Change in Drop-Landing Mechanics Over 2 Years in Young Athletes After Anterior Cruciate Ligament Reconstruction
Change in Drop-Landing Mechanics Over 2 Years in Young Athletes After Anterior Cruciate Ligament Reconstruction
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DOI：
10.1177/0363546519864688
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发表时间：
2019-08-02
影响因子：
4.8
通讯作者：
Schmitt, Laura C.
中科院分区：
文献类型：
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作者：
Ithurburn, Matthew P.;Paterno, Mark, V;Schmitt, Laura C.
背景：虽然前交叉韧带重建 (ACLR) 后四肢间着地不对称与功能不良和额外损伤的风险有关，但目前尚不清楚 ACLR 后着地对称性如何随时间变化。目的/假设：目的是研究在 ACLR 后的年轻运动员前瞻性队列中，从重返运动 (RTS) 许可时到 2 年后，双腿垂直跳高 (DVJ) 着陆和单腿垂直跳跃 (DVJ) 着陆对称性如何变化。据推测，从 RTS 时期到 2 年后，双腿 DVJ 着陆和单腿降落着陆的对称性将会得到改善。研究设计：描述性实验室研究。方法：作者在 RTS 清除后对 64 名患有原发性单侧 ACLR 的年轻运动员进行了为期 2 年的随访。在 RTS 时和 2 年后，在双腿 DVJ 和单腿落地任务期间，通过 3 维运动分析计算了感兴趣的生物力学变量 (VOI) 的肢体间对称性值。 VOI 包括膝关节屈曲偏移、峰值内膝伸展力矩、峰值垂直地面反作用力和峰值躯干屈曲（仅适用于单腿任务）。比较不同时间点之间的对称值和满足 90% 对称截止值的参与者的比例。结果：对于双腿 DVJ 着陆，与 RTS 相比，RTS 后 2 年时所有 VOI 的对称性值以及满足峰值内膝伸展力矩和峰值垂直地面反作用力 90% 截止值的比例更高。对于单腿落地，与 RTS 相比，RTS 后 2 年膝关节屈曲偏移的对称性值较高，躯干峰值屈曲的对称性值较低，但所有 VOI 满足 90% 截止值的比例在不同时间点之间没有差异。结论：在 ACLR 后 RTS 后的 2 年内，双腿 DVJ 着陆对称性在 VOI 上得到了改善，而单腿落地着陆并没有持续改善。应进一步研究 ACLR 后纵向着陆不对称的影响。
Background: While between-limb landing asymmetries after anterior cruciate ligament reconstruction (ACLR) are linked with poor function and risk of additional injury, it is not currently understood how landing symmetry changes over time after ACLR. Purpose/Hypothesis: The purpose was to investigate how double-legged drop vertical jump (DVJ) landing and single-legged drop-landing symmetry changed from the time of return-to-sport (RTS) clearance to 2 years later in a prospective cohort of young athletes after ACLR. It was hypothesized that double-legged DVJ landing and single-legged drop-landing symmetry would improve from the time of RTS to 2 years later. Study Design: Descriptive laboratory study. Methods: The authors followed 64 young athletes with primary, unilateral ACLR for 2 years after RTS clearance. At the time of RTS and 2 years later, between-limb symmetry values for biomechanical variables of interest (VOIs) were calculated with 3-dimensional motion analysis during double-legged DVJ and single-legged drop-landing tasks. VOIs included knee flexion excursion, peak internal knee extension moment, peak vertical ground-reaction force, and peak trunk flexion (for single-legged task only). Symmetry values and proportions of participants meeting 90% symmetry cutoffs were compared between time points. Results: For double-legged DVJ landing, symmetry values for all VOIs and the proportions meeting 90% cutoffs for peak internal knee extension moment and peak vertical ground-reaction force were higher at 2 years after RTS as compared with RTS. For single-legged drop-landing, symmetry values were higher for knee flexion excursion and lower for peak trunk flexion at 2 years after RTS as compared with RTS, but the proportions meeting 90% cutoffs for all VOIs did not differ between time points. Conclusion: Double-legged DVJ landing symmetry improved across VOIs over the 2 years after RTS following ACLR, while single-legged drop-landing did not improve as consistently. The implications of longitudinal landing asymmetry after ACLR should be further studied.