 许可到 2 年后，双侧垂直跳 (DVJ) 着陆和单腿落地着陆的对称性如何变化。假设双足 DVJ 着陆和单腿落地着陆的对称性将从 RTS 时改善到 2 年后。
描述性实验室研究。
作者对 64 名接受单侧 ACLR 的年轻运动员进行了为期 2 年的随访，从 RTS 许可后开始。在 RTS 和 2 年后，通过 3 维运动分析计算双足 DVJ 和单腿落地任务中感兴趣的生物力学变量 (VOI) 的肢体间对称性值。VOI 包括膝关节屈曲度、峰值内膝伸力矩、峰值垂直地面反作用力和峰值躯干前屈（仅适用于单腿任务）。比较了各时间点的对称性值和符合 90%对称性截止值的参与者比例。
对于双足 DVJ 着陆，与 RTS 相比，所有 VOI 的对称性值以及符合峰值内膝伸力矩和峰值垂直地面反作用力 90%截止值的比例在 RTS 后 2 年更高。对于单腿落地，与 RTS 相比，膝关节屈曲度的对称性值较高，峰值躯干前屈较低，但各 VOI 符合 90%截止值的比例在两个时间点之间没有差异。
ACL 重建后 RTS 后 2 年内，双足 DVJ 着陆的对称性在多个 VOI 中均得到改善，而单腿落地则没有得到一致改善。应进一步研究 ACLR 后纵向着陆不对称的影响。
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