Xue Boshi, Yang Xiaowei, Wang Xia, Yang Chen, Zhou Zhipeng
College of Sports and Health, Shandong Sport University, Jinan, China.
Faculty of Sports Science, Ningbo University, Ningbo, China.
Front Physiol. 2024 Oct 21;15:1488001. doi: 10.3389/fphys.2024.1488001. eCollection 2024.
The purpose of this study was to compare the interlimb biomechanical differences in patients who had undergone anterior cruciate ligament reconstruction (ACLR) in either dominant (ACLR-D) or nondominant (ACLR-ND) limbs and healthy controls (CON) during drop vertical jump (DVJ) task. To investigate whether the dominant or nondominant limb influences the risk of re-injury in ACLR patients.
Thirty-three ACLR patients were divided into ACLR-D and ACLR-ND groups according to whether the surgical limb was dominant or nondominant. Seventeen healthy individuals were selected as the CON group. Three-dimensional kinematic data, ground reaction force (GRF) data, and surface electromyographic (EMG) data from the bilateral lower limbs of all participants were collected during the DVJ task. Two-way repeated-measures ANOVAs (limb × group) were performed on the variables of interest to examine the main effects of limb (dominant vs. nondominant) and group (ACLR-D, ACLR-ND, and CON), as well as the interaction between limb and group.
The nonsurgical limbs of ACLR group had significantly greater knee valgus angles, knee extension and valgus moments, peak posterior GRF (PPGRF), and peak vertical GRF (PVGRF) compared to the surgical limbs. The nonsurgical limbs of ACLR-ND patients demonstrated significantly greater knee extension and valgus moments, greater PPGRF and PVGRF, and reduced muscle activity in the vastus medialis and vastus lateralis compared to the CON group. The ACLR patients had reduced muscle activity in the quadriceps of the surgical limb and the hamstrings of the bilateral limbs compared to controls.
The nonsurgical limbs of ACLR patients may suffer an increased risk of ACL injury due to altered landing mechanics and neuromuscular control strategies compared to the surgical limbs. Additionally, limb dominance influences movement patterns and neuromuscular control during DVJ task, the nonsurgical limbs of the ACLR-ND might be at higher risk of ACL injury compared to the ACLR-D group.
本研究旨在比较前交叉韧带重建术(ACLR)患者在进行垂直跳落(DVJ)任务时,优势肢体(ACLR-D)和非优势肢体(ACLR-ND)与健康对照组(CON)之间的肢体间生物力学差异。以调查优势或非优势肢体是否会影响ACLR患者再次受伤的风险。
33例ACLR患者根据手术肢体是优势还是非优势分为ACLR-D组和ACLR-ND组。选取17名健康个体作为CON组。在DVJ任务期间收集所有参与者双侧下肢的三维运动学数据、地面反作用力(GRF)数据和表面肌电图(EMG)数据。对感兴趣的变量进行双向重复测量方差分析(肢体×组),以检验肢体(优势与非优势)和组(ACLR-D、ACLR-ND和CON)的主效应,以及肢体与组之间的相互作用。
与手术肢体相比,ACLR组的非手术肢体具有显著更大的膝外翻角度、膝关节伸展和外翻力矩、后向地面反作用力峰值(PPGRF)和垂直地面反作用力峰值(PVGRF)。与CON组相比,ACLR-ND患者的非手术肢体表现出显著更大的膝关节伸展和外翻力矩、更大的PPGRF和PVGRF,以及股内侧肌和股外侧肌的肌肉活动减少。与对照组相比,ACLR患者手术肢体的股四头肌和双侧肢体的腘绳肌的肌肉活动减少。
与手术肢体相比,ACLR患者的非手术肢体由于着陆力学和神经肌肉控制策略的改变,可能会增加前交叉韧带损伤的风险。此外,肢体优势会影响DVJ任务期间的运动模式和神经肌肉控制,与ACLR-D组相比,ACLR-ND的非手术肢体可能具有更高的前交叉韧带损伤风险。