包含和不包含心理测量指标的运动恢复测试组合对第二次前交叉韧带损伤风险的影响：对四种不同测试组合的批判性评估
No Effect of Return to Sport Test Batteries with and without Psychological PROs on the Risk of a Second ACL Injury: A Critical Assessment of Four Different Test Batteries.
作者信息
Piussi Ramana, Simonson Rebecca, Högberg Johan, Thomeé Roland, Samuelsson Kristian, Hamrin Senorski Eric
机构信息
Sportrehab Sports Medicine Clinic, Stampgatan 14, SE-411 01 Gothenburg, Sweden.
Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, SE-405 30 Gothenburg, Sweden.
出版信息
Int J Sports Phys Ther. 2023 Aug 1;18(4):874-886. doi: 10.26603/001c.81064. eCollection 2023.
BACKGROUND
Patients report psychological barriers as important when returning to sport, however, psychological outcome measures are seldom included in return to sport (RTS) assessment. There is a need for clinical trials to integrate psychological patient-reported outcomes (PROs) in return to sport batteries assessing patients treated with ACL reconstruction.
OBJECTIVE
The aim of this study was to determine the association between passing clinical tests of muscle function and psychological PROs and sustaining a second ACL injury in patients who RTS after primary ACL reconstruction.
DESIGN
Retrospective Cohort study.
METHODS
Patients' sex, age, height and weight, and the results of strength and hop tests, as well as answers to PRO's (including Tegner activity scale, the ACL Return to Sport after Injury scale (ACL-RSI) as well as the Quality of Life (QoL) subscale of the Knee injury and Osteoarthritis Outcome Score [KOOS]), were extracted from a rehabilitation-specific registry. Four different test batteries comprising muscle function tests and PROs were created to assess whether patients were ready to RTS. Passing each of the test batteries (yes/no) was used as an independent variable. A multivariable Cox proportional hazard model analysis was performed, with sustaining a second ACL injury (either ipsi- or contralateral; yes/no) within two years of RTS as the dependent variable.
RESULTS
A total of 419 patients (male, n=214; 51%) were included, of which 51 (12.2%) suffered a second ACL injury within the first two years after RTS. There were no differences in passing rates in the different RTS test batteries comprising muscle function tests and PROs for patients who suffered a second ACL injury compared to patients who did not.
CONCLUSION
No association between passing the RTS clinical tests batteries comprising muscle function and psychological PROs used, and the risk of a second ACL injury could be found.
LEVEL OF EVIDENCE
3©The Author(s).
背景
患者报告心理障碍是恢复运动时的重要因素，然而，心理结局指标很少被纳入运动恢复（RTS）评估中。有必要进行临床试验，将患者报告的心理结局（PROs）纳入评估接受前交叉韧带重建治疗患者的运动恢复指标中。
目的
本研究的目的是确定初次前交叉韧带重建后恢复运动的患者通过肌肉功能临床测试和心理PROs与再次发生前交叉韧带损伤之间的关联。
设计
回顾性队列研究。
方法
从特定康复登记处提取患者的性别、年龄、身高和体重，以及力量和单腿跳测试结果，以及PROs的答案（包括特格纳活动量表、前交叉韧带损伤后恢复运动量表[ACL-RSI]以及膝关节损伤和骨关节炎结局评分[KOOS]的生活质量[QoL]子量表）。创建了四个不同的测试指标，包括肌肉功能测试和PROs，以评估患者是否准备好恢复运动。通过每个测试指标（是/否）作为自变量。进行多变量Cox比例风险模型分析，以再次发生前交叉韧带损伤（同侧或对侧；是/否）作为因变量，在恢复运动后两年内发生为观察指标。
结果
共纳入419例患者（男性，n = 214；51%），其中51例（12.2%）在恢复运动后的前两年内再次发生前交叉韧带损伤。与未发生第二次前交叉韧带损伤的患者相比，发生第二次前交叉韧带损伤的患者在包括肌肉功能测试和PROs的不同运动恢复测试指标中的通过率没有差异。
结论
在使用的包括肌肉功能和心理PROs的运动恢复临床测试指标通过情况与再次发生前交叉韧带损伤的风险之间未发现关联。
证据水平
3©作者。
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