School of Kinesiology, University of Michigan, Ann Arbor, Michigan, U.S.A.
Department of Kinesiology, Aquinas College, Grand Rapids, Michigan, U.S.A.
Arthroscopy. 2022 Nov;38(11):3043-3055. doi: 10.1016/j.arthro.2022.04.021. Epub 2022 Jun 9.
The purpose of this study was to determine 1) whether progressive functional resistance training (FRT) during walking would improve knee biomechanical symmetry after anterior cruciate ligament (ACL) reconstruction and 2) whether the mode of delivery of FRT would have a differential effect on symmetry.
Thirty individuals who underwent primary ACL reconstruction at a single institution volunteered for this study. Participants were randomized into one of three groups: 1) BRACE, 2) BAND, or 3) CONTROL. The BRACE group received FRT with a novel robotic knee brace along with real-time kinematic feedback. The BAND group received FRT with a custom resistance band device along with real-time kinematic feedback. The CONTROL group received only real-time kinematic feedback. Participants in all groups received training (2-3/week for 8 weeks) while walking on a treadmill. Knee angle and moment symmetry were calculated immediately prior to beginning the intervention and within 1 week of completing the intervention. Statistical Parametric Mapping was used to assess differences in biomechanical symmetry between groups across time.
There was a significant interaction in knee moment symmetry from 21 and 24% of the stance phase (P = .046), in which the BAND group had greater improvements following training compared with both BRACE (P = .043) and CONTROL groups (P = .002). There was also a significant time effect in knee angle symmetry from 68 to 79% of the stance phase (P = .028) and from 97 to 100% of the swing phase (P = .050) in which only the BRACE group showed significant improvements after the intervention (stance: P = .020 and swing: P < .001).
The results of this randomized controlled clinical trial indicate that 8 weeks of progressive FRT during treadmill walking in individuals with ACL reconstruction improves knee angle and moment symmetry during gait. The findings suggest that FRT could serve as a potential therapeutic adjuvant to traditional rehabilitation after ACL reconstruction and can help restore knee joint biomechanical symmetry.
Level II, randomized controlled trial.
本研究旨在确定 1）渐进式功能性抗阻训练（FRT）在行走过程中是否会改善前交叉韧带（ACL）重建后的膝关节生物力学对称性，以及 2）FRT 的传递方式是否会对对称性产生不同的影响。
本研究共有 30 名在单家机构接受初次 ACL 重建的个体自愿参与。参与者被随机分为三组：1）BRACE 组、2）BAND 组或 3）CONTROL 组。BRACE 组使用新型机器人膝关节支具和实时运动学反馈进行 FRT。BAND 组使用定制的阻力带装置和实时运动学反馈进行 FRT。CONTROL 组仅接受实时运动学反馈。所有组的参与者都在跑步机上行走时接受训练（每周 2-3 次，共 8 周）。在开始干预之前和干预完成后 1 周，计算膝关节角度和力矩对称性。统计参数映射用于评估各组之间随时间变化的生物力学对称性差异。
在 21%和 24%的支撑阶段，膝关节力矩对称性存在显著的交互作用（P=0.046），其中 BAND 组在训练后改善更为显著，与 BRACE 组（P=0.043）和 CONTROL 组（P=0.002）相比。在 68%至 79%的支撑阶段和 97%至 100%的摆动阶段，膝关节角度对称性也存在显著的时间效应（P=0.028 和 P=0.050），其中仅 BRACE 组在干预后显示出显著的改善（支撑：P=0.020 和摆动：P<0.001）。
这项随机对照临床试验的结果表明，ACL 重建患者在跑步机上行走时进行 8 周的渐进式 FRT 可改善步态中的膝关节角度和力矩对称性。研究结果表明，FRT 可以作为 ACL 重建后传统康复的潜在治疗辅助手段，并有助于恢复膝关节生物力学对称性。
二级，随机对照试验。
