Compensatory Strategies That Reduce Knee Extensor Demand During a Bilateral Squat Change From 3 to 5 Months Following Anterior Cruciate Ligament Reconstruction
Compensatory Strategies That Reduce Knee Extensor Demand During a Bilateral Squat Change From 3 to 5 Months Following Anterior Cruciate Ligament Reconstruction
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DOI：
10.2519/jospt.2018.7977
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发表时间：
2018-09-01
影响因子：
6.1
通讯作者：
Pratt, Kristamarie A.
中科院分区：
文献类型：
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作者：
Sigward, Susan M.;Chan, Ming-Sheng M.;Pratt, Kristamarie A.
背景：前交叉韧带重建（ACLR）后，双侧深蹲手术时膝关节伸肌力矩减少可持续1年以上。这是通过肢间和肢内补偿来实现的。目的：本研究旨在评估ACLR后3个月和5个月纵向深蹲时的负荷，并确定肢间和肢内代偿对膝关节伸肌力矩减少的影响程度。方法：在这项受控的纵向实验室研究中，11名个体（4名男性）在ACLR后3个月和5个月进行了深蹲的三维运动分析。一项重复测量的多变量方差分析（肢体按时间）评估了膝关节和髋关节峰值屈曲角度、膝关节伸肌力矩、垂直地面反作用力和髋-膝关节伸肌力矩比的差异。采用逐步线性回归分析确定肢间（肢间垂直地面反力比）和肢内（手术内-肢髋关节-膝关节力矩比）补偿对肢间膝关节伸肌力矩比的贡献。结果：肢体对膝关节屈曲角度、膝关节伸力矩、垂直地面反力和髋-膝关节伸力矩比有显著影响，而时间对膝关节伸力矩和髋-膝关节伸力矩比有显著影响。3个月时，垂直地面反力比和髋膝伸肌力矩比预测膝关节伸肌力矩比（R-2 = 0.854, P < 0.001）。5个月时，髋关节-膝关节伸肌力矩比预测膝关节伸肌力矩比（R-2 = 0.584, P = 0.006）。结论：在ACLR术后3个月，个体使用肢间和肢内代偿来减少手术肢体的膝关节伸肌力矩。在5个月时，膝关节伸肌力矩的类似降低仅在肢内补偿下完成。
BACKGROUND: Decreased extensor moments in the surgical knee during bilateral squats can persist beyond 1 year following anterior cruciate ligament reconstruction (ACLR). This is accomplished using interlimb and intralimb compensations.OBJECTIVES: This study sought to assess loading during squatting longitudinally, 3 and 5 months post ACLR, and to determine the extent to which interlimb and intralimb compensations contribute to reduced knee extensor moments.METHODS: In this controlled, longitudinal laboratory study, 11 individuals (4 male) underwent 3-D motion analysis of a squat at 3 and 5 months post ACLR. A repeated-measures multivariate analysis of variance (limb by time) assessed differences in peak knee and hip flexion angles, knee extensor moment, vertical ground reaction force, and hip-to-knee extensor moment ratio. Stepwise linear regression analysis was used to determine the contribution of interlimb (between-limb vertical ground reaction force ratio) and intralimb (within-surgical-limb hip-to-knee moment ratio) compensations to the between-limb knee extensor moment ratio.RESULTS: A significant effect of limb was observed for knee flexion angle, knee extensor moment, vertical ground reaction force, and hip-to-knee extensor moment ratio, while a significant effect of time was observed for knee extensor moment and hip-to-knee extensor moment ratio. At 3 months, the vertical ground reaction force ratio and hip-to-knee extensor moment ratio predicted the knee extensor moment ratio (R-2 = 0.854, P < .001). At 5 months, the hip-to-knee extensor moment ratio predicted the knee extensor moment ratio (R-2 = 0.584, P = .006).CONCLUSION: Individuals used interlimb and intralimb compensations to reduce the knee extensor moment of the surgical limb at 3 months post ACLR. Similar reductions in the knee extensor moment at 5 months were accomplished with only intralimb compensations.