前交叉韧带重建术后不同时间点肢体负荷及下肢力量恢复情况分析

Analysis of Limb Loading and Lower Extremity Strength Recovery Across Time After Anterior Cruciate Ligament Reconstruction.

作者信息

Bruce Leicht Amelia S, Thompson Xavier D, Queen Robin M, Rodu Jordan S, Higgins Michael J, Cross Kevin M, Werner Brian C, Resch Jacob E, Hart Joe M

机构信息

University of Kentucky, Department of Athletic Training and Clinical Nutrition, Lexington, Kentucky.

University of Virginia, Department of Kinesiology, Charlottesville, Virginia.

出版信息

Sports Health. 2024 Oct 14:19417381241285859. doi: 10.1177/19417381241285859.

DOI:10.1177/19417381241285859

PMID:39397655

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11556615/

Abstract

BACKGROUND

Evidence as to how patient thigh muscle strength and limb loading (LL) during a squatting task recovers throughout rehabilitation after anterior cruciate ligament reconstruction (ACLR) is lacking.

HYPOTHESIS

Patients will improve LL and strength throughout rehabilitation. Changes in LL and strength over time will be positively correlated.

STUDY DESIGN

Prospective cohort study.

LEVEL OF EVIDENCE

Level 3.

METHODS

A total of 60 participants (28 male/32 female; age, 22.5 ± 9.35 years) participated in 2 visits post-ACLR, assessing LL and strength. Using an instrumented pressure mat, patients completed 3 sets of 3 repetitions of bodyweight squats. Peak force (N), unilateral cumulative load (%), and quadriceps and hamstring isokinetic peak torque (N·m) were calculated and recorded bilaterally. LL and peak torque were compared over time and between limbs.

RESULTS

A significant limb-by-time interaction was observed for LL peak force (N), where patients underloaded the ACLR limb at visit 1 compared with the contralateral limb ( < 0.01). Patients increased their ACLR LL across visits ( = 0.04). A limb-by-time interaction for quadriceps peak torque (N·m) was observed where the ACLR limb increased peak torque across visits ( < 0.01); however, strength deficits persisted at visit 2 ( < 0.01) when compared with the nonoperative limb. Weak correlations were observed between all change scores metrics (, 0.20-0.25).

CONCLUSION

Patients recovering from ACLR exhibited more symmetric loading during a squatting task and improved their lower extremity strength over time. Changes in strength were not related to changes in LL during a squatting task over time.

CLINICAL RELEVANCE

Squatting tasks are safe and easily implemented throughout ACLR recovery. As changes in functional LL and strength recovery are not related, both should be considered in serial postoperative testing for more comprehensive function and strength assessments.

摘要

背景

关于前交叉韧带重建（ACLR）后康复过程中患者在深蹲任务时大腿肌肉力量和肢体负荷（LL）如何恢复的证据尚缺。

假设

患者在整个康复过程中LL和力量将得到改善。LL和力量随时间的变化将呈正相关。

研究设计

前瞻性队列研究。

证据水平

3级。

方法

共有60名参与者（28名男性/32名女性；年龄，22.5±9.35岁）在ACLR后接受2次访视，评估LL和力量。使用仪器化压力垫，患者完成3组，每组3次体重深蹲。计算并双侧记录峰值力（N）、单侧累积负荷（%）以及股四头肌和腘绳肌等速峰值扭矩（N·m）。比较LL和峰值扭矩随时间以及双侧肢体之间的情况。

结果

观察到LL峰值力（N）存在显著的肢体×时间交互作用，在第1次访视时，与对侧肢体相比，ACLR肢体负荷不足（<0.01）。患者在各次访视中ACLR的LL增加（=0.04）。观察到股四头肌峰值扭矩（N·m）存在肢体×时间交互作用，ACLR肢体在各次访视中峰值扭矩增加（<0.01）；然而，与非手术肢体相比，在第2次访视时力量缺陷仍然存在（<0.01）。在所有变化分数指标之间观察到弱相关性（，0.20 - 0.25）。