Rate of Force Development as an Adjunctive Outcome Measure for Return-to-Sport Decisions After Anterior Cruciate Ligament Reconstruction
Rate of Force Development as an Adjunctive Outcome Measure for Return-to-Sport Decisions After Anterior Cruciate Ligament Reconstruction
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DOI：
10.2519/jospt.2012.3780
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发表时间：
2012-09-01
影响因子：
6.1
通讯作者：
Cacchio, Angelo
中科院分区：
文献类型：
--
作者：
Angelozzi, Massimo;Madama, Marco;Cacchio, Angelo
研究设计：描述性、前瞻性、纵向单队列研究。 目的：调查最大自主等长收缩 (MVIC) 的力量发展到 30% (RFD30)、50% (RFD50) 和 90% (RFD90) 的比率，作为确定前十字韧带 (ACL) 重建后恢复运动准备情况的辅助结果指标。 背景：一ACL 重建后完全恢复的标准是能够达到对侧肢体最大力量的 85% 或 90%。然而，在许多类型的日常和体育活动中，增强肌肉力量所需的时间比达到最大力量所需的时间要短得多。因此，除了最大力量外，在恢复的定义中还应考虑RFD等神经肌肉功能。方法：招募45名接受ACL重建的男性职业足球运动员。在受伤后/重建前以及 ACL 重建后 6 个月和 12 个月时，使用国际膝关节文献委员会 (IKDC) 主观膝关节评估表、Tegner 评分和 KT1000 仪器关节计进行评估。作为标准季前评估的一部分，在受伤前以及 ACL 重建后 6 个月和 12 个月时进行 MVIC、RFD30、RFD50 和 RFD90 测试。 结果：重建后 6 个月的平均 MVIC 值为受伤前平均值的 97%。相比之下，6 个月时，RFD30、RFD50 和 RFD90 值分别为受伤前值的 80% (P = .04)、77% (P = .03) 和 63% (P = .007)。仅在 ACL 重建后 12 个月评估时，重建膝关节的平均 RFD 值才达到或超过受伤前平均值的 90%（RFD30，P = .86；RFD50，P = .51；RFD90，P = .56）。 结论：尽管 MVIC 强度已接近恢复至受伤前水平，但 ACL 后 6 个月时 RFD 仍存在显着缺陷重建。经过专注于肌肉力量的康复计划后，ACL 重建后 12 个月，RFD 与受伤前的 RFD 相似。这些结果表明，在 ACL 重建后，RFD 标准可能是决定运动员重返运动的有用的辅助结果衡量标准。 J Orthop Sports Phys Ther 2012；42(9):772-780，Epub 2012 年 7 月 19 日。doi:10.2519/jospt.2012.3780
STUDY DESIGN: Descriptive, prospective, longitudinal single-cohort study.OBJECTIVE: To investigate the rate of force development to 30% (RFD30), 50% (RFD50), and 90% (RFD90) of maximal voluntary isometric contraction (MVIC) as an adjunct outcome measure for determining readiness for return to sport following an anterior cruciate ligament (ACL) reconstruction.BACKGROUND: One criterion of full recovery following an ACL reconstruction is the ability to achieve 85% or 90% of the maximal strength of the contralateral limb. However, the time required to develop muscular strength in many types of daily and sports activities is considerably shorter than that required to achieve maximal strength. Therefore, in addition to maximal strength, neuromuscular functions such as RFD should also be considered in the definition of recovery.METHODS: Forty-five male professional soccer players who underwent an ACL reconstruction were recruited. Assessment with the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Tegner score, and KT1000 instrumented arthrometer was performed postinjury/prereconstruction and at 6 and 12 months after ACL reconstruction. MVIC, RFD30, RFD50, and RFD90 testing was performed preinjury, as part of standard preseason assessment, and at 6 and 12 months post-ACL reconstruction.RESULTS: The average MVIC value 6 months postreconstruction was 97% of the preinjury average value. In contrast, at 6 months, the RFD30, RFD50, and RFD90 values were 80% (P = .04), 77% (P = .03), and 63% (P = .007), respectively, of the preinjury values. The mean RFD values for the reconstructed knee attained or exceeded 90% of the preinjury mean values only at the 12-month post-ACL reconstruction assessment (RFD30, P = .86; RFD50, P = .51; RFD90, P = .56).CONCLUSION: Despite the near recovery of MVIC strength to preinjury levels, there were still significant deficits in RFD at 6 months post-ACL reconstruction. An RFD similar to the preinjury RFD was achieved at 12 months post-ACL reconstruction, following a rehabilitation program focusing on muscle power. These results suggest that, following an ACL reconstruction, RFD criteria may be a useful adjunct outcome measure for the decision to return athletes to sports. J Orthop Sports Phys Ther 2012;42(9):772-780, Epub 19 July 2012. doi:10.2519/jospt.2012.3780