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前交叉韧带重建后步态中力量和时空步态变量与膝关节负荷的关系。

Associations of Strength and Spatiotemporal Gait Variables With Knee Loading During Gait After Anterior Cruciate Ligament Reconstruction.

机构信息

Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA.

Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA.

出版信息

J Athl Train. 2022 Feb 1;57(2):158-164. doi: 10.4085/1062-6050-0186.21.

Abstract

CONTEXT

Altered knee moments are common during gait in patients after anterior cruciate ligament reconstruction (ACLR). Modifiable factors that influence knee moments and are feasible to record in clinical settings such as strength and spatiotemporal values (eg, step length, step width) have not been identified in persons after ACLR.

OBJECTIVE

To identify strength and spatiotemporal gait values that can predict knee moments in persons after ACLR.

DESIGN

Cross-sectional study.

SETTING

Laboratory.

PATIENTS OR OTHER PARTICIPANTS

Twenty-three individuals with ACLR (14.4 ± 17.2 months post-ACLR).

MAIN OUTCOME MEASURE(S): Peak knee-flexion and -adduction moments were measured while the participants walked at self-selected speeds. Peak isokinetic knee-extensor strength (60°/s) was recorded on a dynamometer, and spatiotemporal gait values were recorded using a pressure walkway. Pearson coefficients were calculated to examine the association of peak knee moments with strength and gait values. Variables correlated with peak knee-flexion and -adduction moments were entered into a stepwise regression model.

RESULTS

Knee-extensor strength and step width were the strongest predictors of knee-flexion moment, accounting for 44% of the variance, whereas stance-phase time and step width were the strongest predictors of knee-adduction moment, explaining 62% of the variance.

CONCLUSIONS

The identified spatiotemporal variables could be clinically feasible targets for biofeedback to improve gait after ACLR.

摘要

背景

前交叉韧带重建(ACL)后患者在步态中经常会出现膝关节力矩改变。影响膝关节力矩的可改变因素,以及在 ACL 后患者中可行的临床记录因素,如力量和时空值(例如,步长、步宽),尚未确定。

目的

确定能够预测 ACL 后患者膝关节力矩的力量和时空步态值。

设计

横断面研究。

设置

实验室。

患者或其他参与者

23 名 ACLR 患者(ACL 后 14.4±17.2 个月)。

主要观察指标

参与者以自选速度行走时,测量膝关节最大屈曲和内收力矩。在测力计上记录最大等速膝关节伸肌力量(60°/s),并使用压力步道记录时空步态值。使用 Pearson 系数来检查最大膝关节力矩与力量和步态值之间的相关性。与最大膝关节屈曲和内收力矩相关的变量被纳入逐步回归模型。

结果

膝关节伸肌力量和步宽是膝关节最大屈曲力矩的最强预测因子,占 44%的方差,而支撑相时间和步宽是膝关节最大内收力矩的最强预测因子,占 62%的方差。

结论

确定的时空变量可能是改善 ACL 后步态的生物反馈的临床可行目标。

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