Successful feed-forward strategies following ACL injury and reconstruction
Successful feed-forward strategies following ACL injury and reconstruction
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DOI：
10.1016/j.jelekin.2008.06.001
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发表时间：
2009-10-01
影响因子：
2.5
通讯作者：
Steele, Julie
中科院分区：
文献类型：
--
作者：
Bryant, Adam L.;Newton, Robert U.;Steele, Julie
本研究的目的是阐明在前交叉韧带(ACL)损伤和前交叉韧带重建术(ACLR)后，最成功的前馈策略对增强动态约束能力的作用。10名男性前交叉韧带缺陷症(ACLD)受试者(年龄1835岁)和27名匹配的接受过ACLR手术的男性(14名使用髌腱移植，13名使用半腱和股薄肌联合移植)和22名匹配的对照组受试者被纳入研究对象。在使用辛辛那提膝关节评分系统对他们的膝关节功能(0到100分)进行评分后，每个受试者在受累肢体上进行最大距离的反向运动跳跃，同时收集股外侧肌(VL)、股内侧肌(Vm)、半腱肌(ST)和股二头肌(BF)的肌电数据。使用安装在胫骨粗隆水平的单轴加速度计记录胫骨近端的加速度瞬变。虽然预先编程的肌肉激活策略和从单腿远距离跳跃着陆时的胫骨加速瞬变与前交叉韧带状态无关，但在ACLD和ACLR受试者的神经肌肉变量和膝关节功能之间发现了许多显著的相关性。在ACLD受试者中，腿筋准备活动的增加以及在动态减速期间控制胫骨运动的更强能力与更高水平的膝关节功能相关。ACLR术后成功的前馈策略与植骨选择有关；膝关节功能优越的STGT受试者股四头肌激活更早，能够更好地将最大的腿肌肌活动同步到接近初始地面接触的位置；而功能更好的PT受试者表现出增强的胫骨控制，尽管缺乏证据支持修改的预编程肌肉激活模式。我们的结论是，更多的功能性个体使用感觉反馈来建立特定于治疗的前馈策略，以在执行已知的应激前交叉韧带的任务时增强动态约束。皇冠版权所有(C)2008由爱思唯尔有限公司出版。保留所有权利。
The purpose of this study was to elucidate the most successful feed-forward strategies responsible for enhancing dynamic restraint following anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR). Ten male ACL deficient (ACLD) subjects (1835 years) together with 27 matched males who had undergone ACLR (14 using a patella tendon graft and 13 using a combined semitendinosus and gracilis graft) and 22 matched-control subjects were recruited. After their knee functionality (0- to 100-point scale) was rated using the Cincinnati Knee Rating System, each subject performed a maximal, countermovement hop for distance on their involved limb while EMG data were collected from the vastus lateralis (VL), vastus medialis (VM), semitendinosus (ST) and biceps femoris (BF) muscles. Acceleration transients at the proximal tibia were recorded using a uniaxial accelerometer mounted at the level of the tibial tuberosity. Whilst pre-programmed muscle activation strategies and tibial acceleration transients when landing from a single-leg long hop for distance were not contingent upon ACL status, a number of significant correlations were identified between neuromuscular variables and knee functionality of ACLD and ACLR subjects. Increased hamstring preparatory activity together with a greater ability to control tibial motion during dynamic deceleration was associated with higher levels of knee functionality in the ACLD subjects. Successful feed-forward strategies following ACLR were related to graft selection; STGT subjects with superior knee function activated their quadriceps earlier and were better able to synchronise peak hamstring muscle activity closer to initial ground contact whilst more functional PT subjects demonstrated enhanced tibial control despite a lack of evidence supporting modified pre-programmed muscular activation patterns. Our conclusion was that more functional individuals used sensory feedback to build treatment-specific, feed-forward strategies to enhance dynamic restraint when performing a task known to stress the ACL. Crown Copyright (C) 2008 Published by Elsevier Ltd. All rights reserved.