Wu Xipeng, Zhang Hao, Cui Hongxing, Pei Wenbin, Zhao Yixuan, Wang Shanshan, Cao Zhijie, Li Wei
School of Rehabilitation Medicine, Binzhou Medical University, Yantai, China.
Department of Rehabilitation, Binzhou Medical University Hospital, Binzhou, China.
Orthop Surg. 2025 Jan;17(1):62-70. doi: 10.1111/os.14256. Epub 2024 Oct 5.
An important reason for the poor recovery of anterior cruciate ligament (ACL) injuries is the poor recovery of muscle function. Therefore, we used surface electromyography (sEMG) and gait analysis to explore the muscle activation patterns and gait characteristics between lower limbs under different exercise states in patients, following anterior cruciate ligament reconstruction (ACLR).
Forty-one adults with unilateral ACL injuries in Binzhou Medical University Hospital from October 2022 to June 2023 were allocated to three groups according to the time after ACL reconstruction: group A (≤3 months, 16), group B (3 months-1 year, 13), and group C (>1 year, 12). Patients were tested by sEMG and gait, while straight leg raising (SLR), walking at normal speed, fast walking, and walking up and down the stairs. Two related sample tests were performed for the normalized root mean square (RMS) values and gait parameters.
Muscle function changes varied in different training tasks. The RMS value of the involved side was more than the uninvolved side in biceps femoris and semitendinosus of group A (p < 0.010), and for the bilateral rectus femoris (RS), vastus medialis (VM), and vastus lateralis in group B, only the comparison of the RS was significant in group C during fast walking and going up and down the stairs. The ground impact (0.90 [0.63, 1.33] vs. 0.71 [0.43, 1.02], p = 0.035) of the uninvolved side was significantly decreased compared to those of the involved side in patients with ACLR when going down the stairs.
Different muscles need to be focused on at different stages of the postoperative period. sEMG and gait analysis can guide the development of a rehabilitation program.
前交叉韧带（ACL）损伤恢复不佳的一个重要原因是肌肉功能恢复较差。因此，我们采用表面肌电图（sEMG）和步态分析来探究前交叉韧带重建（ACLR）术后患者在不同运动状态下双下肢的肌肉激活模式和步态特征。
选取2022年10月至2023年6月在滨州医学院附属医院的41名单侧ACL损伤的成年人，根据ACL重建后的时间分为三组：A组（≤3个月，16例）、B组（3个月至1年，13例）和C组（>1年，12例）。患者在进行直腿抬高（SLR）、正常速度行走、快速行走以及上下楼梯时接受sEMG和步态测试。对归一化均方根（RMS）值和步态参数进行两项相关样本测试。
不同训练任务中肌肉功能变化各异。A组股二头肌和半腱肌患侧的RMS值高于健侧（p < 0.010），B组双侧股直肌（RS）、股内侧肌（VM）和股外侧肌在快速行走和上下楼梯时，仅C组中RS的比较有统计学意义。ACLR患者下楼梯时，健侧的地面冲击力（0.90 [0.63, 1.33] 对 0.71 [0.43, 1.02]，p = 0.035）相较于患侧显著降低。
术后不同阶段需要关注不同肌肉。sEMG和步态分析可为康复计划的制定提供指导。
