Amelia S Bruce Leicht, Xavier D Thompson, Robin M Queen, Jordan S Rodu, Michael J Higgins, Kevin M Cross, Brian C Werner, Jacob E Resch, Joe M Hart
{"title":"前十字韧带重建术后肢体负荷和下肢力量恢复分析","authors":"Amelia S Bruce Leicht, Xavier D Thompson, Robin M Queen, Jordan S Rodu, Michael J Higgins, Kevin M Cross, Brian C Werner, Jacob E Resch, Joe M Hart","doi":"10.1177/19417381241285859","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Evidence as to how patient thigh muscle strength and limb loading (LL) during a squatting task recovers throughout rehabilitation after anterior cruciate ligament reconstruction (ACLR) is lacking.</p><p><strong>Hypothesis: </strong>Patients will improve LL and strength throughout rehabilitation. Changes in LL and strength over time will be positively correlated.</p><p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>A total of 60 participants (28 male/32 female; age, 22.5 ± 9.35 years) participated in 2 visits post-ACLR, assessing LL and strength. Using an instrumented pressure mat, patients completed 3 sets of 3 repetitions of bodyweight squats. Peak force (N), unilateral cumulative load (%), and quadriceps and hamstring isokinetic peak torque (N·m) were calculated and recorded bilaterally. LL and peak torque were compared over time and between limbs.</p><p><strong>Results: </strong>A significant limb-by-time interaction was observed for LL peak force (N), where patients underloaded the ACLR limb at visit 1 compared with the contralateral limb (<i>P</i> < 0.01). Patients increased their ACLR LL across visits (<i>P</i> = 0.04). A limb-by-time interaction for quadriceps peak torque (N·m) was observed where the ACLR limb increased peak torque across visits (<i>P</i> < 0.01); however, strength deficits persisted at visit 2 (<i>P</i> < 0.01) when compared with the nonoperative limb. Weak correlations were observed between all change scores metrics (<i>r</i>, 0.20-0.25).</p><p><strong>Conclusion: </strong>Patients recovering from ACLR exhibited more symmetric loading during a squatting task and improved their lower extremity strength over time. Changes in strength were not related to changes in LL during a squatting task over time.</p><p><strong>Clinical relevance: </strong>Squatting tasks are safe and easily implemented throughout ACLR recovery. As changes in functional LL and strength recovery are not related, both should be considered in serial postoperative testing for more comprehensive function and strength assessments.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381241285859"},"PeriodicalIF":2.7000,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556615/pdf/","citationCount":"0","resultStr":"{\"title\":\"Analysis of Limb Loading and Lower Extremity Strength Recovery Across Time After Anterior Cruciate Ligament Reconstruction.\",\"authors\":\"Amelia S Bruce Leicht, Xavier D Thompson, Robin M Queen, Jordan S Rodu, Michael J Higgins, Kevin M Cross, Brian C Werner, Jacob E Resch, Joe M Hart\",\"doi\":\"10.1177/19417381241285859\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Evidence as to how patient thigh muscle strength and limb loading (LL) during a squatting task recovers throughout rehabilitation after anterior cruciate ligament reconstruction (ACLR) is lacking.</p><p><strong>Hypothesis: </strong>Patients will improve LL and strength throughout rehabilitation. Changes in LL and strength over time will be positively correlated.</p><p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>A total of 60 participants (28 male/32 female; age, 22.5 ± 9.35 years) participated in 2 visits post-ACLR, assessing LL and strength. Using an instrumented pressure mat, patients completed 3 sets of 3 repetitions of bodyweight squats. Peak force (N), unilateral cumulative load (%), and quadriceps and hamstring isokinetic peak torque (N·m) were calculated and recorded bilaterally. LL and peak torque were compared over time and between limbs.</p><p><strong>Results: </strong>A significant limb-by-time interaction was observed for LL peak force (N), where patients underloaded the ACLR limb at visit 1 compared with the contralateral limb (<i>P</i> < 0.01). Patients increased their ACLR LL across visits (<i>P</i> = 0.04). A limb-by-time interaction for quadriceps peak torque (N·m) was observed where the ACLR limb increased peak torque across visits (<i>P</i> < 0.01); however, strength deficits persisted at visit 2 (<i>P</i> < 0.01) when compared with the nonoperative limb. Weak correlations were observed between all change scores metrics (<i>r</i>, 0.20-0.25).</p><p><strong>Conclusion: </strong>Patients recovering from ACLR exhibited more symmetric loading during a squatting task and improved their lower extremity strength over time. Changes in strength were not related to changes in LL during a squatting task over time.</p><p><strong>Clinical relevance: </strong>Squatting tasks are safe and easily implemented throughout ACLR recovery. As changes in functional LL and strength recovery are not related, both should be considered in serial postoperative testing for more comprehensive function and strength assessments.</p>\",\"PeriodicalId\":54276,\"journal\":{\"name\":\"Sports Health-A Multidisciplinary Approach\",\"volume\":\" \",\"pages\":\"19417381241285859\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-10-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556615/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sports Health-A Multidisciplinary Approach\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/19417381241285859\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SPORT SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sports Health-A Multidisciplinary Approach","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/19417381241285859","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SPORT SCIENCES","Score":null,"Total":0}
Analysis of Limb Loading and Lower Extremity Strength Recovery Across Time After Anterior Cruciate Ligament Reconstruction.
Background: Evidence as to how patient thigh muscle strength and limb loading (LL) during a squatting task recovers throughout rehabilitation after anterior cruciate ligament reconstruction (ACLR) is lacking.
Hypothesis: Patients will improve LL and strength throughout rehabilitation. Changes in LL and strength over time will be positively correlated.
Study design: Prospective cohort study.
Level of evidence: Level 3.
Methods: A total of 60 participants (28 male/32 female; age, 22.5 ± 9.35 years) participated in 2 visits post-ACLR, assessing LL and strength. Using an instrumented pressure mat, patients completed 3 sets of 3 repetitions of bodyweight squats. Peak force (N), unilateral cumulative load (%), and quadriceps and hamstring isokinetic peak torque (N·m) were calculated and recorded bilaterally. LL and peak torque were compared over time and between limbs.
Results: A significant limb-by-time interaction was observed for LL peak force (N), where patients underloaded the ACLR limb at visit 1 compared with the contralateral limb (P < 0.01). Patients increased their ACLR LL across visits (P = 0.04). A limb-by-time interaction for quadriceps peak torque (N·m) was observed where the ACLR limb increased peak torque across visits (P < 0.01); however, strength deficits persisted at visit 2 (P < 0.01) when compared with the nonoperative limb. Weak correlations were observed between all change scores metrics (r, 0.20-0.25).
Conclusion: Patients recovering from ACLR exhibited more symmetric loading during a squatting task and improved their lower extremity strength over time. Changes in strength were not related to changes in LL during a squatting task over time.
Clinical relevance: Squatting tasks are safe and easily implemented throughout ACLR recovery. As changes in functional LL and strength recovery are not related, both should be considered in serial postoperative testing for more comprehensive function and strength assessments.
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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