Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA.
Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, Arizona, USA.
Am J Sports Med. 2022 Jul;50(8):2111-2118. doi: 10.1177/03635465221097712. Epub 2022 May 23.
Performance on strength and functional tests is often used to guide postoperative rehabilitation progress and return to activity decisions after anterior cruciate ligament reconstruction (ACLR). Clinicians may have difficulty in determining which criteria to follow if there is disagreement in performance outcomes among the tests.
PURPOSE/HYPOTHESIS: The purpose of this study was to compare pass rates between strength tests and single-leg hop (SLHOP) tests among men and women and between patients with lower and higher preinjury activity levels recovering from ACLR. We hypothesized that pass rates would be nonuniformly distributed among test types, sex, and activity level and that more participants would pass hop tests than strength tests.
Cross-sectional study; Level of evidence, 3.
A total of 299 participants (146 men; 153 women)-at a mean of 6.8 ± 1.4 months after primary, unilateral, and uncomplicated ACLR (mean age, 23 ± 9.7 years; mean height, 172 ± 10.5 cm; mean mass, 75.8 ± 18.4 kg)-completed testing. Quadri.tif strength was evaluated using peak torque during isokinetic knee extension at 90 deg/s and 180 deg/s. Jump distance during the SLHOP and triple hop tests was measured (in cm). Strength and hop test measures were evaluated based on the limb symmetry index ((LSI) = (ACLR / contralateral side) × 100). We operationally defined "pass" as 90% on the LSI.
Pass rates were nonuniformly distributed between isokinetic knee extension at 90 deg/s and the SLHOP test ( = 18.64; < .001). Disagreements between isokinetic testing at 90 deg/s and the SLHOP test occurred in 36.5% (109/299) of the participants. Among those who failed strength testing and passed hop testing, a greater portion reported higher activity levels before their injury ( = 6.90; = .01); however, there was no difference in pass rates between men and women. Similar patterns of disagreement were observed between all strength test and hop test outcomes.
ACLR patients with higher activity levels may be more likely to pass hop testing despite failing quadri.tif strength testing. This may be an indicator of movement compensations to achieve jump symmetry in the presence of quadri.tif weakness.
在进行前交叉韧带重建 (ACLR) 后，力量和功能测试的表现通常用于指导术后康复进展和重返活动的决策。如果不同测试的表现结果存在分歧，临床医生可能难以确定遵循哪些标准。
目的/假设：本研究的目的是比较男性和女性以及 ACLR 后活动水平较低和较高的患者之间，力量测试和单腿跳 (SLHOP) 测试的通过率。我们假设通过率在测试类型、性别和活动水平之间分布不均匀，并且更多的参与者将通过跳跃测试而不是力量测试。
横断面研究；证据水平，3 级。
共有 299 名参与者（146 名男性；153 名女性）在初次单侧无并发症 ACLR 后平均 6.8 ± 1.4 个月时完成了测试（平均年龄 23 ± 9.7 岁；平均身高 172 ± 10.5cm；平均体重 75.8 ± 18.4kg）。使用等速膝关节伸展 90°/s 和 180°/s 时的峰值扭矩评估四头肌力量。SLHOP 和三级跳测试的跳跃距离以厘米为单位进行测量。基于肢体对称性指数 (LSI = (ACL / 对侧侧) × 100) 评估力量和跳跃测试测量值。我们将“通过”定义为 LSI 达到 90%。
90°/s 等速膝关节伸展和 SLHOP 测试之间的通过率分布不均匀（ = 18.64；<.001）。在 299 名参与者中，有 36.5%（109/299）的参与者在 90°/s 等速膝关节伸展和 SLHOP 测试之间存在分歧。在力量测试失败但跳跃测试通过的参与者中，有更大比例的人报告受伤前的活动水平更高（ = 6.90；<.01）；然而，男性和女性之间的通过率没有差异。在所有力量测试和跳跃测试结果之间都观察到类似的分歧模式。
活动水平较高的 ACLR 患者可能更有可能通过跳跃测试，尽管他们的四头肌力量测试失败。这可能是在四头肌力量较弱的情况下通过运动代偿来实现跳跃对称性的一个指标。
