Peebles Alexander T, Miller Thomas K, Queen Robin M
Granata Biomechanics Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA.
Department of Orthopedic Surgery, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA.
J Orthop Res. 2022 Jan;40(1):150-158. doi: 10.1002/jor.25039. Epub 2021 Mar 29.
Landing biomechanics provide important information pertaining to second anterior cruciate ligament (ACL) injury risk in patients following ACL reconstruction (ACLR). While traditional motion analysis technologies are often impractical for use in non-laboratory settings, methods to assess landing biomechanics which are inexpensive, portable, and user-friendly have recently been developed and validated. The purpose of this study was to compare landing kinematics and kinetics between ACLR patients and uninjured controls in a non-laboratory setting. Sixteen ACLR patients (7 male/9 female, 6-12 months post-ACLR) and 16 gender-matched controls completed seven bilateral drop vertical jumps and seven unilateral drop landings on each limb. Plantar force was measured bilaterally using force sensing insoles and frontal and sagittal-plane knee kinematics were measured using two tablets, six reflective markers, and automated point tracking software. Plantar force impulse normalized symmetry index (NSI) and knee frontal plane projection angle (FPPA) range of motion were computed during bilateral landing, and knee flexion range of motion NSI was computed during unilateral landing and compared between groups using independent samples t tests. ACLR patients had larger NSIs (reflecting less symmetry) for plantar force impulse during bilateral landing (p < 0.001) and knee flexion range of motion during unilateral landing (p = 0.004). No between-group differences were observed for knee FPPA range of motion (p = 0.111). This study is an important step towards assessing landing biomechanics in non-research settings with the goal of providing quantitative injury risk metrics in a clinical setting that can be used for return to sport decision making.
着陆生物力学为前交叉韧带重建（ACLR）术后患者第二次前交叉韧带（ACL）损伤风险提供了重要信息。虽然传统的运动分析技术在非实验室环境中往往不实用，但最近已经开发并验证了一些评估着陆生物力学的方法，这些方法价格低廉、便于携带且用户友好。本研究的目的是在非实验室环境中比较ACLR患者和未受伤对照组之间的着陆运动学和动力学。16名ACLR患者（7名男性/9名女性，ACLR术后6 - 12个月）和16名性别匹配的对照组完成了每个肢体的七次双侧下落垂直跳跃和七次单侧下落着陆。使用力感应鞋垫双侧测量足底力，并使用两台平板电脑、六个反光标记和自动点跟踪软件测量额状面和矢状面的膝关节运动学。在双侧着陆期间计算足底力冲量归一化对称指数（NSI）和膝关节额状面投影角（FPPA）的运动范围，在单侧着陆期间计算膝关节屈曲运动范围NSI，并使用独立样本t检验比较组间差异。ACLR患者在双侧着陆期间的足底力冲量（p < 0.001）和单侧着陆期间的膝关节屈曲运动范围（p = 0.004）的NSI更大（反映对称性更低）。膝关节FPPA运动范围在组间未观察到差异（p = 0.111）。本研究是朝着在非研究环境中评估着陆生物力学迈出的重要一步，目标是在临床环境中提供可用于运动恢复决策的定量损伤风险指标。
