Quadriceps Function and Hamstrings Co-Activation After Anterior Cruciate Ligament Reconstruction
Quadriceps Function and Hamstrings Co-Activation After Anterior Cruciate Ligament Reconstruction
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DOI：
10.4085/1062-6050-52.3.05
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发表时间：
2017-05-01
影响因子：
3.3
通讯作者：
Blackburn, J. Troy
中科院分区：
文献类型：
--
作者：
Pamukoff, Derek N.;Pietrosimone, Brian G.;Blackburn, J. Troy
内容：前交叉韧带重建（ACLR）患者存在股四头肌功能障碍，导致身体残疾和创伤后膝关节骨关节炎。ACLR肢体的股四头肌功能通常相对于对侧未受伤肢体进行评估。双侧股四头肌功能障碍在ACLR患者中很常见，可能会导致这些评估结果出现偏差。目的：比较ACLR患者和未受伤对照组参与者的股四头肌功能。设计：横断面研究。设置：研究实验室。患者或其他参与者：20例单侧ACLR患者（年龄= 21.1 +/-1.7岁，体重= 68.3 +/-14.9 kg，自ACLR的时间= 50.7 +/-21.3个月;女性= 14; Tegner评分= 7.1 +/-0.3; 16例髌腱自体移植物，3例腘绳肌自体移植物，1例同种异体移植物）与20例对照参与者匹配（年龄= 21.2 ± 1.2岁，体重= 67.9 ± 11.3 kg;女性= 14; Tegner评分= 7.1 ± 0.4）。在等速测力计上进行最大自主等长膝关节伸展。峰值扭矩（PT），扭矩发展率（RTD），肌电图（EMG）振幅，中枢激活率（CAR），和腘绳肌肌电图振幅进行了评估，在最大的自愿等长膝关节伸展和组间比较使用独立样本t检验。使用Pearson相关性评估腘绳肌共激活和股四头肌功能之间的关系。前交叉韧带重建的参与者显示小股四头肌PT（1.86 +/-0.74 vs 2.56 +/-0.37 Nm/kg，P =.001），RTD（39.4 +/-18.7 vs 52.9 +/-16.4 Nm/s/kg，P =.03），EMG振幅（0.25 +/-0.12 vs 0.37 +/-0.26 mV，P =.04），CAR（83.3% ± 11.1% vs 93.7% ± 3.2%，P = 0.002）和更大的腘绳肌共激活（27.2% ± 12.8% vs 14.3% ± 3.7%，P <0.001）。发现腘绳肌共激活与PT（r =-0.39，P =.007）、RTD（r =-0.30，P =.03）和EMG振幅（r =-0.30，P =.03）之间存在相关性。结论：与对照组参与者相比，ACLR个体在PT、RTD和CAR方面存在缺陷。峰值扭矩是所有激动剂和拮抗剂活性的净结果，ACLR患者PT较低部分归因于腘绳肌共同激活。
Context: Individuals with anterior cruciate ligament reconstruction (ACLR) have quadriceps dysfunction that contributes to physical disability and posttraumatic knee osteoarthritis. Quadriceps function in the ACLR limb is commonly evaluated relative to the contralateral uninjured limb. Bilateral quadriceps dysfunction is common in individuals with ACLR, potentially biasing these evaluations.Objective: To compare quadriceps function between individuals with ACLR and uninjured control participants.Design: Cross-sectional study.Setting: Research laboratory.Patients or Other Participants: Twenty individuals with unilateral ACLR (age = 21.1 +/- 1.7 years, mass = 68.3 +/- 14.9 kg, time since ACLR = 50.7 +/- 21.3 months; females = 14; Tegner Score = 7.1 +/- 0.3; 16 patellar tendon autografts, 3 hamstrings autografts, 1 allograft) matched to 20 control participants (age = 21.2 +/- 1.2 years, mass = 67.9 +/- 11.3 kg; females = 14; Tegner Score = 7.1 +/- 0.4) on age, sex, body mass index, and Tegner Activity Scale.Main Outcome Measure(s): Maximal voluntary isometric knee extension was performed on an isokinetic dynamometer. Peak torque (PT), rate of torque development (RTD), electromyographic (EMG) amplitude, central activation ratio (CAR), and hamstrings EMG amplitude were assessed during maximal voluntary isometric knee extension and compared between groups using independent-samples t tests. Relationships between hamstrings co-activation and quadriceps function were assessed using Pearson correlations.Results: Participants with anterior cruciate ligament reconstruction displayed lesser quadriceps PT (1.86 +/- 0.74 versus 2.56 +/- 0.37 Nm/kg, P =.001), RTD (39.4 +/- 18.7 versus 52.9 +/- 16.4 Nm/s/kg, P =.03), EMG amplitude (0.25 +/- 0.12 versus 0.37 +/- 0.26 mV, P =.04), and CAR (83.3% 6 11.1% versus 93.7% +/- 3.2%, P =.002) and greater hamstrings co-activation (27.2% +/- 12.8% versus 14.3% +/- 3.7%, P < .001) compared with control participants. Correlations were found between hamstrings co-activation and PT (r = - 0.39, P =.007), RTD (r = - 0.30, P =.03), and EMG amplitude (r = - 0.30, P =.03).Conclusions: Individuals with ACLR possessed deficits in PT, RTD, and CAR compared with control participants. Peak torque is the net result of all agonist and antagonist activity, and lesser PT in individuals with ACLR is partially attributable to greater hamstrings co-activation.