Gait and Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong,China.
J Sport Rehabil. 2022 Apr 29;31(7):894-903. doi: 10.1123/jsr.2021-0431. Print 2022 Sep 1.
While anterior cruciate ligament (ACL) tears are commonly managed with ACL reconstruction (ACL-R), 35% of ACL-R individuals fail to return to the preinjury elite sport level. Persistent neuromuscular deficits in the hamstrings and quadriceps have been observed. It has been proposed that aquatic therapy can be used to optimize neuromuscular control after ACL-R.
(1) To compare muscle activity in ACL-R individuals during aquatic treadmill (ATM) running at different water depths and (2) to compare muscle activity during ATM running between ACL-R and healthy individuals.
A total of 38 participants, including 18 ACL-R individuals (mean postoperative time [SD] = 25.8 [25.0] mo) and 20 healthy individuals were recruited. Muscle activity of biceps femoris (BF), rectus femoris (RF), tibialis anterior, and medial gastrocnemius during land treadmill and ATM running at mid-shin, mid-thigh, and waist levels were recorded using surface electromyography (sEMG). The sEMG signals of the selected muscles were normalized and expressed in % Maximal Voluntary Contraction (%MVC). Muscle activity of the ACL-R, ACL-contralateral, and healthy control limbs at different water depths was compared.
Among the 3 groups, the ACL-R group demonstrated the most prominent percentage increase of 101.97% (P = .001) at mid-shin level, 139.66% (P = .001) at mid-thigh level, and 141.97% (P < .001) at waist level, respectively, in %MVC when compared to land. In the ACL-R group, muscle activity of BF in the stance phase (BFSt) was significantly higher than the control group on land at all water depths. Muscle activity of RF in the swing phase (RFSw) in the ACL-R group significantly increased in all water depths immersion when compared to land, respectively.
This study showed an increasing trend in muscle activity of BFSt and RFSw in ACL-R individuals during ATM running at increased water depths. ATM running could be implemented as neuromuscular training in rehabilitation after ACL-R.
虽然前交叉韧带 (ACL) 撕裂通常采用 ACL 重建 (ACL-R) 进行治疗，但仍有 35%的 ACL-R 患者无法恢复到受伤前的精英运动水平。研究发现，ACL-R 患者的腘绳肌和股四头肌仍存在持续的神经肌肉功能缺陷。有人提出，水中运动疗法可用于优化 ACL-R 后的神经肌肉控制。
（1）比较 ACL-R 患者在不同水深的水上跑步机 (ATM) 跑步时的肌肉活动；（2）比较 ACL-R 患者和健康个体在 ATM 跑步时的肌肉活动。
共招募 38 名参与者，包括 18 名 ACL-R 患者（平均术后时间 [SD] = 25.8 [25.0] 个月）和 20 名健康个体。使用表面肌电图 (sEMG) 记录股二头肌 (BF)、股直肌 (RF)、胫骨前肌和内侧腓肠肌在陆地跑步机和 ATM 跑步时的肌肉活动，水深分别为中胫骨、中大腿和腰部。选择肌肉的 sEMG 信号进行归一化，并以最大随意收缩百分比 (%MVC) 表示。比较不同水深时 ACL-R、ACL 对侧和健康对照组肢体的肌肉活动。
在 3 组中，与陆地相比，ACL-R 组在中胫骨水平的百分比增加最大，为 101.97%（P =.001），在中大腿水平为 139.66%（P =.001），在腰部水平为 141.97%（P <.001），均为%MVC。在 ACL-R 组中，BF 在支撑期 (BFSt) 的肌肉活动在所有水深的陆地时均明显高于对照组。与陆地相比，ACL-R 组在所有水深的摆动期 (RFSw) 的 RF 肌肉活动均显著增加。
本研究表明，ACL-R 患者在 ATM 跑步时，BFSt 和 RFSw 的肌肉活动在增加的水深下呈上升趋势。ATM 跑步可作为 ACL-R 后康复的神经肌肉训练。
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