在计算前交叉韧带重建术后恢复运动单腿跳测试对称性时，使用未受累肢体作为对照。
Use of the Uninvolved Limb as Comparator When Calculating Return to Sports Hop Test Symmetry After ACL Reconstruction.
作者信息
Arhos Elanna K, Smith Angela H, Ito Naoaki, Risberg May Arna, Snyder-Mackler Lynn, Silbernagel Karin Grävare
机构信息
Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois.
PhysioFit Delaware, LLC, Wilmington, Delaware.
出版信息
Sports Health. 2025 May 3:19417381251334639. doi: 10.1177/19417381251334639.
BACKGROUND
Horizontal hop testing is a reliable measure included in test batteries after anterior cruciate ligament (ACL) reconstruction (ACLR). Hop test results are typically expressed as limb symmetry indexes (LSIs) comparing the involved limb with the uninvolved limb. Using the uninvolved limb as a comparative measure has been questioned due to concerns that performance may be reduced in this limb also and may not be a stable comparison across time, leading to a falsely inflated LSI. Here, we report changes in uninvolved limb hop scores over 5 timepoints after ACLR.
HYPOTHESIS
Uninvolved limb hop scores would be similar between preoperative rehabilitation and 2 years after ACLR.
STUDY DESIGN
Cohort study.
LEVEL OF EVIDENCE
Level III.
METHODS
Level I and II athletes were enrolled after isolated ACL injury. Participants completed a preoperative hop testing battery after impairment resolution, preoperative rehabilitation, and 6 months, 1 year, and 2 years after ACLR. Linear mixed-effects models were performed separately for each hop and each limb to characterize change in scores over time. Pairwise comparisons for fixed effects of timepoint and estimated marginal means are reported.
RESULTS
A total of 182 athletes (25.0 ± 8.8 years, 44% female) were enrolled a mean of 54 days from ACL injury. For each hop, the uninvolved limb hop distance was statistically different from the impairment resolution timepoint only to various follow-up timepoints ( ≤ 0.009). If athletes underwent preoperative rehabilitation, uninvolved limb hop distance was stable throughout the duration of rehabilitation until 2 years, apart from timed hop from 6 months to 2 years ( = 0.04).
CONCLUSION
The uninvolved limb is a stable comparison for calculating hop test LSIs as part of return-to-sport decisions.
CLINICAL RELEVANCE
These results increase confidence in using symmetry as an outcome and are important for clinicians lacking preinjury hop testing data.
背景
单腿跳测试是前交叉韧带（ACL）重建（ACLR）后测试组合中一项可靠的测量方法。单腿跳测试结果通常表示为将患侧肢体与未患侧肢体进行比较的肢体对称性指数（LSIs）。由于担心未患侧肢体的表现也可能降低，且随着时间推移可能不是一个稳定的比较标准，从而导致LSIs被错误地夸大，因此使用未患侧肢体作为比较指标受到了质疑。在此，我们报告了ACLR后5个时间点未患侧肢体单腿跳得分的变化情况。
假设
术前康复与ACLR后2年之间，未患侧肢体的单腿跳得分相似。
研究设计
队列研究。
证据水平
III级。
方法
I级和II级运动员在单纯ACL损伤后入组。参与者在损伤恢复、术前康复后以及ACLR后6个月、1年和2年完成了术前单腿跳测试组合。对每条腿的每次单腿跳分别进行线性混合效应模型分析，以描述得分随时间的变化。报告了时间点固定效应和估计边际均值的成对比较结果。
结果
共有182名运动员（25.0±8.8岁，44%为女性）在ACL损伤后平均54天入组。对于每次单腿跳，未患侧肢体的单腿跳距离仅在不同的随访时间点与损伤恢复时间点存在统计学差异（≤0.009）。如果运动员接受了术前康复，未患侧肢体的单腿跳距离在整个康复期间直至2年都是稳定的，6个月至2年的定时单腿跳除外（P = 0.04）。
结论
作为重返运动决策的一部分，未患侧肢体是计算单腿跳测试LSIs的一个稳定比较标准。
临床意义
这些结果增加了将对称性作为一项指标的可信度，对缺乏伤前单腿跳测试数据的临床医生来说很重要。
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