Keith A Knurr, Daniel G Cobian, Stephanie A Kliethermes, Mikel R Joachim, Bryan C Heiderscheit
{"title":"前交叉韧带重建术后跑步速度和时间对大学生运动员下肢运动的影响。","authors":"Keith A Knurr, Daniel G Cobian, Stephanie A Kliethermes, Mikel R Joachim, Bryan C Heiderscheit","doi":"10.1249/MSS.0000000000003695","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Following anterior cruciate ligament reconstruction (ACLR), individuals present with significant and persistent deficits in surgical knee biomechanics during running. Little is known regarding the role of the hip and ankle in compensating for these knee-specific deficits. The purpose of this study was to characterize how limb (surgical and non-surgical), time post-operatively (3.5-7 months [EARLY], 8-13 months [LATE]), and running speed influence lower extremity joint-specific and total work during running post-ACLR.</p><p><strong>Methods: </strong>Fifty-six Division I collegiate athletes post-ACLR (EARLY: n = 41, LATE: n = 42, Both: n = 27) completed running analyses at 2.68, 2.95, 3.35, 3.80 and 4.47 m/s or up to their maximum comfortable speed. Linear mixed effects models assessed the influence of limb, speed, time post-ACLR, and their interactions on hip, knee, ankle, and total negative and positive work.</p><p><strong>Results: </strong>Surgical limb hip positive work was greater (0.044 J/kg [0.015, 0.074], p < 0.001) than the non-surgical limb EARLY. Surgical limb ankle negative (-0.054 J/kg [-0.093, -0.015], p = 0.003) and positive work (-0.115 J/kg [-0.168, -0.063], p < 0.001) were less than the non-surgical limb EARLY. Surgical limb knee negative (EARLY: -0.339 J/kg [-0.382, -0.296], p < 0.001; LATE: -0.222 J/kg [-0.265, -0.180], p < 0.001) and positive work (EARLY: -0.214 J/kg [-0.246, -0.182], p < 0.001; LATE: -0.142 J/kg [-0.174, -0.110], p < 0.001) were less than the non-surgical limb. Total negative and positive work followed the same pattern as the knee. Conclusions: Athletes post-ACLR exhibited greater hip positive work and lesser ankle positive and negative work during running of the surgical limb EARLY, that resolved LATE. Both knee and total negative and positive work of the surgical limb were substantially less than the non-surgical limb, which improved from EARLY to LATE, but between-limb asymmetries remained.</p>","PeriodicalId":18426,"journal":{"name":"Medicine and Science in Sports and Exercise","volume":" ","pages":""},"PeriodicalIF":4.1000,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Influence of Running Speed and Time Post-Operatively on Lower Extremity Work in Collegiate Athletes after Anterior Cruciate Ligament Reconstruction.\",\"authors\":\"Keith A Knurr, Daniel G Cobian, Stephanie A Kliethermes, Mikel R Joachim, Bryan C Heiderscheit\",\"doi\":\"10.1249/MSS.0000000000003695\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Following anterior cruciate ligament reconstruction (ACLR), individuals present with significant and persistent deficits in surgical knee biomechanics during running. Little is known regarding the role of the hip and ankle in compensating for these knee-specific deficits. The purpose of this study was to characterize how limb (surgical and non-surgical), time post-operatively (3.5-7 months [EARLY], 8-13 months [LATE]), and running speed influence lower extremity joint-specific and total work during running post-ACLR.</p><p><strong>Methods: </strong>Fifty-six Division I collegiate athletes post-ACLR (EARLY: n = 41, LATE: n = 42, Both: n = 27) completed running analyses at 2.68, 2.95, 3.35, 3.80 and 4.47 m/s or up to their maximum comfortable speed. Linear mixed effects models assessed the influence of limb, speed, time post-ACLR, and their interactions on hip, knee, ankle, and total negative and positive work.</p><p><strong>Results: </strong>Surgical limb hip positive work was greater (0.044 J/kg [0.015, 0.074], p < 0.001) than the non-surgical limb EARLY. Surgical limb ankle negative (-0.054 J/kg [-0.093, -0.015], p = 0.003) and positive work (-0.115 J/kg [-0.168, -0.063], p < 0.001) were less than the non-surgical limb EARLY. Surgical limb knee negative (EARLY: -0.339 J/kg [-0.382, -0.296], p < 0.001; LATE: -0.222 J/kg [-0.265, -0.180], p < 0.001) and positive work (EARLY: -0.214 J/kg [-0.246, -0.182], p < 0.001; LATE: -0.142 J/kg [-0.174, -0.110], p < 0.001) were less than the non-surgical limb. Total negative and positive work followed the same pattern as the knee. Conclusions: Athletes post-ACLR exhibited greater hip positive work and lesser ankle positive and negative work during running of the surgical limb EARLY, that resolved LATE. Both knee and total negative and positive work of the surgical limb were substantially less than the non-surgical limb, which improved from EARLY to LATE, but between-limb asymmetries remained.