University of Virginia, Charlottesville.
Creighton University, Omaha, NE.
J Athl Train. 2023 Jun 1;58(6):536-541. doi: 10.4085/1062-6050-0207.22.
Isometric quadriceps strength metrics and patient-reported outcomes are commonly used in return-to-sport assessments in those with anterior cruciate ligament reconstruction (ACLR). Patients may experience clinical knee-related symptoms aggravating enough to seek additional medical care after ACLR. In addition to seeking additional medical care, these patient-reported clinical knee-related symptoms may also influence function after ACLR. However, whether an association exists between these common quadriceps metrics and the patient-reported clinical knee-related symptom state is unknown.
To determine if meeting isometric quadriceps strength and symmetry criteria is associated with acceptable clinical knee-related symptoms at 5 to 7 months post-ACLR.
Cross-sectional study.
Laboratories.
We classified individuals at 5 to 7 months post-ACLR based on their isometric ACLR and uninvolved-limb quadriceps strength or quadriceps strength symmetry. We also dichotomized participants based on the Englund et al criteria for unacceptable clinical knee-related symptoms.
MAIN OUTCOME MEASURE(S): Quadriceps strength variables were compared between groups using analysis of covariance, and the relative risk of a participant in each quadriceps strength group reporting acceptable clinical knee-related symptoms was determined using binary logistic regression.
A total of 173 individuals participated. The isometric quadriceps strength and limb symmetry index were different (P < .001) between quadriceps strength groups. Those categorized as both strong and symmetric had a 1.28 (95% CI = 0.94, 1.74) and individuals categorized as symmetric only had a 1.29 (95% CI = 0.97, 1.73) times greater relative risk of reporting acceptable clinical knee-related symptoms compared with the neither strong nor symmetric group.
The majority of individuals (85%) recovering from ACLR failed to meet either the clinical quadriceps strength or symmetry criteria at 5 to 7 months post-ACLR. Quadriceps strength and quadriceps strength symmetry are clinically important but may not be primary determinants of the clinical knee-related symptom state within the first 6 months post-ACLR.
等长股四头肌力量指标和患者报告的结果常用于前交叉韧带重建（ACLR）后运动员重返运动的评估。ACL 重建后，患者可能会出现足以寻求额外医疗护理的临床膝关节相关症状加重的情况。除了寻求额外的医疗护理外，这些患者报告的临床膝关节相关症状也可能会影响 ACLR 后的功能。然而，这些常见的股四头肌指标与患者报告的临床膝关节相关症状状态之间是否存在关联尚不清楚。
确定在 ACLR 后 5 至 7 个月时，是否符合等长股四头肌力量和对称性标准与可接受的临床膝关节相关症状相关。
横断面研究。
实验室。
我们根据 5 至 7 个月时的 ACLR 及非受累侧股四头肌力量或股四头肌力量对称性，将个体分为 ACLR 组和非 ACLR 组。我们还根据 Englund 等人的标准将参与者分为不可接受的临床膝关节相关症状组和可接受的临床膝关节相关症状组。
使用协方差分析比较各组之间的股四头肌力量变量，并使用二项逻辑回归确定每组股四头肌力量参与者报告可接受的临床膝关节相关症状的相对风险。
共有 173 人参与。股四头肌力量和肢体对称性指数在股四头肌力量组之间存在差异（P<0.001）。那些被归类为同时具有强力量和对称性的人报告可接受的临床膝关节相关症状的相对风险为 1.28（95%CI=0.94，1.74），而仅被归类为具有对称性的人报告可接受的临床膝关节相关症状的相对风险为 1.29（95%CI=0.97，1.73），与既不强也不对称的组相比。
大多数（85%）ACL 重建后患者在术后 5 至 7 个月时既不符合临床股四头肌力量标准，也不符合对称性标准。股四头肌力量和股四头肌力量对称性具有重要的临床意义，但可能不是 ACLR 后前 6 个月内临床膝关节相关症状状态的主要决定因素。
