Oleksy Łukasz, Mika Anna, Sulowska-Daszyk Iwona, Kielnar Renata, Dzięcioł-Anikiej Zofia, Zyznawska Joanna, Adamska Olga, Stolarczyk Artur
Faculty of Health Sciences, Department of Physiotherapy, Jagiellonian University Medical College Krakow, 31-008 Krakow, Poland.
Oleksy Medical & Sports Sciences, 37-100 Łańcut, Poland.
J Clin Med. 2023 Feb 1;12(3):1144. doi: 10.3390/jcm12031144.
This study was aimed at evaluating knee stabilizer (quadriceps and hamstring) muscle strength and the medio-lateral symmetry of hamstring fatigue in football players after ACL reconstruction and with mild lower extremity injuries. The study comprised 65 professional football players who were divided into three groups: Group 1 (n = 24; 22.7 ± 3.6 years; 175 ± 4 cm; 77.3 ± 7.6 kg) after ACL reconstruction, Group 2 (n = 21; 20.5 ± 3.7 years; 177 ± 6 cm; 74.3 ± 9.1 kg) with mild lower-limb injuries (grade 1 muscle strains) and Group 3 (n = 20; 23.1 ± 2.8 years; 178 ± 6 cm; 75.8 ± 8.8 kg) without injuries in the past 3 years. The concentric isokinetic test (10 knee flexions and extensions at 60, 180 and 300°/s with a 30 s interval for rest) was performed on both limbs. Fatigue symmetry between the medial and lateral hamstrings was measured with sEMG during 60 s of isometric contractions. In comparison to the other groups, the injured leg demonstrated significantly lower values of peak torque for the quadriceps (G1-G2 = 48%, 38%, 14%; G1-G3 = 49%, 25%, 14%) and hamstring muscles (G1-G2 = 36%, 35%, 18%; G1-G3 = 64%, 28%, 17%) as well as lower values of hamstring muscle work (G1-G2 = 262 J, 157 J; G1-G3 = 219 J, 179 J) and power (G1-G2 = 34 W; 11 W; G1-G3 = 29 W, 12 W). No significant differences were noted in strength between Groups 2 and 3. The significantly higher fatigue of the BF compared to the SEM muscle was seen in Group 1 for the involved (mean difference = 0.12) and uninvolved limbs (mean difference = -0.10), but in Group 2, a non-significant trend towards asymmetry was also noted. No asymmetry in hamstring muscle fatigue was determined in Group 3. The results of our study allow us to indicate that active football players who previously met the RTS criteria, had deficits in lower-limb muscle performance 2-3 years after reconstruction, which could lead to ACL re-injury. This observation is potentially of importance because these deficits may not be subjectively reported by such athletes and also may not be visible in regular orthopedic and physiotherapeutic assessment.
本研究旨在评估前交叉韧带重建术后以及伴有轻度下肢损伤的足球运动员的膝关节稳定肌（股四头肌和腘绳肌）肌力，以及腘绳肌疲劳的内外侧对称性。该研究纳入了65名职业足球运动员，他们被分为三组：第1组（n = 24；年龄22.7 ± 3.6岁；身高175 ± 4厘米；体重77.3 ± 7.6千克）为前交叉韧带重建术后，第2组（n = 21；年龄20.5 ± 3.7岁；身高177 ± 6厘米；体重74.3 ± 9.1千克）为伴有轻度下肢损伤（1级肌肉拉伤），第3组（n = 20；年龄23.1 ± 2.8岁；身高178 ± 6厘米；体重75.8 ± 8.8千克）在过去3年中无损伤。对双下肢进行了等速向心测试（在60°/秒、180°/秒和300°/秒下进行10次膝关节屈伸，每次间隔30秒休息）。在等长收缩60秒期间，通过表面肌电图测量腘绳肌内侧和外侧之间的疲劳对称性。与其他组相比，受伤腿的股四头肌（第1组与第2组相比：48%、38%、14%；第1组与第3组相比：49%、25%、14%）和腘绳肌的峰值扭矩值显著更低（第1组与第2组相比：36%、35%、18%；第1组与第3组相比：64%、28%、17%），腘绳肌的做功值（第1组与第2组相比：262焦耳、157焦耳；第1组与第3组相比：219焦耳、179焦耳）和功率（第1组与第2组相比：34瓦、11瓦；第1组与第3组相比：29瓦、12瓦）也更低。第2组和第3组之间的肌力无显著差异。在第1组中，患侧（平均差异 = 0.12）和未患侧肢体（平均差异 = -0.10）的股薄肌相比半膜肌疲劳明显更高，但在第2组中，也注意到了不对称的非显著趋势。第3组未确定腘绳肌疲劳的不对称性。我们的研究结果表明，先前符合重返运动标准的现役足球运动员，在重建后2 - 3年下肢肌肉表现存在缺陷，这可能导致前交叉韧带再次损伤。这一观察结果可能具有重要意义，因为这些缺陷可能不会被此类运动员主观报告，并且在常规的骨科和物理治疗评估中也可能不明显。
