Piussi Ramana, Beischer Susanne, Thomeé Roland, Hamrin Senorski Eric
Sportrehab Sports Medicine Clinic, Stampgatan 14, SE-411 01 Gothenburg, Sweden.
2Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, SE-405 30 Gothenburg, Sweden.
BMC Sports Sci Med Rehabil. 2020 May 13;12:32. doi: 10.1186/s13102-020-00182-z. eCollection 2020.
There is growing interest in assessing psychological well-being in patients after anterior cruciate ligament (ACL) reconstruction. It is unknown whether an assessment of psychological outcome in addition to tests of muscle function can facilitate decisions on return to sport (RTS). Therefore, the aim of this study was to evaluate passing rates in different physical RTS test batteries, with and without the inclusion of psychological outcome measures 1 year after ACL reconstruction.
In this cross-sectional cohort study a total of 320 patients (51% men) aged 18-65 years were included 1 year after ACL reconstruction Passing rates on different muscle function (MF) test batteries (with results presented as Limb Symmetry Index (LSI)), consisting of knee extension and flexion strength tests, 3 hop tests, and 2 psychological patient-reported outcomes (PROs); Quality of Life subscale from the Knee injury and Osteoarthritis Outcome Score (KOOS QoL) and ACL Return to Sport after Injury (ACL-RSI), were evaluated 1 year after ACL reconstruction. Muscle function test batteries comprised: 2 MF tests (vertical hop and hop for distance; pass = 90% LSI); 2 MF tests and 2 PRO (pass = 90% LSI, 62.5 points on KOOS QoL and 76.6 points on ACL-RSI), 5 MF tests (2 strength and 3 hop tests, pass = 90% LSI), and 5 MF tests and 2 PRO (pass = 90% LSI, 62.5 points on KOOS QoL and 76.6 points on ACL-RSI).
Passing rates in the different test batteries were 47% for 2 MF tests, 19% for 2 MF tests and 2 PROs, 29% for 5 MF tests and 13% for 5 MF tests and 2 PROs. The use of psychological PROs together with tests of muscle function gave the lowest passing rate (13%). There was a very strong correlation between passing 2 hop tests and 2 PROs and passing 5 MF tests (rφ = 0.41) as well as passing 5 MF tests and 2 PROs (rφ = 0.79).
The use of hop tests together with psychological PROs provides a clinician-friendly RTS test battery for assessment 1 year after ACL reconstruction as the passing rate was 19% when using 2 hop-tests combined with 2 PROs, compared with 29% when using 5 tests of MF requiring advanced testing equipment.
评估前交叉韧带（ACL）重建术后患者的心理健康状况越来越受到关注。除肌肉功能测试外，心理结果评估是否有助于做出恢复运动（RTS）的决策尚不清楚。因此，本研究的目的是评估ACL重建术后1年，在不同的身体RTS测试组合中，纳入和不纳入心理结果测量时的通过率。
在这项横断面队列研究中，共有320名年龄在18 - 65岁之间的患者（51%为男性）在ACL重建术后1年被纳入研究。评估了不同肌肉功能（MF）测试组合的通过率（结果以肢体对称指数（LSI）表示），包括膝关节伸展和屈曲力量测试、3次单腿跳测试以及2项患者自我报告的心理结果（PROs）；膝关节损伤和骨关节炎结果评分（KOOS QoL）中的生活质量子量表以及ACL损伤后恢复运动（ACL-RSI），这些评估在ACL重建术后1年进行。肌肉功能测试组合包括：2项MF测试（垂直单腿跳和跳远；通过标准 = LSI 90%）；2项MF测试和2项PRO（通过标准 = LSI 90%，KOOS QoL 62.5分，ACL-RSI 76.6分），5项MF测试（2项力量测试和3次单腿跳测试，通过标准 = LSI 90%），以及5项MF测试和2项PRO（通过标准 = LSI 90%，KOOS QoL 62.5分，ACL-RSI 76.6分）。
不同测试组合的通过率分别为：2项MF测试为47%，2项MF测试和2项PRO为19%，5项MF测试为29%，5项MF测试和2项PRO为13%。将心理PROs与肌肉功能测试一起使用时通过率最低（13%）。通过2次单腿跳测试和2项PRO与通过5项MF测试之间（rφ = 0.41）以及通过5项MF测试和2项PRO之间（rφ = 0.79）存在非常强的相关性。
将单腿跳测试与心理PROs一起使用，为ACL重建术后1年的评估提供了一种临床医生友好的RTS测试组合，因为当使用2次单腿跳测试与2项PRO组合时通过率为19%，而使用需要先进测试设备的5项MF测试时通过率为29%。
