膝关节特定角度（60°-90°）联合与孤立动力链对前交叉韧带重建术后恢复结果的影响：一项随机对照试验。
Effect of Knee Angle Specific (60°-90°) Combine versus Isolated Kinetic Chain on Post ACL Recovery Outcomes: A Randomized Control Trial.
作者信息
Khan Danish Ali, Ahmad Ashfaq, Karimi Hossein, Hanif Asif, Almansour Abdullatif Mansour, Almansour Abdulelah Mansour, Aldahmash Badr, Rady Ahmed, Almansour Mansour I
机构信息
University Institute of Physical Therapy, Faculty of Allied Health Sciences; The University of Lahore Lahore, Punjab, Pakistan.
Department of Biostatistics, Faculty of Medicine, Sakarya University, Esentepe, Sakarya, Turkey.
出版信息
J Multidiscip Healthc. 2025 Sep 13;18:5801-5815. doi: 10.2147/JMDH.S528778. eCollection 2025.
BACKGROUND
The demand for anterior cruciate ligament (ACL) reconstruction is steadily rising, necessitating a comprehensive post-ACL rehabilitation plan to accelerate recovery. This study explores the comparative effects of Open Kinetic Chain (OKC), Closed Kinetic Chain (CKC), and their combined effect at a specific knee angle (60° to 90°) in post-ACL reconstruction patients.
METHODOLOGY
This clinical trial was registered in the Iranian Registry of Clinical Trials (IRCT) on 21-04-2020 (Ref# IRCT20200331046903N1) and conducted on 54 post-ACL reconstruction patients, randomly allocated to three groups (OKC, CKC, and Combined KC) using the lottery method. All groups underwent 16-week rehabilitation programs. Outcomes assessed were pain, range of motion (ROM), and knee function using the visual analog scale, goniometer, and Lysholm score, respectively. Statistical analysis was conducted using one-way and repeated measures ANOVA in SPSS-25.
RESULTS
The mean age was 27.25±4.16 years and BMI 25.12±4.03 kg/m². All groups showed statistically significant improvement over 16 weeks (p<0.0001). At week 16, mean pain scores were 10.56±4.38 (Group A), 9.78±3.81 (Group B), and 3.28±3.12 (Group C) (p<0.001); ROM improved to 131.83±7.35, 129.22±7.57, and 140.61±6.13, respectively (p=0.001); knee function scores reached 90.78±4.83, 91.67±4.49, and 97.50±2.15, respectively (p=0.001). All outcome measures showed significant main effects of Group and Visit, with large effect sizes and significant Group×Visit interactions. From baseline to week 16, pain decreased by 85% (Group A), 86% (Group B), and 95% (Group C); ROM increased by 73%, 72%, and 90%; knee function improved by 58%, 63%, and 72%, respectively.
CONCLUSION
These findings indicate that the combined kinetic chain approach is most effective in improving ROM, knee function, and pain reduction following ACL reconstruction.
TRIAL REGISTRATION
背景
前交叉韧带（ACL）重建的需求正在稳步上升，因此需要一个全面的ACL术后康复计划来加速恢复。本研究探讨了开放动力链（OKC）、闭合动力链（CKC）及其在特定膝关节角度（60°至90°）对ACL重建术后患者的联合作用。
方法
本临床试验于2020年4月21日在伊朗临床试验注册中心（IRCT）注册（注册号：IRCT20200331046903N1），并对54例ACL重建术后患者进行了研究，采用抽签法将其随机分为三组（OKC组、CKC组和联合动力链组）。所有组均接受为期16周的康复计划。分别使用视觉模拟量表、角度计和Lysholm评分评估疼痛、活动范围（ROM）和膝关节功能。使用SPSS-25软件进行单因素和重复测量方差分析进行统计分析。
结果
平均年龄为27.25±4.16岁，体重指数为25.12±4.03kg/m²。所有组在16周内均显示出统计学上的显著改善（p<0.0001）。在第16周时，平均疼痛评分分别为A组10.56±4.38、B组9.78±3.81和C组3.28±3.12（p<0.001）；ROM分别改善到131.83±7.35、129.22±7.57和140.61±6.13（p=0.001）；膝关节功能评分分别达到90.78±4.83、91.67±4.49和97.50±2.15（p=0.001）。所有结局指标均显示出组间和访视的显著主效应，并具有较大的效应量和显著的组×访视交互作用。从基线到第16周，A组疼痛降低85%，B组降低86%，C组降低95%；ROM分别增加73%、72%和90%；膝关节功能分别改善58%、63%和72%。
结论
这些结果表明，联合动力链方法在改善ACL重建术后的ROM、膝关节功能和减轻疼痛方面最有效。
试验注册
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