Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand.
BMC Musculoskelet Disord. 2022 Jun 10;23(1):560. doi: 10.1186/s12891-022-05488-2.
Elastic knee sleeves are often worn following anterior cruciate ligament reconstruction (ACLR) but their effects on movement patterns are unclear.
To determine the immediate and six-week effects of wearing a knee sleeve on biomechanics of the knee during a step-down hop task.
Using a cross-over design, we estimated sagittal plane knee kinematics and kinetics and stance duration during a step-down hop for 31 participants (age 26.0 [SD 6.6] years, 15 women) after ACLR (median 16 months post-surgery) with and without wearing a knee sleeve. In a subsequent randomised clinical trial, participants in the 'Sleeve Group' (n = 9) then wore the sleeve for 6 weeks at least 1 h daily, while a 'Control Group' (n = 9) did not wear the sleeve. We used statistical parametric mapping to compare (1) knee flexion/extension angle and external flexion/extension moment trajectories between three conditions at baseline (uninjured side, unsleeved injured side and sleeved injured side); (2) within-participant changes for knee flexion angles and external flexion/extension moment trajectories from baseline to follow-up between groups. We compared discrete flexion angles and moments, and stance duration between conditions and between groups.
Without sleeves, knee flexion was lower for the injured than the uninjured sides during mid-stance phase. When wearing the sleeve on the injured side, knee flexion increased during the loading phase of the stance phase. Discrete initial and peak knee flexion angles increased by (mean difference, 95% CIs) 2.7° (1.3, 4.1) and 3.0° (1.2, 4.9), respectively, when wearing the knee sleeve. Knee external flexion moments for the unsleeved injured sides were lower than the uninjured sides for 80% of stance phase, with no change when sleeved. The groups differenced for within-group changes in knee flexion trajectories at follow-up. Knee flexion angles increased for the Control group only. Stance duration decreased by 22% for the Sleeve group from baseline to follow-up (-89 ms; -153, -24) but not for the Controls.
Application of knee sleeves following ACLR is associated with improved knee flexion angles during hop landing training. Longer term (daily) knee sleeve application may help improve hop stance duration, potentially indicating improved hop performance.
The trial was prospectively registered with the Australia New Zealand Clinical Trials Registry No: ACTRN12618001083280, 28/06/2018. ANZCTR.
在进行前交叉韧带重建（ACLR）后，常穿戴弹性护膝，但它们对运动模式的影响尚不清楚。
在单腿跳下任务中，确定穿戴护膝对 ACLR 后膝关节生物力学的即时和 6 周影响。
采用交叉设计，我们在 31 名参与者（年龄 26.0[标准差 6.6]岁，15 名女性）进行 ACLR 后（术后中位数 16 个月）评估矢状面膝关节运动学和动力学以及单腿跳下时的支撑期，有无穿戴护膝。在随后的随机临床试验中，“护膝组”（n=9）随后至少每天佩戴护膝 1 小时 6 周，而“对照组”（n=9）则不佩戴护膝。我们使用统计参数映射来比较（1）基线时（未受伤侧、未佩戴护膝的受伤侧和佩戴护膝的受伤侧）三个条件下的膝关节屈伸角度和外屈/伸力矩轨迹；（2）组内参与者从基线到随访时膝关节屈伸角度和外屈/伸力矩轨迹的变化。我们比较了不同条件和组间的离散屈曲角度和力矩以及支撑期。
不佩戴护膝时，受伤侧膝关节在支撑中期的屈曲度低于未受伤侧。当在受伤侧佩戴护膝时，膝关节在支撑期的负荷阶段屈曲增加。当佩戴护膝时，离散的初始和峰值膝关节屈曲角度分别增加了 2.7°（1.3, 4.1）和 3.0°（1.2, 4.9）。未佩戴护膝的受伤侧膝关节外屈力矩在 80%的支撑期低于未受伤侧，佩戴护膝后无变化。组内变化的差异在于随访时膝关节屈曲轨迹的变化。只有对照组的膝关节屈曲角度增加。从基线到随访，护膝组的支撑期缩短了 22%（-89 毫秒；-153，-24），但对照组没有变化。
ACL 重建后应用护膝可改善单腿跳下时的膝关节屈曲角度。长期（每天）应用护膝可能有助于改善单腿跳的支撑期持续时间，这可能表明跳跃表现有所提高。
该试验前瞻性地在澳大利亚新西兰临床试验注册处注册，编号为 ACTRN12618001083280，2018 年 6 月 28 日。ANZCTR。
