Aizawa Junya, Hirohata Kenji, Ohji Shunsuke, Ohmi Takehiro, Mitomo Sho, Koga Hideyuki, Yagishita Kazuyoshi
Department of Physical Therapy, Faculty of Health Science, Juntendo University, 3-2-12 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Department of Rehabilitation Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
BMC Sports Sci Med Rehabil. 2022 Jun 1;14(1):97. doi: 10.1186/s13102-022-00491-5.
Information about specific factors of physical function that contribute to psychological readiness is needed to plan rehabilitation for a return to sports. The purpose of this study was to identify specific physical functions related to the psychological readiness of patients aiming to return to sports 6 months after reconstruction. We hypothesized that the knee strength is a factor related to the Anterior Cruciate Ligament-Return to Sport after Injury scale (ACL-RSI) cutoff score for a return to sports.
This was a cross-sectional study. Fifty-four patients who had undergone primary reconstruction using hamstring tendon participated in this study. Psychological readiness was measured using the ACL-RSI in patients at 6 months after reconstruction. To identify specific physical functions related to the ACL-RSI score, participants were divided into groups with ACL-RSI scores of ≥ 60 or < 60. Non-paired t-tests or the Mann-Whitney test were performed to analyze group differences in objective variables in physical function: (1) knee strength in both legs; (2) leg anterior reach distance on both sides; and (3) single-leg hop (SLH) distances in three directions for both legs.
Significant differences between groups were identified in knee flexion strength (60°/s) for the uninvolved limb, hamstring-to-quadriceps ratio (60°/s) for the uninvolved limb, knee flexion strength (180°/s) for the involved limb, limb symmetry index (LSI) of leg anterior reach distance, the ratio of the distance to the height of the patient and LSI of SLH distances in lateral and medial directions.
This study revealed that at 6 months after reconstruction, increased knee flexion strength (ratio of peak torque measured to body mass of the patient), hamstring-to-quadriceps ratio, leg anterior reach distance LSI, and lateral and medial SLH appear important to exceed the ACL-RSI cutoff for a return to sports. The present results may be useful for planning post-operative rehabilitation for long-term return to sports after reconstruction.
为了制定恢复运动的康复计划，需要了解有助于心理准备的身体功能的具体因素。本研究的目的是确定与重建后6个月旨在恢复运动的患者心理准备相关的特定身体功能。我们假设膝关节力量是与损伤后前交叉韧带恢复运动量表（ACL-RSI）恢复运动临界值相关的一个因素。
这是一项横断面研究。54例使用腘绳肌腱进行初次重建的患者参与了本研究。在重建后6个月时，使用ACL-RSI对患者的心理准备情况进行测量。为了确定与ACL-RSI评分相关的特定身体功能，将参与者分为ACL-RSI评分≥60或<60的组。采用非配对t检验或Mann-Whitney检验分析身体功能客观变量的组间差异：（1）双腿的膝关节力量；（2）双侧腿部前伸距离；（3）双腿三个方向的单腿跳（SLH）距离。
在非患侧肢体的膝关节屈曲力量（60°/s）、非患侧肢体的腘绳肌与股四头肌比值（60°/s）、患侧肢体的膝关节屈曲力量（180°/s）、腿部前伸距离的肢体对称指数（LSI）、患者身高与距离的比值以及SLH在外侧和内侧方向的LSI方面，组间存在显著差异。
本研究表明，在重建后6个月，增加膝关节屈曲力量（测量的峰值扭矩与患者体重的比值）、腘绳肌与股四头肌比值、腿部前伸距离LSI以及外侧和内侧SLH对于超过ACL-RSI恢复运动临界值似乎很重要。目前的结果可能有助于制定重建后长期恢复运动的术后康复计划。