</p>\",\"PeriodicalId\":18426,\"journal\":{\"name\":\"Medicine and Science in Sports and Exercise\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2025-03-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medicine and Science in Sports and Exercise\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1249/MSS.0000000000003695\",\"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":"Medicine and Science in Sports and Exercise","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1249/MSS.0000000000003695","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SPORT SCIENCES","Score":null,"Total":0}
引用次数: 0
摘要
目的：在前交叉韧带重建术（ACLR）后，个体在跑步过程中出现明显和持续的手术膝关节生物力学缺陷。关于髋关节和踝关节在补偿这些膝关节特异性缺陷中的作用，我们知之甚少。本研究的目的是表征肢体（手术和非手术）、术后时间（3.5-7个月[EARLY]、8-13个月[LATE]）和跑步速度对aclr术后跑步时下肢关节特异性功和总功的影响。方法：56名大学一级运动员（早期：n = 41，晚期：n = 42，两者：n = 27）在aclr后以2.68,2.95,3.35,3.80和4.47 m/s或最大舒适速度进行跑步分析。线性混合效应模型评估肢体、速度、aclr后时间及其相互作用对髋关节、膝关节、踝关节和总负功和正功的影响。结果：手术肢体髋关节阳性功大于非手术肢体EARLY （0.044 J/kg [0.015, 0.074], p < 0.001）。手术肢体踝关节阴性（-0.054 J/kg [-0.093, -0.015], p = 0.003）和阳性功（-0.115 J/kg [-0.168, -0.063], p < 0.001）少于非手术肢体EARLY。手术肢体膝关节阴性(EARLY: -0.339 J/kg [-0.382, -0.296], p < 0.001；LATE: -0.222 J/kg [-0.265, -0.180], p < 0.001)和positive work (EARLY: -0.214 J/kg [-0.246, -0.182], p < 0.001；LATE: -0.142 J/kg [-0.174, -0.110], p < 0.001)低于非手术肢体。总的负功和正功与膝盖的模式相同。结论：aclr后的运动员在早期手术肢体运动中表现出更大的髋关节正功和更小的踝关节正功和负功，并在后期消退。手术肢体的膝关节和总负功和正功明显小于非手术肢体，从早期到晚期有所改善，但肢体间不对称仍然存在。
Influence of Running Speed and Time Post-Operatively on Lower Extremity Work in Collegiate Athletes after Anterior Cruciate Ligament Reconstruction.
Purpose: Following anterior cruciate ligament reconstruction (ACLR), individuals present with significant and persistent deficits in surgical knee biomechanics during running. Little is known regarding the role of the hip and ankle in compensating for these knee-specific deficits. The purpose of this study was to characterize how limb (surgical and non-surgical), time post-operatively (3.5-7 months [EARLY], 8-13 months [LATE]), and running speed influence lower extremity joint-specific and total work during running post-ACLR.
Methods: Fifty-six Division I collegiate athletes post-ACLR (EARLY: n = 41, LATE: n = 42, Both: n = 27) completed running analyses at 2.68, 2.95, 3.35, 3.80 and 4.47 m/s or up to their maximum comfortable speed. Linear mixed effects models assessed the influence of limb, speed, time post-ACLR, and their interactions on hip, knee, ankle, and total negative and positive work.
Results: Surgical limb hip positive work was greater (0.044 J/kg [0.015, 0.074], p < 0.001) than the non-surgical limb EARLY. Surgical limb ankle negative (-0.054 J/kg [-0.093, -0.015], p = 0.003) and positive work (-0.115 J/kg [-0.168, -0.063], p < 0.001) were less than the non-surgical limb EARLY. Surgical limb knee negative (EARLY: -0.339 J/kg [-0.382, -0.296], p < 0.001; LATE: -0.222 J/kg [-0.265, -0.180], p < 0.001) and positive work (EARLY: -0.214 J/kg [-0.246, -0.182], p < 0.001; LATE: -0.142 J/kg [-0.174, -0.110], p < 0.001) were less than the non-surgical limb. Total negative and positive work followed the same pattern as the knee. Conclusions: Athletes post-ACLR exhibited greater hip positive work and lesser ankle positive and negative work during running of the surgical limb EARLY, that resolved LATE. Both knee and total negative and positive work of the surgical limb were substantially less than the non-surgical limb, which improved from EARLY to LATE, but between-limb asymmetries remained.
期刊介绍：
Medicine & Science in Sports & Exercise® features original investigations, clinical studies, and comprehensive reviews on current topics in sports medicine and exercise science. With this leading multidisciplinary journal, exercise physiologists, physiatrists, physical therapists, team physicians, and athletic trainers get a vital exchange of information from basic and applied science, medicine, education, and allied health fields.
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