Smuoviti, Viale Giulio Cesare, 29, 24121, Bergamo (BG), Italy; StudioErre, Via Della Badia, 18, 25127, Brescia (BS), Italy; London Sport Institute, School of Science and Technology, Middlesex University, Greenlands Lane, London, United Kingdom.
Institute of Sport, Exercise and Health, London, United Kingdom; School of Sport and Exercise, University of Gloucestershire, Gloucester, UK 15, United Kingdom.
Phys Ther Sport. 2021 Jan;47:91-104. doi: 10.1016/j.ptsp.2020.11.024. Epub 2020 Nov 10.
Residual deficits in athletic performance are common despite rehabilitation guidelines following anterior cruciate ligament reconstruction including criterion-based progressions to protect healing structures, ensure safe restoration of fundamental physical capacities, and guide appropriate return to sports activities. A synthesis of the available literature is warranted to examine the physical readiness to re-perform of athletic populations in the later stages of rehabilitation in comparison to healthy controls.
To determine the level of strength, power, rate of force development, and reactive strength in adult males who are more than six months following anterior cruciate ligament reconstruction.
A systematic review of the literature was undertaken using the Medline, CINAHL and SPORTDiscus databases and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies including males only and assessed strength, power, rate of force development and reactive strength comparing performance to healthy controls were included. A meta-analysis was also performed to compute standardized mean differences (SMD ± 95% confidence intervals), calculated using Hedge's g, and examine the effect of ACLR on these fundamental physical capacities.
2023 articles were identified, of which 14 articles with similar level of evidence and methodological quality met the inclusion criteria. The most commonly investigated and impaired physical capacity was quadriceps (g = -0.89, 95% CI [-1.33,-0.44]) and hamstring strength (g = -0.44, 95% CI [-0.78,-0.10]). Only one study investigated rate of force development and none measuring reactive strength met our eligibility criteria.
Pooled data showed moderate evidence indicating large and small negative deficits on knee peak extension and flexion, respectively, in male adults at more than 6 months post anterior cruciate ligament reconstruction. The magnitude of these differences are influenced by graft type and can be mitigated by targeted rehabilitation programs. Insufficient evidence is available in male adults following anterior cruciate ligament reconstruction to examine rate of force development and reactive strength.
尽管前交叉韧带重建后有康复指南，包括基于标准的进展以保护愈合结构、确保基本身体能力的安全恢复，并指导适当的重返体育活动，但运动员在康复后期的身体准备状态与健康对照组相比，运动表现仍存在残留缺陷。有必要对现有文献进行综合分析，以检查前交叉韧带重建后 6 个月以上的成年男性运动员的身体准备情况。
确定前交叉韧带重建后 6 个月以上的成年男性在力量、功率、力量发展速度和反应力量方面的水平。
采用 Medline、CINAHL 和 SPORTDiscus 数据库进行文献系统综述，并遵循 PRISMA（系统评价和荟萃分析的首选报告项目）指南。纳入仅纳入男性并评估力量、功率、力量发展速度和反应力量，并将表现与健康对照组进行比较的研究。还进行了荟萃分析，以计算标准化均数差（SMD ± 95%置信区间），使用 Hedge 的 g 计算，并检查 ACLR 对这些基本身体能力的影响。
共确定了 2023 篇文章，其中 14 篇具有相似的证据水平和方法学质量符合纳入标准。最常被研究和受损的身体能力是股四头肌（g = -0.89，95%置信区间 [-1.33，-0.44]）和腘绳肌力量（g = -0.44，95%置信区间 [-0.78，-0.10]）。只有一项研究调查了力量发展速度，而没有一项测量反应强度的研究符合我们的入选标准。
汇总数据表明，在前交叉韧带重建后 6 个月以上的男性成年人中，膝关节伸展和屈曲的峰值存在中等证据表明存在较大和较小的负向缺陷。这些差异的大小受移植物类型的影响，可以通过针对性的康复计划来减轻。在前交叉韧带重建后男性成年人中，尚无足够的证据来检查力量发展速度和反应强度。
