Changes in isometric mid-thigh pull peak force and symmetry across anterior cruciate ligament reconstruction rehabilitation phases

Johannes P. J. Stofberg, K. Aginsky, Mariaan van Aswegen, Mark Kramer
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Abstract

Whether functionally relevant strength assessments, such as the isometric mid-thigh pull (IMTP), can be used either bilaterally or unilaterally to evaluate and guide rehabilitation progress in those with anterior cruciate ligament reconstruction (ACLR) is under-researched. This study assessed changes in peak force (PF) and asymmetry across 3 phases for bilateral and unilateral IMTP assessments in patients with ACLR. Peak isometric force from the IMTP was compared to peak torque from isokinetic dynamometry as well as against a cohort of healthy, uninjured individuals.Participants (ACLR, n = 15) completed bilateral and unilateral IMTP assessments at weeks 12 (baseline), 16 (phase 3), and 20 (phase 4) of rehabilitation to evaluate changes in PF and asymmetry. Asymmetry was evaluated using the asymmetry angle. Isometric data from the IMTP were compared to that from an isokinetic dynamometer as well as against a cohort of healthy, uninjured participants (n = 63) allowing for a detailed analysis of limb-specific force production.The PF during the bilateral IMTP increased for both the injured (0.94 N/kg) and uninjured (0.26 N/kg) limbs from baseline to phase 4, whereas the PF of the injured limb increased by 1.5 N/kg during the unilateral IMTP in the same time frame. Asymmetry values systematically reduced by ∼1% and ∼0.5% for the bilateral and unilateral IMTP tests from baseline to phase 4. Significant differences in PF of the injured limb were evident between those with ACLR and healthy controls across all phases (p = 0.022–0.001). The rate of progression in PF capacity was dependent on test type, amounting to 0.1 and 0.2 body weights per week for the bilateral and unilateral IMTP respectively. Small-to-large correlations (r = 0.12–0.88) were evident between IMTP PF and peak torque from the isokinetic dynamometer as well as between asymmetry metrics from both tests.The findings suggest that IMTP PF has potential for monitoring changes in PF and asymmetry during the ACLR rehabilitation progress. Both injured limb and uninjured limb show improvement in force-generating capacity, implying a positive adaptation to rehabilitation protocols. The findings highlight that ACLR is a unilateral injury that requires bilateral rehabilitation.
大腿中部等距拉力峰值和对称性在前十字韧带重建康复阶段的变化
对于与功能相关的力量评估(如等长大腿中部牵拉(IMTP))是否可用于双侧或单侧评估和指导前交叉韧带重建(ACLR)患者的康复进展,研究尚不充分。本研究评估了前交叉韧带重建患者在双侧和单侧 IMTP 评估的 3 个阶段中峰值力(PF)和不对称的变化。参与者(前交叉韧带损伤,n = 15)在康复的第 12 周(基线)、第 16 周(第 3 阶段)和第 20 周(第 4 阶段)完成了双侧和单侧 IMTP 评估,以评估 PF 和不对称性的变化。不对称度使用不对称角进行评估。从基线到第 4 阶段,受伤肢体(0.94 牛/公斤)和未受伤肢体(0.26 牛/公斤)在双侧 IMTP 期间的 PF 均有所增加,而受伤肢体在单侧 IMTP 期间的 PF 在同一时间内增加了 1.5 牛/公斤。从基线到第 4 阶段,双侧和单侧 IMTP 测试的不对称值分别降低了 1% 和 0.5%。在所有阶段中,前交叉韧带损伤者和健康对照组的受伤肢体的PF均存在明显差异(p = 0.022-0.001)。PF能力的进展速度取决于测试类型,双侧和单侧IMTP的进展速度分别为每周0.1和0.2体重。研究结果表明,在前交叉韧带损伤(ACLR)康复过程中,IMTP PF 具有监测 PF 和不对称变化的潜力。受伤肢体和未受伤肢体的发力能力都有所提高,这意味着对康复方案有积极的适应性。研究结果突出表明,前交叉韧带损伤是一种单侧损伤,需要进行双侧康复。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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