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临床决策算法与前交叉韧带重建后重返运动相关。

Clinical Decision Algorithm Associated With Return to Sport After Anterior Cruciate Ligament Reconstruction.

机构信息

Knee and Sports Research Group, Federal University of Ceará, Fortaleza, Brazil.

Master Program in Physiotherapy and Functioning, Federal University of Ceará, Fortaleza, Brazil.

出版信息

J Athl Train. 2020 Jul 1;55(7):691-698. doi: 10.4085/1062-6050-82-19.


DOI:10.4085/1062-6050-82-19
PMID:32396470
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7384465/
Abstract

CONTEXT: Understanding the factors that predict return to sport (RTS) after anterior cruciate ligament reconstruction facilitates clinical decision making. OBJECTIVE: To develop a clinical decision algorithm that could predict RTS and non-RTS based on the differences in the variables after anterior cruciate ligament reconstruction. DESIGN: Cross-sectional study. SETTING: University laboratory. PATIENTS OR OTHER PARTICIPANTS: A total of 150 athletes in any sport involving deceleration, jumping, cutting, or turning enrolled in the study. All participants answered the International Knee Documentation Committee and Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) questionnaires and performed balance and isokinetic tests. MAIN OUTCOME MEASURE(S): The classification and regression tree (CART) was used to determine the clinical decision algorithm associated with RTS at any level and RTS at the preinjury level. The diagnostic accuracy of the CART was verified. RESULTS: Of the 150 participants, 57.3% (n = 86) returned to sport at any level and 12% (n = 18) returned to sport at the preinjury level. The interactions among the peak torque extension at 300°/s >93.55 Nm, ACL-RSI score >27.05 (P = .06), and postoperative time >7.50 months were associated with RTS at any level identified by CART and were factors associated with RTS. An ACL-RSI score >72.85% was the main variable associated with RTS at the preinjury level. The interaction among an ACL-RSI score of 50.40% to 72.85%, agonist : antagonist ratio at 300°/s ≤63.6%, and anteroposterior stability index ≤2.4 in these participants was the second factor associated with RTS at the preinjury level. CONCLUSIONS: Athletes who had more quadriceps strength tended to RTS at any level more quickly, even with less-than-expected psychological readiness. Regarding a return at the preinjury level, psychological readiness was the most important factor in not returning, followed by a better agonist : antagonist ratio and better balance.

摘要

背景:了解预测前交叉韧带重建后重返运动(RTS)的因素有助于临床决策。 目的:制定一种临床决策算法,根据前交叉韧带重建后变量的差异,预测 RTS 和非 RTS。 设计:横断面研究。 设置:大学实验室。 患者或其他参与者:共有 150 名从事减速、跳跃、切割或转弯等运动的运动员参与了这项研究。所有参与者均回答了国际膝关节文献委员会和前交叉韧带损伤后重返运动的评估(ACL-RSI)问卷,并进行了平衡和等速测试。 主要观察指标:分类回归树(CART)用于确定与任何水平和受伤前水平 RTS 相关的临床决策算法。验证了 CART 的诊断准确性。 结果:在 150 名参与者中,57.3%(n=86)在任何水平上重返运动,12%(n=18)在受伤前水平上重返运动。300°/s 时的峰值扭矩伸膝>93.55 Nm、ACL-RSI 评分>27.05(P=0.06)和术后时间>7.50 个月之间的相互作用与 CART 确定的任何水平的 RTS 相关,是 RTS 的相关因素。ACL-RSI 评分>72.85%是与受伤前水平 RTS 相关的主要变量。在这些参与者中,ACL-RSI 评分为 50.40%至 72.85%、300°/s 时的收缩/拮抗比值≤63.6%和前后稳定性指数≤2.4 之间的相互作用是与受伤前水平 RTS 相关的第二个因素。 结论:股四头肌力量较强的运动员往往会更快地在任何水平上恢复运动,即使他们的心理准备程度低于预期。至于恢复到受伤前的水平,心理准备是最重要的因素,其次是更好的收缩/拮抗比值和更好的平衡。

相似文献

[1]
Clinical Decision Algorithm Associated With Return to Sport After Anterior Cruciate Ligament Reconstruction.

J Athl Train. 2020-7-1

[2]
Decision to Return to Sport Participation After Anterior Cruciate Ligament Reconstruction, Part II: Self-Reported and Functional Performance Outcomes.

J Athl Train. 2018-5-18

[3]
Combining return to sport, psychological readiness, body mass, hamstring strength symmetry, and hamstring/quadriceps ratio increases the risk of a second anterior cruciate ligament injury.

Knee Surg Sports Traumatol Arthrosc. 2023-11

[4]
Importance of functional performance and psychological readiness for return to preinjury level of sports 1 year after ACL reconstruction in competitive athletes.

