Popovich John M, Tsai Liang-Ching, Brito Marisa, Xerogeanes John W, Lyle Mark A
Center for Neuromusculoskeletal Clinical Research, Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan.
Department of Physical Therapy, Georgia State University, Atlanta, Georgia.
Sports Health. 2025 Jun 14:19417381251343092. doi: 10.1177/19417381251343092.
Biomechanical asymmetries after anterior cruciate ligament reconstruction (ACLR) may be amplified and perpetuated by progressing athletes to higher-demand tasks despite impairments in lower-demand tasks.
(1) Between-limb asymmetries in limb loading and joint kinetics will be greater during the higher-demand drop jump compared with squatting. (2) Asymmetries in limb loading and joint kinetics during squatting will be associated with asymmetries during drop jump.
Descriptive laboratory study.
Level 4.
A total of 22 (11 female) participants after primary ACLR (6.4 ± 0.5 months) performed bilateral squat and drop jump tasks. Vertical ground-reaction force (vGRF), knee and hip extensor net joint moments (NJMs), hip/knee mean NJM ratio, and limb symmetry index (LSI) were calculated during the eccentric phase. Comparisons between limbs and across tasks were analyzed using 2-way repeated measures analyses of variance. Pearson's correlations assessed associations between vGRF and NJM LSIs, and hip/knee NJM ratios across tasks.
Mean vGRF LSI and knee NJM LSI were significantly more asymmetric during drop jump compared with squatting (79.7 ± 14.9 vs 90.0 ± 11.0%, < 0.001 and 55.8 ± 17.6 vs 66.4 ± 25.6%, = 0.02, respectively). Mean vGRF LSI ( = 0.58; = 0.004) and knee NJM LSI ( = 0.61; = 0.002) were moderately correlated between tasks. The hip/knee ratio for the ACLR limb correlated strongly between tasks ( = 0.69; < 0.001); nonsurgical limb: r = 0.39; P = 0.07).
Underloading and reduced functional use of the ACLR knee were amplified during the drop jump compared with squatting. Limb mechanics during lower-demand squatting are informative of performance during drop jump.
Criterion-based rehabilitation guidelines may benefit from requiring symmetry in lower-demand tasks before progressing to higher-level activities to optimize recovery and reduce risk of reinjury.
尽管在低需求任务中存在功能障碍，但让前交叉韧带重建（ACLR）后的运动员进行更高需求的任务，可能会加剧并延续生物力学不对称性。
（1）与深蹲相比，在更高需求的纵跳过程中，肢体负荷和关节动力学的双侧不对称性会更大。（2）深蹲过程中肢体负荷和关节动力学的不对称性将与纵跳过程中的不对称性相关。
描述性实验室研究。
4级。
共有22名（11名女性）初次ACL重建术后（6.4±0.5个月）的参与者进行了双侧深蹲和纵跳任务。在离心阶段计算垂直地面反作用力（vGRF）、膝关节和髋关节伸肌净关节力矩（NJMs）、髋/膝平均NJMs比值以及肢体对称指数（LSI）。使用双向重复测量方差分析对肢体间和任务间的比较进行分析。Pearson相关性评估了vGRF和NJMs LSI以及各任务间髋/膝NJMs比值之间的关联。
与深蹲相比，纵跳过程中平均vGRF LSI和膝关节NJMs LSI的不对称性显著更大（分别为79.7±14.9%对90.0±11.0%，P<0.001；55.8±17.6%对66.4±25.6%，P = 0.02）。各任务间平均vGRF LSI（r = 0.58；P = 0.004）和膝关节NJMs LSI（r = 0.61；P = 0.002）呈中度相关。ACLR肢体的髋/膝比值在各任务间相关性很强（r = 0.69；P<0.001）；非手术肢体：r = 0.39；P = 0.07）。
与深蹲相比，纵跳过程中ACLR膝关节的负荷不足和功能使用减少更为明显。低需求深蹲过程中的肢体力学情况可反映纵跳过程中的表现。
基于标准的康复指南可能会受益于在进展到更高水平活动之前要求在低需求任务中达到对称性，以优化恢复并降低再次受伤的风险。
