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前交叉韧带重建术后重返运动决策:范围综述。

Anterior Cruciate Ligament Reconstruction Return-to-Sport Decision-Making: A Scoping Review.

机构信息

Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.

Division of Orthopedic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.

出版信息

Sports Health. 2024 Jan-Feb;16(1):115-123. doi: 10.1177/19417381221147524. Epub 2023 Jan 27.


DOI:10.1177/19417381221147524
PMID:36707977
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10732109/
Abstract

CONTEXT: Clinical guidelines support the use of testing batteries to assess athlete readiness for return to sport (RTS) and risk of reinjury after anterior cruciate ligament (ACL) reconstruction (ACL-R). There is no consensus on the composition of the testing batteries. Test selection is based mainly on commonality in research, personal preference, and equipment availability. Including athletic performance assessments (APA) used in the athlete's sport may assist RTS decision-making for stakeholders. OBJECTIVE: To determine whether APA for speed, agility, strength, or cardiovascular endurance are (1) used in ACL-R RTS literature and (2) indicative of RTS or reinjury rates. DATA SOURCES: A systematic search was performed in MEDLINE, EMBASE, CINAHL, SPORTDiscus, Scopus, Web of Science, and ProQuest Dissertations and Theses Global. STUDY SELECTION: Eligibility criteria were as follows: (1) athletes between 6 months and 2 years post-ACL-R, (2) commonly used APA, (3) peer-reviewed primary study with original published data. STUDY DESIGN: Scoping Review. LEVEL OF EVIDENCE: Level 4. DATA EXTRACTION: A total of 17 studies included 24 instances of APA with a high degree of heterogeneity for both tests and protocols. RESULTS: Agility makes up 75% of the APA. Only 17.6% of studies reported RTS or reinjury rates, none of which reported a significant relationship between these rates and APA outcomes. CONCLUSION: Speed, strength, and cardiovascular endurance tests are underrepresented in ACL-R RTS literature. Compared with healthy controls, deficits in APA results for ACL-R athletes were common; however, many studies reported significant improvements in results for ACL-R athletes over time. There is some evidence that well-trained ACL-R athletes can match the performance of uninjured athletes in high-level sports.

摘要

背景:临床指南支持使用测试组合来评估运动员重返运动(RTS)的准备情况和前交叉韧带(ACL)重建(ACL-R)后的再受伤风险。对于测试组合的组成,尚未达成共识。测试选择主要基于研究中的常见性、个人偏好和设备可用性。包括运动员运动中使用的竞技表现评估(APA),可能有助于利益相关者做出 RTS 决策。

目的:确定速度、敏捷性、力量或心血管耐力的 APA 是否(1)用于 ACL-R RTS 文献中,以及(2)是否与 RTS 或再受伤率相关。

数据来源:在 MEDLINE、EMBASE、CINAHL、SPORTDiscus、Scopus、Web of Science 和 ProQuest Dissertations and Theses Global 中进行了系统检索。

研究选择:纳入标准如下:(1)ACL-R 后 6 个月至 2 年的运动员,(2)常用 APA,(3)同行评议的原始发表数据的主要研究。

研究设计:范围综述。

证据水平:4 级。

数据提取:共有 17 项研究纳入了 24 项 APA,测试和方案的异质性均很高。

结果:敏捷性占 APA 的 75%。只有 17.6%的研究报告了 RTS 或再受伤率,没有一项研究报告这些比率与 APA 结果之间存在显著关系。

结论:速度、力量和心血管耐力测试在 ACL-R RTS 文献中代表性不足。与健康对照组相比,ACL-R 运动员的 APA 结果存在缺陷很常见;然而,许多研究报告称,随着时间的推移,ACL-R 运动员的结果有了显著改善。有一些证据表明,训练有素的 ACL-R 运动员可以在高水平运动中与未受伤的运动员相匹配。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eea5/10732109/f28f2a113905/10.1177_19417381221147524-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eea5/10732109/f28f2a113905/10.1177_19417381221147524-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eea5/10732109/f28f2a113905/10.1177_19417381221147524-fig1.jpg

相似文献

[1]
Anterior Cruciate Ligament Reconstruction Return-to-Sport Decision-Making: A Scoping Review.

Sports Health. 2024

[2]
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[3]
Eighty-three per cent of elite athletes return to preinjury sport after anterior cruciate ligament reconstruction: a systematic review with meta-analysis of return to sport rates, graft rupture rates and performance outcomes.

Br J Sports Med. 2017-2-21

[4]
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[5]
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[6]
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[7]
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[8]
Factors Associated With Psychological Readiness to Return to Sport After Anterior Cruciate Ligament Reconstruction Surgery.

Am J Sports Med. 2018-5-2

[9]
No Relationship Between Strength and Power Scores and Anterior Cruciate Ligament Return to Sport After Injury Scale 9 Months After Anterior Cruciate Ligament Reconstruction.

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[10]
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引用本文的文献

[1]
How Can We Optimize a Safe Return to Sport for Youth Athletes? Emerging Concepts and Perspectives - Multidisciplinary Approach.

Open Access J Sports Med. 2025-8-31

[2]
Innovative Rehabilitation of an Anterior Cruciate Ligament Tear in a Football Player: Muscle Chain Approach-A Case Study.

J Clin Med. 2025-7-14

[3]
Current State of Baseball Interval Throwing Programs: A Systematic Review of Content, Structure, and Variability of Published Throwing Programs.

Sports Health. 2025-4-29

[4]
Combining an internal tension relieving technique with anterior cruciate ligament reconstruction (ACLR) reduces graft failure rate and improves functional outcomes: a systematic review and meta-analysis.

J Orthop Surg Res. 2025-1-7

本文引用的文献

[1]
Anterior Cruciate Ligament Injury Incidence in Adolescent Athletes: A Systematic Review and Meta-analysis.

Am J Sports Med. 2021-6

[2]
Physical Performance Improves With Time and a Functional Knee Brace in Athletes After ACL Reconstruction.

Orthop J Sports Med. 2020-8-12

[3]
Return to sports bridge program improves outcomes, decreases ipsilateral knee re-injury and contralateral knee injury rates post-ACL reconstruction.

Knee Surg Sports Traumatol Arthrosc. 2020-11

[4]
Barbell Squat Relative Strength as an Identifier for Lower Extremity Injury in Collegiate Athletes.

J Strength Cond Res. 2020-5

[5]
Young Athletes Who Return to Sport Before 9 Months After Anterior Cruciate Ligament Reconstruction Have a Rate of New Injury 7 Times That of Those Who Delay Return.

J Orthop Sports Phys Ther. 2020-2

[6]
Measures of Agility and Single-Legged Balance as Clinical Assessments in Patients With Anterior Cruciate Ligament Reconstruction and Healthy Individuals.

J Athl Train. 2019-10-16

[7]
Keep calm and carry on testing: a substantive reanalysis and critique of 'what is the evidence for and validity of return-to-sport testing after anterior cruciate ligament reconstruction surgery? A systematic review and meta-analysis'.

Br J Sports Med. 2019-12

[8]
How should clinicians rehabilitate patients after ACL reconstruction? A systematic review of clinical practice guidelines (CPGs) with a focus on quality appraisal (AGREE II).

Br J Sports Med. 2019-6-7

[9]
Optimising the Late-Stage Rehabilitation and Return-to-Sport Training and Testing Process After ACL Reconstruction.

Sports Med. 2019-7

[10]
Which criteria are used to clear patients to return to sport after primary ACL reconstruction? A scoping review.

Br J Sports Med. 2019-2-2

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