Knee Surg Sports Traumatol Arthrosc. 2019-11-2

[5]
The Role of Psychological Readiness in Return to Sport Assessment After Anterior Cruciate Ligament Reconstruction.

Am J Sports Med. 2021-4

[6]
Knee Function, Strength, and Resumption of Preinjury Sports Participation in Young Athletes Following Anterior Cruciate Ligament Reconstruction.

J Orthop Sports Phys Ther. 2019-2-15

[7]
Quadriceps Strength Deficit at 6 Months After ACL Reconstruction Does Not Predict Return to Preinjury Sports Level.

Sports Health. 2018-2-27

[8]
No Relationship Between Strength and Power Scores and Anterior Cruciate Ligament Return to Sport After Injury Scale 9 Months After Anterior Cruciate Ligament Reconstruction.

Am J Sports Med. 2020-1

[9]
Factors Associated With Psychological Readiness to Return to Sport After Anterior Cruciate Ligament Reconstruction Surgery.

Am J Sports Med. 2018-5-2

[10]
Factors Associated With Sports Function and Psychological Readiness to Return to Sports at 12 Months After Anterior Cruciate Ligament Reconstruction: A Cross-sectional Study.

Am J Sports Med. 2023-10

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The Effect of Mild Residual Rotational Laxity on Performance After Anterior Cruciate Ligament Reconstruction.

Orthop J Sports Med. 2025-7-16

[2]
Beyond physical recovery: investigating athletic identity as a mediator between social support and psychological readiness for return to sport.

Aust J Psychol. 2024-9-16

[3]
Assessing the Predictive Value of Preoperative Knee Function Tests and Self-Report Scores in Anterior Cruciate Ligament Injury Recovery.

Sports Health. 2025-3-27

[4]
Physical demands of collegiate basketball practice: a preliminary report on novel methods and metrics.

Front Sports Act Living. 2024-9-23

[5]
Psychosocial interventions seem redact kinesiophobia after anterior cruciate ligament reconstruction but higher level of evidence is needed: a systematic review and meta-analysis.

Knee Surg Sports Traumatol Arthrosc. 2023-12

[6]
Gender does not impact clinical outcomes following SLAP repair.

Shoulder Elbow. 2023-10

[7]
Combining return to sport, psychological readiness, body mass, hamstring strength symmetry, and hamstring/quadriceps ratio increases the risk of a second anterior cruciate ligament injury.

Knee Surg Sports Traumatol Arthrosc. 2023-11

[8]
[Return to sports WeChat applet for evaluating the rehabilitation effects after anterior cruciate ligament reconstruction].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023-9-15

[9]
Association of Psychological Readiness to Return to Sports With Subjective Level of Return at 12 Months After ACL Reconstruction.

Orthop J Sports Med. 2023-9-7

[10]
[Progress in evaluation of return to sports after anterior cruciate ligament reconstruction].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023-4-15

本文引用的文献

[1]
Decision to Return to Sport Participation After Anterior Cruciate Ligament Reconstruction, Part II: Self-Reported and Functional Performance Outcomes.

J Athl Train. 2018-5-18

[2]
Quality of Life in Symptomatic Individuals After Anterior Cruciate Ligament Reconstruction, With and Without Radiographic Knee Osteoarthritis.

J Orthop Sports Phys Ther. 2018-4-18

[3]
Quadriceps Strength Deficit at 6 Months After ACL Reconstruction Does Not Predict Return to Preinjury Sports Level.

Sports Health. 2018-2-27

[4]
Concomitant injuries may not reduce the likelihood of achieving symmetrical muscle function one year after anterior cruciate ligament reconstruction: a prospective observational study based on 263 patients.

Knee Surg Sports Traumatol Arthrosc. 2018-2-5

[5]
Young Athletes Cleared for Sports Participation After Anterior Cruciate Ligament Reconstruction: How Many Actually Meet Recommended Return-to-Sport Criterion Cutoffs?

J Orthop Sports Phys Ther. 2017-11

[6]
Functional performance 6 months after ACL reconstruction can predict return to participation in the same preinjury activity level 12 and 24 months after surgery.

Br J Sports Med. 2018-3

[7]
Translation, cross-adaptation and measurement properties of the Brazilian version of the ACL-RSI Scale and ACL-QoL Questionnaire in patients with anterior cruciate ligament reconstruction.

Braz J Phys Ther. 2017-9-12

[8]
Quadriceps Function and Hamstrings Co-Activation After Anterior Cruciate Ligament Reconstruction.

J Athl Train. 2017-5

[9]
Optimization of the Return-to-Sport Paradigm After Anterior Cruciate Ligament Reconstruction: A Critical Step Back to Move Forward.

Sports Med. 2017-8

[10]
Complex systems approach for sports injuries: moving from risk factor identification to injury pattern recognition-narrative review and new concept.

Br J Sports Med. 2016-11

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