功能性抗阻训练改善急性前交叉韧带重建术后膝关节力量和功能：1 例病例报告。
Functional Resistance Training to Improve Knee Strength and Function After Acute Anterior Cruciate Ligament Reconstruction: A Case Study.
机构信息
Neuromuscular and Rehabilitation Robotics Laboratory (NeuRRo Lab), Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan.
Biomedical Engineering, University of Michigan, Ann Arbor, Michigan.
出版信息
Sports Health. 2021 Mar;13(2):136-144. doi: 10.1177/1941738120955184. Epub 2020 Dec 18.
BACKGROUND
Thigh muscle weakness after anterior cruciate ligament reconstruction (ACLR) can persist after returning to activity. While resistance training can improve muscle function, "nonfunctional" training methods are not optimal for inducing transfer of benefits to activities such as walking. Here, we tested the feasibility of a novel functional resistance training (FRT) approach to restore strength and function in an individual with ACLR.
HYPOTHESIS
FRT would improve knee strength and function after ACLR.
STUDY DESIGN
Case report.
LEVEL OF EVIDENCE
Level 5.
METHODS
A 15-year-old male patient volunteered for an 8-week intervention where he performed 30 minutes of treadmill walking, 3 times per week, while wearing a custom-designed knee brace that provided resistance to the thigh muscles of his ACLR leg. Thigh strength, gait mechanics, and corticospinal and spinal excitability were assessed before and immediately after the 8-week intervention. Voluntary muscle activation was evaluated immediately after the intervention.
RESULTS
Knee extensor and flexor strength increased in the ACLR leg from pre- to posttraining (130 to 225 N·m [+74%] and 44 to 88 N·m [+99%], respectively) and increases in between-limb extensor and flexor strength symmetry (45% to 92% [+74%] and 47% to 72% [+65%], respectively) were also noted. After the intervention, voluntary muscle activation in the ACLR leg was 72%, compared with the non-ACLR leg at 75%. Knee angle and moment during late stance phase decreased (ie, improved) in the ACLR leg and appeared more similar to the non-ACLR leg after FRT training (18° to 14° [-23.4] and 0.07 to -0.02 N·m·kg·m [-122.8%], respectively). Corticospinal and spinal excitability in the ACLR leg decreased (3511 to 2511 [-28.5%] and 0.42 to 0.24 [-43.7%], respectively) from pre- to posttraining.
CONCLUSION
A full 8 weeks of FRT that targeted both quadriceps and hamstring muscles lead to improvements in strength and gait, suggesting that FRT may constitute a promising and practical alternative to traditional methods of resistance training.
CLINICAL RELEVANCE
FRT may serve as a viable approach to improve knee strength and function after ACL reconstruction.
背景
前交叉韧带重建 (ACLR) 后大腿肌肉力量减弱，在恢复活动后仍持续存在。虽然阻力训练可以改善肌肉功能，但“非功能性”训练方法对于将益处转移到行走等活动中并不理想。在这里，我们测试了一种新的功能性阻力训练 (FRT) 方法在 ACLR 后恢复力量和功能的可行性。
假设
FRT 将改善 ACLR 后的膝关节力量和功能。
研究设计
病例报告。
证据水平
5 级。
方法
一名 15 岁男性患者自愿参加了一项 8 周的干预措施，他每周进行 3 次，每次 30 分钟的跑步机行走，同时穿着一种定制的膝关节支具，该支具为 ACLR 腿的大腿肌肉提供阻力。在 8 周的干预前后评估了大腿力量、步态力学以及皮质脊髓和脊髓兴奋性。干预后立即评估自愿肌肉激活。
结果
ACL 腿的膝关节伸肌和屈肌力量在训练前至训练后增加（130 至 225 N·m [+74%] 和 44 至 88 N·m [+99%]），并且在两腿之间的伸肌和屈肌力量对称性增加（45%至 92% [+74%] 和 47%至 72% [+65%]）。干预后，ACL 腿的自愿肌肉激活为 72%，而非 ACLR 腿为 75%。ACL 腿在后期站立阶段的膝关节角度和力矩减小（即改善），并且在 FRT 训练后看起来更类似于非 ACLR 腿（18°至 14° [-23.4] 和 0.07 至 -0.02 N·m·kg·m [-122.8%]）。ACL 腿的皮质脊髓和脊髓兴奋性在训练前至训练后降低（3511 至 2511 [-28.5%] 和 0.42 至 0.24 [-43.7%]）。
结论
为期整整 8 周的针对股四头肌和腘绳肌的 FRT 导致力量和步态的改善，这表明 FRT 可能成为传统阻力训练方法的一种有前途且实用的替代方法。
临床相关性
FRT 可能是改善 ACL 重建后膝关节力量和功能的可行方法。
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