Use of the Uninvolved Limb as Comparator When Calculating Return to Sports Hop Test Symmetry After ACL Reconstruction.

IF 2.7 2区 医学 Q1 SPORT SCIENCES
Elanna K Arhos, Angela H Smith, Naoaki Ito, May Arna Risberg, Lynn Snyder-Mackler, Karin Grävare Silbernagel
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引用次数: 0

Abstract

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 (P ≤ 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 (P = 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.

在计算前交叉韧带重建后运动跳跃测试对称性的恢复时,使用未受感肢体作为比较器。
背景:水平跳跃测试是前交叉韧带(ACL)重建(ACLR)后测试电池的可靠措施。Hop测试结果通常表示为肢体对称指数(LSIs),比较受累肢体和未受累肢体。使用非相关肢体作为比较测量一直受到质疑,因为担心该肢体的性能也可能下降,并且可能不是一个稳定的比较,从而导致错误的夸大LSI。在这里,我们报告了ACLR术后5个时间点未受损伤肢跳评分的变化。假设:未受累肢跳评分在术前康复和ACLR术后2年相似。研究设计:队列研究。证据等级:三级。方法:选取孤立性前交叉韧带损伤后的一级和二级运动员。参与者在损伤消退、术前康复以及ACLR术后6个月、1年和2年后完成了术前跳跃测试。分别对每个跳跃和每个肢体进行线性混合效应模型,以表征分数随时间的变化。报告了时间点固定效应和估计边际均值的两两比较。结果: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。对于每一跳,仅从损伤消退时间点到各随访时间点,未累及肢体跳距离有统计学差异(P≤0.009)。如果运动员接受术前康复,在整个康复期间,直到2年,除了6个月至2年的定时跳跃外,无受损伤肢体跳跃距离是稳定的(P = 0.04)。结论:未受累肢体是计算跳跃测试lsi作为回归运动决策的一部分的稳定比较。临床相关性:这些结果增加了使用对称性作为结果的信心,对缺乏损伤前跳跃测试数据的临床医生很重要。
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来源期刊
Sports Health-A Multidisciplinary Approach
Sports Health-A Multidisciplinary Approach Medicine-Orthopedics and Sports Medicine
CiteScore
6.90
自引率
9.10%
发文量
101
期刊介绍: Sports Health: A Multidisciplinary Approach is an indispensable resource for all medical professionals involved in the training and care of the competitive or recreational athlete, including primary care physicians, orthopaedic surgeons, physical therapists, athletic trainers and other medical and health care professionals. Published bimonthly, Sports Health is a collaborative publication from the American Orthopaedic Society for Sports Medicine (AOSSM), the American Medical Society for Sports Medicine (AMSSM), the National Athletic Trainers’ Association (NATA), and the Sports Physical Therapy Section (SPTS). The journal publishes review articles, original research articles, case studies, images, short updates, legal briefs, editorials, and letters to the editor. Topics include: -Sports Injury and Treatment -Care of the Athlete -Athlete Rehabilitation -Medical Issues in the Athlete -Surgical Techniques in Sports Medicine -Case Studies in Sports Medicine -Images in Sports Medicine -Legal Issues -Pediatric Athletes -General Sports Trauma -Sports Psychology
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