Single-Legged Hop Tests as Predictors of Self-Reported Knee Function After Anterior Cruciate Ligament Reconstruction
Single-Legged Hop Tests as Predictors of Self-Reported Knee Function After Anterior Cruciate Ligament Reconstruction
复制标题
单腿跳跃测试作为前十字韧带重建后自我报告膝关节功能的预测指标
DOI：
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发表时间：
2012
影响因子：
4.8
通讯作者：
L. Snyder
中科院分区：
文献类型：
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作者：
David S. Logerstedt;H. Grindem;Andrew D. Lynch;I. Eitzen;L. Engebretsen;M. Risberg;M. Axe;L. Snyder
背景：单腿跳跃试验是目前常用的能反映前交叉韧带(ACL)重建术后患者肢体不对称的功能指标。HOP试验有可能作为个人重建前交叉韧带后自我报告的膝关节功能的预测因素。假设：术前进行的单腿跳跃试验和前交叉韧带重建后6个月不能预测前交叉韧带重建一年后自我报告的膝关节功能(国际膝关节文献委员会2000)。研究设计：队列研究(预后)；证据水平，2。方法：120例接受前交叉韧带重建术的患者在术前和术后6个月进行了4次单腿跳跃试验。自我报告的正常范围内的膝关节功能被定义为术后1年IKDC 2000评分大于或等于特定年龄和性别的标准第15百分位数。Logistic回归分析用于确定正常范围内自我报告的膝关节功能的预测因素。用受试者工作特性曲线的曲线下面积(AUC)作为判别准确度的量度。结果：85例患者在术后6个月完成单腿HOP试验，术后1年随访，68例患者术后1年自我报告膝关节功能正常。交叉跳跃和6-m节段性肢体对称性指数(LSI)是自报膝关节功能的最强个体预测因子(优势比分别为1.09和1.10)，也是判别准确度(AUC)可信区间(AUC)>0.5的唯一2项测试(AUC=0.68)。膝关节功能低于正常范围的患者，其6米定时跳跃LSI低于88%临界值的可能性是膝关节功能正常患者的5倍以上。膝关节功能在正常范围内的患者交叉跳跃LSI大于95%的可能性是膝关节功能低于正常范围的患者的4倍。术前单腿跳试验不能预测重建前交叉韧带1年后自我报告的膝关节功能在正常范围内(均P>；.353)。结论：前交叉韧带重建术后6个月进行的单腿跳跃试验可以预测前交叉韧带重建术后1年成功和不成功的可能性。6个月后在6米计时跳跃测试中得分低于88%的患者可能会受益于有针对性的训练，以改善肢体对称性，试图使功能正常化。如果患者在6个月的交叉跳跃测试中两侧差异最小，如果他们继续目前的训练方案，1年后可能会有良好的膝关节功能。术前单腿跳试验不能预测术后结果。
Background: Single-legged hop tests are commonly used functional performance measures that can capture limb asymmetries in patients after anterior cruciate ligament (ACL) reconstruction. Hop tests hold potential as predictive factors of self-reported knee function in individuals after ACL reconstruction. Hypothesis: Single-legged hop tests conducted preoperatively would not and 6 months after ACL reconstruction would predict self-reported knee function (International Knee Documentation Committee [IKDC] 2000) 1 year after ACL reconstruction. Study Design: Cohort study (prognosis); Level of evidence, 2. Methods: One hundred twenty patients who were treated with ACL reconstruction performed 4 single-legged hop tests preoperatively and 6 months after ACL reconstruction. Self-reported knee function within normal ranges was defined as IKDC 2000 scores greater than or equal to the age- and sex-specific normative 15th percentile score 1 year after surgery. Logistic regression analyses were performed to identify predictors of self-reported knee function within normal ranges. The area under the curve (AUC) from receiver operating characteristic curves was used as a measure of discriminative accuracy. Results: Eighty-five patients completed single-legged hop tests 6 months after surgery and the 1-year follow-up with 68 patients classified as having self-reported knee function within normal ranges 1 year after reconstruction. The crossover hop and 6-m timed hop limb symmetry index (LSI) 6 months after ACL reconstruction were the strongest individual predictors of self-reported knee function (odds ratio, 1.09 and 1.10) and the only 2 tests in which the confidence intervals of the discriminatory accuracy (AUC) were above 0.5 (AUC = 0.68). Patients with knee function below normal ranges were over 5 times more likely of having a 6-m timed hop LSI lower than the 88% cutoff than those with knee function within normal ranges. Patients with knee function within normal ranges were 4 times more likely to have a crossover hop LSI greater than the 95% cutoff than those with knee function below normal ranges. No preoperative single-legged hop test predicted self-reported knee function within normal ranges 1 year after ACL reconstruction (all P > .353). Conclusion: Single-legged hop tests conducted 6 months after ACL reconstruction can predict the likelihood of successful and unsuccessful outcome 1 year after ACL reconstruction. Patients demonstrating less than the 88% cutoff score on the 6-m timed hop test at 6 months may benefit from targeted training to improve limb symmetry in an attempt to normalize function. Patients with minimal side-to-side differences on the crossover hop test at 6 months possibly will have good knee function at 1 year if they continue with their current training regimen. Preoperative single-legged hop tests are not able to predict postoperative outcomes.