优化前十字韧带重建后的重返工作决策：职业性损伤患者的客观功能评估和康复结果的12周评估

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-04-16 DOI:10.1016/j.clinbiomech.2025.106532

Raquel S. Salinas Gonzalez , Javier Pérez-de la Torre , Cristina Herrera Ligero

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引用次数: 0

摘要

背景：前交叉韧带（ACL）损伤是常见的，但在非运动员职业人群中，关于康复的知识差距很大。这种缺乏研究转化为缺乏客观标准来指导这些患者有效的临床决策。本研究旨在评估职业性前交叉韧带损伤患者使用专业工具进行为期12周的康复计划对其恢复和重返工作岗位的影响。方法一项前瞻性、观察性的单中心研究评估前交叉韧带重建患者的康复效果。20名接受前交叉韧带重建的患者参加了为期12周的临床功能随访计划。通过生物力学步态分析（动力学平台和NedAMH/IBV®软件）、等速动力学(（Biodex 3™）和Lysholm量表评估康复治疗，以评估患者报告的功能。统计分析包括正态性检验（Kolmogorov-Smirnov和Shapiro-Wilk检验）和适当的参数检验（重复测量的单向方差分析）或非参数数据检验（Friedman检验与Wilcoxon符号秩事后检验）。通过生物力学分析和等速动力学测量，康复改善了步态力学（减少了站立时间，改善了第9周的地面反作用力）和肌肉力量（减少了缺陷，改善了第8 - 12周的峰值扭矩）。从第六周开始，患者报告的功能（Lysholm量表）也显示出显著的改善。我们的研究结果表明，前交叉韧带重建后的康复可以显著提高工伤患者的功能，如步态、力量和自我报告结果的改善。这些客观评估在促进安全重返工作岗位的决策方面发挥着重要作用。需要进一步的研究来探索针对工作的康复策略。

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Optimizing return-to-work decisions following anterior cruciate ligament reconstruction: A 12-week evaluation of objective functional assessment and rehabilitation outcomes in patients with occupational injuries

Background

Anterior cruciate ligament (ACL) injuries are common, yet there is a critical knowledge gap regarding rehabilitation in non-athlete occupational populations. This lack of research translates to insufficient objective criteria to guide effective clinical decision-making in these patients. This research aimed to assess the impact of a 12-week rehabilitation program with specialized tools on the recovery and return-to-work potential of patients with occupational ACL injuries.

Methods

A prospective, observational single-center study evaluated rehabilitation outcomes in patients after ACL reconstruction. Twenty patients undergoing ACL reconstruction participated in a 12-week clinical-functional follow-up program. Rehabilitation treatment was assessed through biomechanical gait analysis (dynamometric platform and NedAMH/IBV® software), isokinetic dynamometry ((Biodex 3™), and the Lysholm scale to assess patient-reported function. Statistical analysis included normality testing (Kolmogorov-Smirnov and Shapiro-Wilk tests) and appropriate tests for parametric (one-way ANOVA with repeated measures) or non-parametric data (Friedman test with Wilcoxon signed-rank post-hoc tests).

Findings

Rehabilitation improved gait mechanics (reduced stance time, improved ground reaction forces by the ninth week) and muscle strength (decreased deficit, improved peak torque by 8th–12th week) as measured by biomechanical analysis and isokinetic dynamometry. Patient-reported function (Lysholm scale) also showed significant improvements from the sixth week onwards.

Interpretation

Our findings indicate that rehabilitation following ACL reconstruction significantly enhances patient function in work-related injuries, as demonstrated by improvements in gait, strength, and self-reported outcomes. These objective assessments play a significant role in facilitating safe return-to-work decisions. Further research is necessary to explore job-specific rehabilitation strategies.

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.