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常报告的等速参数并不能揭示跟腱断裂手术后三腿头肌复合体的长期力量缺陷。

Commonly reported isokinetic parameters do not reveal long-term strength deficits of the Triceps surae complex following operative treatment of Achilles tendon rupture.

机构信息

Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom.

Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom.

出版信息

J Biomech. 2020 Mar 5;101:109630. doi: 10.1016/j.jbiomech.2020.109630. Epub 2020 Jan 16.

DOI:10.1016/j.jbiomech.2020.109630
PMID:31983406
Abstract

Isokinetic strength assessments are common outcome measures following operatively treated Achilles tendon (AT) ruptures. However, there is a lack of clarity on whether commonly reported outcome measures (such as peak joint moment) are sufficient to describe the extent of long-term functional deficits following AT rupture and repair. The present study conducted a comprehensive isokinetic evaluation of the Triceps surae complex in 12 participants who previously underwent AT rupture and repair. Testing occurred 4.4 (±2.6) years following surgery, and consisted of maximal isokinetic strength assessments of the plantarflexors at two angular velocities (30 and 60°∙s) with the knee in flexed and straight positions. Differences between injured and non-injured limbs were tested through discrete and statistical parametric mapping analysis. Average joint moment showed significant main effects between injured and non-injured limbs, but common isokinetic parameters such as peak moment and angle of peak moment did not. The normalised moment curves showed a significant main effect of limb, angular velocity and knee joint position on joint moment throughout different portions of the range of motion. Temporal analysis revealed a significantly greater ability of the non-injured limb to sustain plantarflexor moments across a range of testing conditions. Participants who had undergone operative treatment of AT ruptures did not display inter-limb differences in discrete isokinetic strength outcomes that are often used in the literature. Instead, temporal analyses were required to highlight the reduced capacity of the injured limb to generate end-range joint moments and to sustain higher levels of joint moment for longer periods.

摘要

等速肌力评估是跟腱(AT)断裂术后常见的结局指标。然而,对于常用的报告结果指标(如峰值关节力矩)是否足以描述 AT 断裂和修复后长期功能缺陷的程度,目前仍存在一些模糊性。本研究对 12 名先前接受过 AT 断裂和修复的参与者的比目鱼肌复合体进行了全面的等速评估。测试在术后 4.4(±2.6)年进行,包括在膝关节弯曲和伸直位置下以 30°和 60°/s 的两个角速度对跖屈肌进行最大等速肌力评估。通过离散和统计参数映射分析测试受伤和未受伤肢体之间的差异。平均关节力矩显示受伤和未受伤肢体之间存在显著的主要影响,但常见的等速参数,如峰值力矩和峰值力矩角度,则没有。归一化力矩曲线显示了肢体、角速度和膝关节位置对整个运动范围内关节力矩的显著主要影响。时间分析显示,未受伤的肢体在各种测试条件下都能更好地维持跖屈肌力矩。接受 AT 断裂手术治疗的参与者在离散等速力量结果上没有表现出肢体间差异,而时间分析则需要强调受伤肢体产生终末关节力矩的能力降低,以及更长时间维持更高水平的关节力矩的能力降低。

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