Read Paul J, Michael Auliffe Sean, Wilson Mathew G, Graham-Smith Philip
Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
School of Sport and Exercise Sciences, University of Gloucestershire, Gloucester, UK.
Am J Sports Med. 2020 May;48(6):1365-1373. doi: 10.1177/0363546520912218. Epub 2020 Apr 15.
Residual between-limb deficits are a possible contributing factor to poor outcomes in athletic populations after anterior cruciate ligament reconstruction (ACLR). Comprehensive appraisals of movement strategies utilized by athletes at key clinical milestones during rehabilitation are warranted.
To examine kinetic parameters recorded during a countermovement jump with a force platform in healthy professional soccer players and to compare their performance with those who had undergone ACLR at different stages of their rehabilitation.
Cross-sectional study; Level of evidence, 3.
A total of 370 male professional soccer players attended a physical screening assessment where they performed at counter jump movement protocol on dual force plates and were divided into 4 groups: group 1 (<6 months post-ACLR), group 2 (6-9 months post-ACLR), group 3 (>9 months post-ACLR), and group 4 (healthy matched controls).
Players in the later phases of rehabilitation increased their jump performance; however, values were significantly lower than those of healthy matched controls ( > .05). Significant between-limb differences were present for both eccentric- and concentric-phase variables ( < .05), with effect sizes ranging from moderate to very large ( = 0.42-1.35). Asymmetries were lower in players who were further away from surgery; however, between-limb differences remained significantly greater in players >9 months after ACLR versus matched controls-specifically, for concentric impulse, concentric peak force, eccentric deceleration impulse, and eccentric deceleration rate of force development asymmetry ( < .05). Logistic regression identified concentric impulse asymmetry as being most strongly associated with a history of ACLR when group prediction analysis was performed (ACLR group 1, 2, or 3 vs matched controls), with odds ratios ranging from 1.50 to 1.91.
Between-limb deficits in key eccentric and concentric loading parameters remain >9 months after ACLR, indicating a compensatory offloading strategy to protect the involved limb during an athletic performance task. Concentric impulse asymmetry could be considered an important variable to monitor during rehabilitation.
肢体间残余功能缺陷可能是前交叉韧带重建（ACLR）后运动员群体预后不良的一个潜在因素。有必要对康复过程中关键临床节点上运动员所采用的运动策略进行全面评估。
研究健康职业足球运动员在使用测力平台进行反向跳跃时记录的动力学参数，并将他们的表现与处于康复不同阶段的ACL重建运动员进行比较。
横断面研究；证据等级，3级。
共有370名男性职业足球运动员参加了一次身体筛查评估，他们在双测力板上进行反向跳跃动作测试，并被分为4组：第1组（ACLR术后<6个月），第2组（ACLR术后6 - 9个月），第3组（ACLR术后>9个月），以及第4组（健康匹配对照组）。
康复后期的运动员跳跃表现有所提高；然而，其数值显著低于健康匹配对照组（P>0.05）。离心和向心阶段变量均存在显著的肢体间差异（P<0.05），效应大小从中度到非常大（Cohen's d = 0.42 - 1.35）。离手术时间越远的运动员不对称性越低；然而，ACLR术后>9个月的运动员与匹配对照组相比，肢体间差异仍然显著更大——具体而言，对于向心冲量、向心峰值力、离心减速冲量以及离心减速力发展速率不对称性（P<0.05）。当进行组预测分析（ACLR第1、2或3组与匹配对照组）时，逻辑回归确定向心冲量不对称性与ACLR病史关联最为紧密，优势比范围为1.50至1.91。
ACLR术后>9个月，关键离心和向心负荷参数的肢体间缺陷仍然存在，表明在运动表现任务中存在一种补偿性卸载策略以保护患侧肢体。向心冲量不对称性可被视为康复过程中一个需要监测的重要变量。
