Gait patterns differ between ACL-reconstructed athletes who pass return-to-sport criteria and those who fail.
Gait patterns differ between ACL-reconstructed athletes who pass return-to-sport criteria and those who fail.
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DOI：
10.1177/0363546513482718
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发表时间：
2013-06
期刊：
影响因子：
--
通讯作者：
Snyder-Mackler L
中科院分区：
文献类型：
--
作者：
Di Stasi SL;Logerstedt D;Gardinier ES;Snyder-Mackler L
当前，运动员在前交叉韧带（ACL）重建后重返运动的实践标准各不相同。通常建议在术后6个月尝试恢复活动，但功能表现缺陷和步态异常通常仍然明显，并可能对未来功能产生重要影响。当比较受累和未受累肢体时，未达到恢复运动（RTS）标准的患者将显示（1）受累肢体膝关节处的峰值膝关节角度、伸肌力矩和峰值功率吸收较小，（2）受累肢体的峰值髋关节角度、伸肌力矩和峰值功率产生较大。对照实验室研究。共42例患者在ACL重建后6个月完成功能和生物力学步态评估。功能测试包括等长四头肌力量测试、4次单腿跳跃测试和2份自我报告问卷。三维运动分析用于测量髋关节和膝关节的矢状面运动学和动力学。采用混合模型方差分析和事后t检验比较通过和未通过RTS标准的患者的肢体对称性。根据健康步态数据计算最小临床重要差异，并用于进一步定义有意义的肢体不对称。42例患者中有20例（48%）在ACL重建后6个月通过RTS标准。未通过标准的患者在膝关节的所有运动学和动力学变量方面表现出肢体之间的统计学显著差异（P ≤ .027）。在该组中还发现了具有临床意义的髋关节不对称。在通过RTS标准的患者中，仅发现膝关节的动力学不对称。在ACL重建后6个月表现出上级功能表现的运动员可能比表现较差的运动员有更少的异常和不对称步态行为。未通过RTS标准的患者不仅表现出肢体之间较大的运动学和动力学不对称，而且在ACL断裂后早期使用的步态策略与运动员更接近。功能性性能指标的电池性能不佳可能与ACL重建后运动员的运动不对称性有关。目的RTS标准有可能为临床医生提供信息，以确定这些运动员何时恢复活动，并可能有助于制定有针对性的康复方案，以解决潜在的运动不对称。
The current standard of practice for an athlete to return to sport after anterior cruciate ligament (ACL) reconstruction is varied. Attempt to return to activity is typically advised 6 months after surgery, but functional performance deficits and gait abnormalities are often still evident and may have important implications on future function. When comparing the involved and uninvolved limbs, patients who failed return-to-sport (RTS) criteria would demonstrate (1) smaller peak knee angles, extensor moments, and peak power absorption at the knee of the involved limb and (2) larger peak hip angles, extensor moments, and peak power generation of the involved limb. Controlled laboratory study. A total of 42 patients completed functional and biomechanical gait assessment 6 months after ACL reconstruction. Functional testing involved an isometric quadriceps strength test, 4 single-legged hop tests, and 2 self-report questionnaires. Three-dimensional motion analysis was used to measure sagittal plane kinematics and kinetics of the hip and knee. A mixed-model analysis of variance and post hoc t tests were used to compare the limb symmetry of those who passed and those who did not pass RTS criteria. Minimal clinically important differences were calculated from healthy gait data and used to further define meaningful limb asymmetries. Twenty of the 42 (48%) patients passed RTS criteria 6 months after ACL reconstruction. Patients who did not pass the criteria demonstrated statistically significant differences between limbs on all kinematic and kinetic variables at the knee (P ≤ .027). Clinically meaningful asymmetries at the hip were also identified in this group. Only kinetic asymmetries at the knee were identified in the patients who passed RTS criteria. Athletes who demonstrate superior functional performance 6 months after ACL reconstruction may have fewer abnormal and asymmetrical gait behaviors than their poorer performing counterparts. Patients who did not pass RTS criteria not only demonstrated larger kinematic and kinetic asymmetries between limbs but also appeared to use a gait strategy more closely aligned with athletes early after ACL rupture. Poor performance on a battery of functional performance measures may be related to the presence of movement asymmetries in athletes after ACL reconstruction. Objective RTS criteria have the potential to provide information to clinicians who determine when these athletes return to activity, and may aid in the prescription of targeted rehabilitation to address underlying movement asymmetry.
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影响因子：
1.8
作者：
Gao, Bo;Zheng, Naiquan (Nigel)
通讯作者：
Zheng, Naiquan (Nigel)
影响因子：
1.8
作者：
Di Stasi, Stephanie L.;Snyder-Mackler, Lynn
通讯作者：
Snyder-Mackler, Lynn
DOI：
10.2106/00004623-199808000-00006
发表时间：
1998-08-01
影响因子：
5.3
作者：
Irrgang, JJ;Snyder-Mackler, L;Harner, CD
通讯作者：
Harner, CD
影响因子：
6.1
作者：
Hurd, Wendy J.;Axe, Michael J.;Snyder-Mackler, Lynn
通讯作者：
Snyder-Mackler, Lynn
影响因子：
3.8
作者：
Fitzgerald, GK;Axe, MJ;Snyder-Mackler, L
通讯作者：
Snyder-Mackler, L