Meierbachtol Adam, Obermeier Michael, Yungtum William, Bottoms John, Paur Eric, Nelson Bradley J, Tompkins Marc, Chmielewski Terese L
Physical Therapy Department, TRIA Orthopedic Center, Bloomington, Minnesota, USA.
Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
J Orthop Res. 2022 Jan;40(1):191-199. doi: 10.1002/jor.25072. Epub 2021 May 18.
Patients with anterior cruciate ligament reconstruction (ACLR) are often psychologically and physically under-prepared for sports participation. This study compared readiness to return to sport based on completion of advanced training after ACLR. Patients with ACLR who self-selected participation in a 6-week group-format advanced training program (TRAINING) were compared to age- and sex-matched patients who did not participate (NoTRAINING). Each group had 23 participants (14 females). Advanced training consisted of plyometric, strengthening, and agility exercises. Baseline and follow-up testing included psychological measures (Anterior Cruciate Ligament Return to Sport after Injury [ACL-RSI]; Tampa Scale for Kinesiophobia [TSK-11]; Knee Activity Self-Efficacy [KASE]; and fear intensity for the primary fear-evoking task or situation) and a hop test battery. Return to sport criteria were ACL-RSI score ≥70 points and limb symmetry index ≥90% on all hop tests. At follow-up, KASE score was higher in TRAINING than NoTRAINING (92.7 vs. 89.1 points; respectively), but ACL-RSI, TSK-11 and fear intensity scores were not significantly different between groups. Return to sport criteria passing rate was not significantly different between groups at baseline (TRAINING: 13%, NoTRAINING: 30%) or follow-up (TRAINING: 52%, NoTRAINING: 43%); however, the distribution of criteria met at follow-up differed with more patients in TRAINING than NoTRAINING meeting hop test criteria (30% vs. 4%, respectively) and more patients in NoTRAINING than TRAINING failing to meet any criteria (25% vs. 0%, respectively). Advanced training after ACLR facilitated readiness for sport participation by improving confidence and hop performance, but may not have a preferential effect on fear.
前交叉韧带重建术（ACLR）患者在心理和身体上往往对恢复运动准备不足。本研究比较了前交叉韧带重建术后完成进阶训练后恢复运动的准备情况。将自行选择参加为期6周的小组形式进阶训练计划（训练组）的前交叉韧带重建术患者与未参加的年龄和性别匹配患者（非训练组）进行比较。每组有23名参与者（14名女性）。进阶训练包括增强式、力量训练和敏捷性练习。基线和随访测试包括心理测量（损伤后前交叉韧带恢复运动量表[ACL-RSI]；坦帕运动恐惧量表[TSK-11]；膝关节活动自我效能感[KASE]；以及对主要恐惧诱发任务或情境的恐惧强度）和一组单腿跳测试。恢复运动的标准是ACL-RSI评分≥70分且所有单腿跳测试的肢体对称指数≥90%。在随访时，训练组的KASE评分高于非训练组（分别为92.7分和89.1分），但两组之间的ACL-RSI、TSK-11和恐惧强度评分无显著差异。在基线时（训练组：13%，非训练组：30%）或随访时（训练组：52%，非训练组：43%），两组恢复运动标准的通过率无显著差异；然而，随访时达到标准的分布情况有所不同，训练组达到单腿跳测试标准的患者多于非训练组（分别为30%和4%），非训练组未达到任何标准的患者多于训练组（分别为25%和0%）。前交叉韧带重建术后的进阶训练通过提高自信心和单腿跳表现促进了运动参与的准备，但可能对恐惧没有优先影响。
