Alfuth Martin, Plücken Nina, Klemp Jonas, Bloch Wilhelm
Faculty of Health Care, Therapeutic Sciences, Niederrhein University of Applied Sciences, Krefeld, Germany.
Institute of Cardiovascular Research and Sport Medicine, Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Cologne, Germany.
Z Orthop Unfall. 2025 Oct;163(5):432-442. doi: 10.1055/a-2577-7304. Epub 2025 Apr 28.
After anterior cruciate ligament reconstruction (ACLR), patients have been found to have reduced plantar sensation, which may result in reduced afferent input to the central nervous system and thus contribute to motor deficits. Textured surfaces are thought to have a beneficial neurosensory effect. The aim of this cross-sectional study was to compare plantar sensation and leg muscle activity while stepping on different textured surfaces between patients after ACLR and healthy controls.Plantar cutaneous thresholds to light touch were measured in 10 patients at least 6 months after ACLR and in 10 healthy controls. Patients or controls were asked to step forward on the centre of a force plate with the affected (ACLR) or randomly assigned (healthy controls) leg and maintain the single-legged stance for 10 seconds (floor condition). They were instructed to perform the same task on a balance board with a textured surface, the same balance board with a smooth surface, and a balance pad in random order. Muscle activity of four leg muscles was recorded using surface electromyography. The significance of differences in plantar sensation and mean muscle activity within three time frames between and within ACLR patients and healthy controls was analysed using non-parametric statistical tests with Bonferroni correction ( < 0.05).There were no significant differences between patients with ACLR and healthy controls in plantar sensation and muscle activity for all unstable surface conditions ( > 0.05). Friedman tests revealed significant differences in the activities of all muscles between surface conditions at the first peak of the vertical ground reaction force (vGRF) after the rapid increase in the force-time curve (transition from early lifting phase to late lifting phase) within both groups ( < 0.01). Post-hoc Wilcoxon signed-rank tests showed significantly altered activity for most muscles between the smooth and textured balance board conditions only at the first vGRF peak ( ≤ 0.01) in both patients and healthy controls.Although plantar sensation and muscle activity did not differ between patients with ACLR and healthy controls, altered muscle activity in both groups, especially during the transition from the early to the late lifting phase of stepping on a textured unstable surface, may indicate an acute change in the afferent input of plantar mechanoreceptors in response to the surface stimulus. In addition, it may indicate an acute change in motor output caused by a beneficial neurosensory effect. This effect should be considered with caution due to the small sample size.
在前交叉韧带重建（ACLR）后，已发现患者足底感觉减退，这可能导致传入中枢神经系统的输入减少，从而导致运动功能障碍。有纹理的表面被认为具有有益的神经感觉效应。本横断面研究的目的是比较ACLR术后患者和健康对照在踩踏不同纹理表面时的足底感觉和腿部肌肉活动。
在10例ACLR术后至少6个月的患者和10例健康对照中测量了足底皮肤对轻触的阈值。要求患者或对照用患侧（ACLR）或随机分配的腿（健康对照）向前踩在测力板中心，并单腿站立10秒（地面条件）。他们被指示以随机顺序在有纹理表面的平衡板、表面光滑的同一平衡板和平衡垫上执行相同任务。使用表面肌电图记录四条腿部肌肉的活动。使用带有Bonferroni校正的非参数统计检验分析ACLR患者和健康对照之间以及内部三个时间框架内足底感觉和平均肌肉活动差异的显著性（<0.05）。
在所有不稳定表面条件下，ACLR患者和健康对照在足底感觉和肌肉活动方面均无显著差异（>0.05）。Friedman检验显示，两组在力-时间曲线快速上升（从早期抬起阶段过渡到晚期抬起阶段）后的垂直地面反作用力（vGRF）第一个峰值时，所有肌肉的活动在表面条件之间存在显著差异（<0.01）。事后Wilcoxon符号秩检验显示，仅在第一个vGRF峰值时，患者和健康对照在光滑和有纹理的平衡板条件之间，大多数肌肉的活动有显著改变（≤0.01）。
虽然ACLR患者和健康对照在足底感觉和肌肉活动方面没有差异，但两组肌肉活动的改变，尤其是在踩踏有纹理的不稳定表面从早期抬起阶段过渡到晚期抬起阶段时，可能表明足底机械感受器的传入输入因表面刺激而发生急性变化。此外，这可能表明有益的神经感觉效应导致运动输出发生急性变化。由于样本量小，应谨慎考虑这种效应。
