Benjamin Dutaillis, Tyler Collings, Philip Bellinger, Ryan G Timmins, Morgan D Williams, Mathew N Bourne
{"title":"前交叉韧带重建后下肢力量、垂直跳跃指标的时间变化及其与患者报告结果的关系。","authors":"Benjamin Dutaillis, Tyler Collings, Philip Bellinger, Ryan G Timmins, Morgan D Williams, Mathew N Bourne","doi":"10.1002/ksa.12694","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To (1) investigate how lower limb strength, vertical jump metrics, and patient reported outcome measures (PROMs) change in the initial 3- to 12-months of recovery following ACLR; and (2) explore which strength and vertical jump metrics best differentiate between lower and higher Knee Osteoarthritis Outcome Score (KOOS) and Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) scores.</p><p><strong>Methods: </strong>Thirty recreationally active athletes undergoing unilateral primary ACLR underwent field-based assessments of knee flexion and extension strength, hip adduction and abduction strength, and double and single leg countermovement (CMJ) and drop vertical jump (DVJ) kinetics at 3-, 6-, 9- and 12-months following surgery. The KOOS and ACL-RSI were also completed. Mixed models were used to investigate how measures of lower limb strength, vertical jump metrics and PROMs change across the first 12-months of rehabilitation. Mixed model decision trees were used to determine which strength and vertical jump measures best discriminated between lower and higher PROMs.</p><p><strong>Results: </strong>Vertical jump height and reactive strength index (RSI) improved significantly over time (p < 0.001), with reductions in contraction and contact times (p < 0.05). Isometric knee extension and eccentric knee flexion strength increased significantly (p < 0.001), as did KOOS and ACL-RSI scores (p < 0.001). Surgically reconstructed limbs displayed deficits in most vertical jump and strength measures compared to the uninjured contralateral limb, although deficits reduced over time with between limb asymmetry deceasing in 70% of these variables (p range: 0.05 to <0.001). Single leg CMJ jump height < 8.4 cm best discriminated between lower and higher ACL-RSI scores (r<sup>2</sup> = 0.67, d = 0.8), whilst knee extension peak force asymmetry < 38.3% best discriminated between lower and higher KOOS scores (r<sup>2</sup> = -0.78, d = 0.9) across the time-course of rehabilitation.</p><p><strong>Conclusion: </strong>Most measures of lower limb strength and vertical jump metrics change in both the ACLR and uninjured contralateral limbs across the first 12-months of recovery following primary ACLR. A strong relationship was found between measures of lower limb strength and vertical jump performance with PROMs.</p><p><strong>Level of evidence: </strong>Level II, lower quality prospective cohort study.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Time-course changes in lower limb strength, vertical jump metrics and their relationship with patient reported outcomes following anterior cruciate ligament reconstruction.\",\"authors\":\"Benjamin Dutaillis, Tyler Collings, Philip Bellinger, Ryan G Timmins, Morgan D Williams, Mathew N Bourne\",\"doi\":\"10.1002/ksa.12694\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To (1) investigate how lower limb strength, vertical jump metrics, and patient reported outcome measures (PROMs) change in the initial 3- to 12-months of recovery following ACLR; and (2) explore which strength and vertical jump metrics best differentiate between lower and higher Knee Osteoarthritis Outcome Score (KOOS) and Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) scores.</p><p><strong>Methods: </strong>Thirty recreationally active athletes undergoing unilateral primary ACLR underwent field-based assessments of knee flexion and extension strength, hip adduction and abduction strength, and double and single leg countermovement (CMJ) and drop vertical jump (DVJ) kinetics at 3-, 6-, 9- and 12-months following surgery. The KOOS and ACL-RSI were also completed. Mixed models were used to investigate how measures of lower limb strength, vertical jump metrics and PROMs change across the first 12-months of rehabilitation. Mixed model decision trees were used to determine which strength and vertical jump measures best discriminated between lower and higher PROMs.</p><p><strong>Results: </strong>Vertical jump height and reactive strength index (RSI) improved significantly over time (p < 0.001), with reductions in contraction and contact times (p < 0.05). Isometric knee extension and eccentric knee flexion strength increased significantly (p < 0.001), as did KOOS and ACL-RSI scores (p < 0.001). Surgically reconstructed limbs displayed deficits in most vertical jump and strength measures compared to the uninjured contralateral limb, although deficits reduced over time with between limb asymmetry deceasing in 70% of these variables (p range: 0.05 to <0.001). Single leg CMJ jump height < 8.4 cm best discriminated between lower and higher ACL-RSI scores (r<sup>2</sup> = 0.67, d = 0.8), whilst knee extension peak force asymmetry < 38.3% best discriminated between lower and higher KOOS scores (r<sup>2</sup> = -0.78, d = 0.9) across the time-course of rehabilitation.</p><p><strong>Conclusion: </strong>Most measures of lower limb strength and vertical jump metrics change in both the ACLR and uninjured contralateral limbs across the first 12-months of recovery following primary ACLR. A strong relationship was found between measures of lower limb strength and vertical jump performance with PROMs.</p><p><strong>Level of evidence: </strong>Level II, lower quality prospective cohort study.</p>\",\"PeriodicalId\":17880,\"journal\":{\"name\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-05-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.12694\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ksa.12694","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Time-course changes in lower limb strength, vertical jump metrics and their relationship with patient reported outcomes following anterior cruciate ligament reconstruction.
Purpose: To (1) investigate how lower limb strength, vertical jump metrics, and patient reported outcome measures (PROMs) change in the initial 3- to 12-months of recovery following ACLR; and (2) explore which strength and vertical jump metrics best differentiate between lower and higher Knee Osteoarthritis Outcome Score (KOOS) and Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) scores.
Methods: Thirty recreationally active athletes undergoing unilateral primary ACLR underwent field-based assessments of knee flexion and extension strength, hip adduction and abduction strength, and double and single leg countermovement (CMJ) and drop vertical jump (DVJ) kinetics at 3-, 6-, 9- and 12-months following surgery. The KOOS and ACL-RSI were also completed. Mixed models were used to investigate how measures of lower limb strength, vertical jump metrics and PROMs change across the first 12-months of rehabilitation. Mixed model decision trees were used to determine which strength and vertical jump measures best discriminated between lower and higher PROMs.
Results: Vertical jump height and reactive strength index (RSI) improved significantly over time (p < 0.001), with reductions in contraction and contact times (p < 0.05). Isometric knee extension and eccentric knee flexion strength increased significantly (p < 0.001), as did KOOS and ACL-RSI scores (p < 0.001). Surgically reconstructed limbs displayed deficits in most vertical jump and strength measures compared to the uninjured contralateral limb, although deficits reduced over time with between limb asymmetry deceasing in 70% of these variables (p range: 0.05 to <0.001). Single leg CMJ jump height < 8.4 cm best discriminated between lower and higher ACL-RSI scores (r2 = 0.67, d = 0.8), whilst knee extension peak force asymmetry < 38.3% best discriminated between lower and higher KOOS scores (r2 = -0.78, d = 0.9) across the time-course of rehabilitation.
Conclusion: Most measures of lower limb strength and vertical jump metrics change in both the ACLR and uninjured contralateral limbs across the first 12-months of recovery following primary ACLR. A strong relationship was found between measures of lower limb strength and vertical jump performance with PROMs.
Level of evidence: Level II, lower quality prospective cohort study.
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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