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基于标准的前交叉韧带重建术后康复计划及重返运动测试:病例系列

CRITERION-BASED REHABILITATION PROGRAM WITH RETURN TO SPORT TESTING FOLLOWING ACL RECONSTRUCTION: A CASE SERIES.

作者信息

Joreitz Rick, Lynch Andrew, Popchak Adam, Irrgang Jay

机构信息

Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA.

Rehabilitation and Movement Sciences, Rutgers University, Newark, NJ, USA.

出版信息

Int J Sports Phys Ther. 2020 Dec;15(6):1151-1173. doi: 10.26603/ijspt20201151.

Abstract

BACKGROUND

Less than 50% of those sustaining an anterior cruciate ligament (ACL) injury return to their preinjury level of sports participation or participate in competitive sport at two to seven years post ACL reconstruction (ACLR). After ACLR, it has been reported that frequency of subsequent ACL tears has reached as high as 31%.

PURPOSE

The purpose of this case series was to evaluate return to sport and reinjury rates following the use of a criterion-based rehabilitation protocol with a final return to sport test that utilizes minimal equipment following ACL reconstruction.

STUDY DESIGN

Case series.

METHODS

Following ACL reconstruction, participants were included if they had a goal of returning to their pre-injury sport or level of activity, were between 16 and 50 years of age at the time of evaluation, had at least 25 physical therapy visits covered by insurance, and planned to complete physical therapy until clearance for return to sport.

RESULTS

Forty-three participants met the inclusion criteria and enrolled in the study. Twenty-one participants completed the full course of rehabilitation including passing their return to sport test and nineteen participants completed the two-year follow-up. Data obtained at two years indicated that 84% were able to return to their preinjury level of sports competition. A smaller percentage (16%) were able to return to a reduced level of sport and only one participant reported a second ACL injury.

CONCLUSION

Participants that completed the full course of rehabilitation and passed return to sport testing had a larger percentage that were able to return to preinjury participation levels than currently reported in the literature. This case series did not exclude participants based on graft type, single vs double bundle procedure, ACL revision surgeries, nor concomitant procedures or injuries.

LEVEL OF EVIDENCE

Level 4.

摘要

背景

前交叉韧带(ACL)损伤患者中,不到50%的人在ACL重建(ACLR)后两到七年恢复到受伤前的运动参与水平或参加竞技运动。据报道,ACLR后,后续ACL撕裂的发生率高达31%。

目的

本病例系列的目的是评估在使用基于标准的康复方案并进行最终的运动恢复测试(该测试使用最少的设备)后,ACLR后的运动恢复情况和再损伤率。

研究设计

病例系列。

方法

ACLR后,若参与者有恢复到受伤前运动或活动水平的目标,在评估时年龄在16至50岁之间,有至少25次保险覆盖的物理治疗就诊次数,且计划完成物理治疗直至获得恢复运动的许可,则纳入研究。

结果

43名参与者符合纳入标准并参与了研究。21名参与者完成了整个康复过程,包括通过运动恢复测试,19名参与者完成了两年随访。两年时获得的数据表明,84%的人能够恢复到受伤前的运动竞赛水平。较小比例(16%)的人能够恢复到较低水平的运动,只有一名参与者报告了第二次ACL损伤。

结论

完成整个康复过程并通过运动恢复测试的参与者中,能够恢复到受伤前参与水平的比例高于目前文献报道。本病例系列未根据移植物类型、单束与双束手术、ACL翻修手术、以及伴随的手术或损伤排除参与者。

证据水平

4级。

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