College of Health Sciences, Department of Physical Therapy, University of Kentucky, Lexington, Kentucky.
College of Medicine, Department of Orthopedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky.
Sports Health. 2021 May-Jun;13(3):251-257. doi: 10.1177/1941738120946323. Epub 2020 Nov 17.
Many patients live with long-term deficits in knee function after an anterior cruciate ligament reconstruction (ACLR). However, research is inconclusive as to which physical performance measure is most strongly related to long-term patient-reported outcomes after ACLR.
Quadriceps strength would be most strongly associated with patient-reported long-term outcomes after ACLR.
Cross-sectional study.
Level 3.
A total of 40 patients (29 female) consented and participated an average of 10.9 years post-ACLR (range, 5-20 years). Patients completed the Lower Extremity Functional Scale (LEFS), the International Knee Documentation Committee (IKDC) Scale, Knee injury and Osteoarthritis Outcome Score Quality of Life (KOOS QoL) and Sport (KOOS Sport) subscales, and the Tampa Scale of Kinesiophobia (TSK-17). Each patient subsequently performed maximal isometric quadriceps contraction, a 60-second single-leg step-down test, and the single-leg single hop and triple hop for distance tests. Multivariate linear and logistic regression models determined how performance testing was associated with each patient-reported outcome when controlling for time since surgery, age, and TSK-17.
When controlling for time since surgery, age at the time of consent, and TSK-17 score, maximal isometric quadriceps strength normalized to body weight was the sole physical performance measure associated with IKDC ( < 0.001), KOOS Sport ( = 0.006), KOOS QoL ( = 0.001), and LEFS scores ( < 0.001). Single-leg step-down, single hop, and triple hop did not enter any of the linear regression models ( > 0.20). Additionally, TSK-17 was associated with all patient-reported outcomes ( ≤ 0.01) while time since surgery was not associated with any outcomes ( > 0.05).
Isometric quadriceps strength and kinesiophobia are significantly associated with long-term patient-reported outcomes after ACLR.
These results suggest that training to improve quadriceps strength and addressing kinesiophobia in the late stages of recovery from ACLR may improve long-term self-reported function.
许多患者在前交叉韧带重建 (ACLR) 后长期存在膝关节功能缺陷。然而，研究结果并不一致，无法确定哪种体能测试与 ACLR 后患者长期报告的结果最相关。
股四头肌力量与 ACLR 后患者报告的长期结果最相关。
横断面研究。
3 级。
共有 40 名患者（29 名女性）同意并参与，平均在 ACLR 后 10.9 年（范围 5-20 年）。患者完成了下肢功能量表 (LEFS)、国际膝关节文献委员会 (IKDC) 量表、膝关节损伤和骨关节炎结局评分生活质量 (KOOS QoL) 和运动 (KOOS Sport) 子量表以及 Tampa 运动恐惧量表 (TSK-17)。每位患者随后进行最大等长股四头肌收缩、60 秒单腿台阶下降测试以及单腿单跳和单腿三跳测试。多元线性和逻辑回归模型确定了在控制手术时间、年龄和 TSK-17 后，体能测试与每位患者报告的结果之间的关系。
在控制手术时间、同意时的年龄和 TSK-17 评分后，最大等长股四头肌力量与体重的比值是与 IKDC（<0.001）、KOOS Sport（=0.006）、KOOS QoL（=0.001）和 LEFS 评分（<0.001）相关的唯一体能测试指标。单腿台阶下降、单腿跳跃和单腿三跳均未进入任何线性回归模型（>0.20）。此外，TSK-17 与所有患者报告的结果相关（≤0.01），而手术时间与任何结果均不相关（>0.05）。
等长股四头肌力量和运动恐惧与 ACLR 后患者长期报告的结果显著相关。
这些结果表明，在 ACLR 康复的后期阶段，通过训练来增强股四头肌力量和解决运动恐惧可能会改善长期的自我报告功能。
