Costley Jill A E, Miles Joshua J, King Enda, Daniels Katherine A J
Sports Medicine Research Department, Sports Surgery Clinic, Dublin, Republic of Ireland.
Department for Health, University of Bath, Bath, UK.
Sports Biomech. 2023 Jan;22(1):123-141. doi: 10.1080/14763141.2021.1945137. Epub 2021 Sep 21.
Later-stage rehabilitation following anterior cruciate ligament (ACL) reconstruction (ACLR) provides a valuable opportunity to target performance deficits before return to sport. This study aimed to: (1) evaluate bilateral counter-movement jump (CMJ) phase-specific impulse and isokinetic strength inter-limb asymmetry progression from 6 to 9 months post-ACLR; and (2) examine the extent to which individual changes in strength asymmetry could explain changes in impulse asymmetry. Male athletes ( = 44) with a hamstring tendon or bone-patellar tendon-bone autograft were tested 6 and 9 months post-ACLR. Two-way mixed-model ANOVAs were used to identify inter-session and inter-graft differences in CMJ phase-specific impulse asymmetries and knee isokinetic flexor and extensor strength asymmetries, as well as in absolute impulse and strength values of independent (ACLR/uninvolved) limbs. Linear regression models were used to assess the relationship between changes in impulse asymmetry and strength asymmetry. Reductions in strength asymmetry arose from improved ACLR-limb performance, whereas concentric impulse asymmetry reduced consequent to decreased uninvolved-limb performance and eccentric deceleration impulses decreased bilaterally. Graft type did not modulate findings. Changes in strength asymmetry had little or no ability to explain changes in impulse asymmetry. Consideration of approaches that may influence persisting deficits observed bi-laterally throughout vertical jumping performance post-ACLR may enhance rehabilitation practice.
前交叉韧带(ACL)重建术后的后期康复为在恢复运动前针对功能缺陷提供了宝贵机会。本研究旨在:(1)评估ACL重建术后6至9个月双侧反向移动跳(CMJ)特定阶段的冲量和等速肌力的肢体间不对称进展情况;(2)研究力量不对称的个体变化在多大程度上可以解释冲量不对称的变化。对44名采用绳肌腱或骨-髌腱-骨自体移植物的男性运动员在ACL重建术后6个月和9个月进行了测试。采用双向混合模型方差分析来确定CMJ特定阶段冲量不对称以及膝关节等速屈伸肌力不对称在不同测试阶段和不同移植物之间的差异,以及独立(ACL重建侧/未受累侧)肢体的绝对冲量和力量值的差异。使用线性回归模型来评估冲量不对称变化与力量不对称变化之间的关系。力量不对称的减少源于ACL重建侧肢体表现的改善,而向心冲量不对称的减少是由于未受累侧肢体表现的下降,且离心减速冲量双侧均降低。移植物类型并未调节研究结果。力量不对称的变化几乎没有或根本没有能力解释冲量不对称的变化。考虑可能影响ACL重建术后整个垂直跳跃表现中双侧持续存在的缺陷的方法,可能会加强康复实践。