Soma Yuichiro, Mutsuzaki Hirotaka, Yoshioka Tomokazu, Kubota Shigeki, Iwai Koichi, Shimizu Yukiyo, Kanamori Akihiro, Yamazaki Masashi
Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba 305-8576, Japan.
Division of Regenerative Medicine for Musculoskeletal System, Institute of Medicine, University of Tsukuba, Tsukuba 305-8576, Japan.
J Clin Med. 2023 Sep 22;12(19):6117. doi: 10.3390/jcm12196117.
Decreased muscle strength often occurs after anterior cruciate ligament (ACL) reconstruction; this can include muscle atrophy, neuromuscular dysfunction, and reduced force generation efficiency. Hybrid assistive limb (HAL) technology, which integrates an interactive biofeedback system connecting the musculoskeletal system to the brain and spinal motor nerves, offers a potential intervention. Our study, conducted from March 2018 to August 2023 using knee HAL single-joint technology, was a prospective non-randomized controlled trial involving 27 patients who had undergone arthroscopic ACL reconstruction. They were split into two groups: HAL (18 patients) and control (nine patients). Beginning 18 weeks after their surgery, the HAL group participated in three weekly sessions of knee HAL-assisted exercises. Both the HAL and control groups underwent isokinetic muscle strength tests at postoperative weeks 17 and 21. Testing utilized an isokinetic dynamometer at 60°/s, 180°/s, and 300°/s. The Limb Symmetry Index (LSI) was employed to measure side-to-side differences. The HAL group showed significant LSI improvements in peak extension torque across all testing velocities and for peak flexion torque at 60°/s and 300°/s. The rate of change in LSI for peak flexion torque at 300°/s was significantly higher post-measurements ( = 0.036; effect size = 1.089). The change rate for LSI in peak extension torque at 300°/s and all peak flexion torques showed medium to large effect sizes in Cohen's d. In conclusion, knee HAL single-joint training positively influenced muscle strength recovery and efficiency. The HAL training group exhibited superior muscle strength at various isokinetic testing velocities compared to the control group.
前交叉韧带（ACL）重建术后常出现肌肉力量下降；这可能包括肌肉萎缩、神经肌肉功能障碍以及力量产生效率降低。混合辅助肢体（HAL）技术集成了一个将肌肉骨骼系统与大脑和脊髓运动神经相连的交互式生物反馈系统，提供了一种潜在的干预方法。我们的研究于2018年3月至2023年8月使用膝关节HAL单关节技术进行，是一项前瞻性非随机对照试验，涉及27例接受关节镜下ACL重建的患者。他们被分为两组：HAL组（18例患者）和对照组（9例患者）。在手术后18周开始，HAL组每周参加三次膝关节HAL辅助训练课程。HAL组和对照组均在术后第17周和第21周进行等速肌力测试。测试使用等速测力计，速度分别为60°/秒、180°/秒和300°/秒。使用肢体对称指数（LSI）来测量两侧差异。HAL组在所有测试速度下的峰值伸展扭矩以及60°/秒和300°/秒的峰值屈曲扭矩方面，LSI均有显著改善。在300°/秒时峰值屈曲扭矩的LSI变化率在测量后显著更高（ = 0.036；效应大小 = 1.089）。在300°/秒时峰值伸展扭矩以及所有峰值屈曲扭矩的LSI变化率在Cohen's d中显示出中等至较大的效应大小。总之，膝关节HAL单关节训练对肌肉力量恢复和效率有积极影响。与对照组相比，HAL训练组在各种等速测试速度下表现出更强的肌肉力量。
