Asymmetry in Limb Stiffness, Joint Power, and Joint Work During Landing in Anterior Cruciate Ligament Reconstruction Patients.

IF 2.7 2区 医学 Q1 SPORT SCIENCES
Michael A Teater, Daniel Schmitt, Douglas W Powell, Robin M Queen
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引用次数: 0

Abstract

Background: Kinetic and kinematic side-to-side limb asymmetries can increase after anterior cruciate ligament reconstruction (ACLR). Limb stiffness asymmetry has not been previously explored.

Hypothesis: Athletes with ACLR will exhibit greater asymmetry in limb stiffness, peak eccentric joint power, and eccentric joint work compared with asymptomatic controls during landing.

Study design: Case-control study.

Level of evidence: Level 4.

Methods: Forty athletes with 5.9 ± 1.4 months removed from ACLR and 40 asymptomatic athletes completed 7 stop-jumps (SJs) during a single session. Three-dimensional motion capture and ground-reaction force data were collected during landing. Normalized symmetry index values for limb stiffness, peak eccentric joint power, and eccentric joint work of athletes with bone-patellar tendon-bone (BPTB) grafts, athletes with hamstring grafts, and control athletes were compared.

Results: Athletes with ACLR had greater knee power Athletes with ACLR had greater knee power (BPTB, 29.1 ± 17.6; hamstring, 27.3 ± 14.1; Control, 14.2 ± 10.7; P < 0.01) and knee work (BPTB, 35.2 ± 21.5; hamstring, 32.1 ± 18.4; Control, 14.9 ± 10.1; P < 0.01) asymmetries than control athletes. Athletes with BPTB grafts and hamstring grafts both displayed larger knee power and work asymmetries compared with control athletes (P < 0.01 for each comparison), with no differences between graft types (P = 0.90 and P = 0.80, respectively). No between-group differences were found in limb stiffness (BPTB, 16.2 ± 10.8; hamstring, 13.5 ± 9.83; Control, 13.9 ± 9.33; P = 0.63), ankle power (BPTB, 16.5 ± 11.4; hamstring, 14.4 ± 13.0; Control, 18.3 ± 14.0; P = 0.55), ankle work (BPTB, 20.9 ± 13.0; hamstring, 17.4 ± 14.9; Control, 18.4 ± 12.8; P = 0.69), hip power (BPTB, 17.6 ± 12.8; hamstring, 19.5 ± 11.3; Control, 13.3 ± 9.08; P = 0.09), or hip work (BPTB, 17.2 ± 13.9; hamstring, 24.6 ± 14.1; Control, 16.2 ± 11.7; P = 0.06) asymmetries.

Conclusion: Athletes with ACLR use asymmetric landing strategies that favor their nonsurgical limb, resulting in greater knee power and knee work asymmetries compared with controls. No between-group asymmetry differences in limb stiffness, ankle power and work, and hip power and work were found.

Clinical relevance: After 5.9 ± 1.4 months removed from ACLR surgery, athletes favor their nonsurgical limb at the knee, risking further injury. While limb stiffness asymmetry was not different between groups, the groups appeared to modulate limb stiffness differently between limbs to produce similar asymmetry values.

前交叉韧带重建患者着陆时肢体僵硬、关节力量和关节工作的不对称性。
背景:前交叉韧带重建(ACLR)后,动力学和运动学侧对侧肢体不对称会增加。肢体僵硬不对称以前没有被研究过。假设:与无症状对照者相比,ACLR运动员在着陆过程中会表现出更大的肢体刚度、峰值偏心关节力量和偏心关节功的不对称性。研究设计:病例对照研究。证据等级:四级。方法:40名ACLR切除5.9±1.4个月的运动员和40名无症状运动员在单次训练中完成7次停止跳跃(SJs)。在着陆过程中收集了三维运动捕捉和地面反作用力数据。比较骨-髌骨肌腱-骨(BPTB)移植运动员、腿筋移植运动员和对照组运动员的肢体刚度、峰值偏心关节力量和偏心关节功的归一化对称指数值。结果:ACLR患者膝关节力量更大(BPTB, 29.1±17.6;腘绳肌,27.3±14.1;对照组:14.2±10.7;P < 0.01)和膝关节工作(BPTB, 35.2±21.5;腿筋,32.1±18.4;对照组,14.9±10.1;P < 0.01)。与对照组运动员相比,移植BPTB和腿筋的运动员膝盖力量和工作不对称性都更大(P < 0.01),移植类型之间无差异(P = 0.90和P = 0.80)。肢体僵硬度组间无差异(BPTB, 16.2±10.8;腿筋,13.5±9.83;对照组:13.9±9.33;P = 0.63),踝关节力量(BPTB, 16.5±11.4;腿筋,14.4±13.0;对照组,18.3±14.0;P = 0.55),踝关节工作(BPTB, 20.9±13.0;腿筋,17.4±14.9;对照组:18.4±12.8;P = 0.69),髋部力量(BPTB, 17.6±12.8;腿筋,19.5±11.3;对照组:13.3±9.08;P = 0.09),或髋部工作(BPTB, 17.2±13.9;腿筋,24.6±14.1;对照组:16.2±11.7;P = 0.06)不对称。结论:与对照组相比,ACLR运动员使用非对称着陆策略,有利于他们的非手术肢体,导致更大的膝关节力量和膝关节工作不对称。两组之间在肢体僵硬、踝关节力量和功、髋关节力量和功方面没有不对称差异。临床相关性:ACLR手术切除5.9±1.4个月后,运动员倾向于膝关节处的非手术肢体,有进一步损伤的风险。虽然各组之间的肢体刚度不对称没有差异,但各组似乎对四肢之间的肢体刚度进行了不同的调节,以产生相似的不对称值。
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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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