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对侧膝关节神经肌肉练习对前交叉韧带重建运动员静态和动态平衡、膝关节功能和疼痛的影响:一项单盲随机对照试验。

The Effect of Contralateral Knee Neuromuscular Exercises on Static and Dynamic Balance, Knee Function, and Pain in Athletes Who Underwent Anterior Cruciate Ligament Reconstruction: A Single-Blind Randomized Controlled Trial.

机构信息

School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa,Canada.

Student Research Committee, Shiraz University of Medical Sciences, Shiraz,Iran.

出版信息

J Sport Rehabil. 2023 Mar 14;32(5):524-539. doi: 10.1123/jsr.2021-0380. Print 2023 Jul 1.

Abstract

CONTEXT

Contralateral training in the early stages after surgery can improve the balance of the reconstructed knee, which is impaired following anterior cruciate ligament reconstruction (ACLR). However, little is known about the neuromuscular cross exercise after ACLR.

OBJECTIVE

To investigate the effects of an 8-week cross exercise on balance and function of the reconstructed knee following ACLR.

DESIGN

A single-blind randomized clinical trial.

PARTICIPANTS

Thirty athletic males who underwent ACLR were randomly divided into intervention (n = 15) and control groups (n = 15).

INTERVENTION

The intervention and control groups received a routine physiotherapy program. In addition, the intervention group performed neuromuscular exercises on the nonoperated limb.

OUTCOME MEASURES

Before and 9 weeks after ACLR, dynamic and static balance, function, and pain in the reconstructed knee were measured by Star Excursion Balance Test (SEBT), stork balance stand test, balance error scoring system (BESS), Lysholm questionnaire, and visual analog scale. Data were analyzed by SPSS using 2-independent sample t test, paired t test, and analysis of covariance.

RESULTS

Between-group comparison showed that, contralateral knee neuromuscular exercises significantly increased in the reaching distance in SEBT in the anterior (P < .001), posterior (P < .001), posteromedial (P = .010), and posterolateral directions (P = .007), decreased the number of errors in 4 stance positions of BESS including single stance on the firm (P ≤ .001) and foam surface (P ≤ .001), and tandem stance on the firm (P = .028) and foam surface (P ≤ .001). It also increased the time of standing of the stork stand test (P = .044) and decreased the pain intensity (P = .014).

CONCLUSION

Neuromuscular exercise of the nonsurgical knee could improve the dynamic and static balance, and pain in the early stages following ACLR in the surgical leg. These findings may be potentially valuable for current rehabilitation protocols.

摘要

背景

手术后早期的对侧训练可以改善重建膝关节的平衡,而前交叉韧带重建(ACLR)后这种平衡会受损。然而,对于 ACLR 后的神经肌肉交叉运动知之甚少。

目的

探讨 8 周交叉运动对 ACLR 后重建膝关节平衡和功能的影响。

设计

单盲随机临床试验。

参与者

30 名接受 ACLR 的运动男性被随机分为干预组(n=15)和对照组(n=15)。

干预

干预组和对照组均接受常规物理治疗方案。此外,干预组对未手术的肢体进行神经肌肉运动。

结果测量

在 ACLR 前后 9 周,通过星型伸展平衡测试(SEBT)、鹳立平衡测试、平衡错误评分系统(BESS)、Lysholm 问卷和视觉模拟评分测量重建膝关节的动态和静态平衡、功能和疼痛。使用 2 个独立样本 t 检验、配对 t 检验和协方差分析对数据进行分析。

结果

组间比较显示,对侧膝关节神经肌肉运动显著增加了 SEBT 在前(P <.001)、后(P <.001)、后内侧(P =.010)和后外侧方向(P =.007)的伸展距离,减少了 BESS 中 4 个单足姿势的错误数,包括在坚实(P ≤.001)和泡沫表面(P ≤.001)上的单足站立,以及在坚实(P =.028)和泡沫表面(P ≤.001)上的串联站立。它还增加了鹳立平衡测试的站立时间(P =.044),并降低了疼痛强度(P =.014)。

结论

非手术膝关节的神经肌肉运动可以改善 ACLR 后手术腿的动态和静态平衡以及疼痛。这些发现可能对当前的康复方案具有潜在价值。

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