Neuromuscular compensatory strategies at the trunk and lower limb are not resolved following an ACL reconstruction
Neuromuscular compensatory strategies at the trunk and lower limb are not resolved following an ACL reconstruction
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DOI：
10.1016/j.gaitpost.2017.11.014
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发表时间：
2018-02-01
期刊：
影响因子：
2.4
通讯作者：
Noehren, Brian
中科院分区：
文献类型：
--
作者：
Boggess, Grant;Morgan, Kristin;Noehren, Brian
背景：前交叉韧带重建术(ACLR)后，患者出现同侧躯干更大的倾斜，这可能会影响膝关节的动力并增加再损伤的风险。然而，在健康受试者和ACLR受试者之间，很少有关于控制躯干的神经肌肉因素以及它们与膝关节的关系的研究。研究设计：横断面研究，证据水平：3.方法：11名健康受试者和11名ACLR受试者在年龄、体重和身高方面匹配。受试者被要求以自己选择的速度跑步，同时进行仪表化步态分析。为每个受试者创建了一个人体测量比例的OpenSim模型。对静态优化的躯干和肌腱在冲击峰值时的肌力进行了分析。结果：ACLR受试者表现出更均衡的竖脊肌联合收缩[p<；0.01]，以及更大的腿绳肌力[股二头肌长头肌(p=0.02)，半膜肌(0.01)，半腱肌(0.01)]。其他肌肉组无统计学差异。结论：尽管ACLR受试者已恢复运动，但他们的躯干僵硬程度仍在继续增加，同时他们的肌腱力量也在增加，从而有可能减少胫骨前移位。
Background: Following anterior cruciate ligament reconstruction (ACLR), patients present with greater trunk ipsilateral lean, which may affect knee kinetics and increase re-injury risk. However, there has been little research into neuromuscular factors controlling the trunk and their relation to the knee between healthy and ACLR subjects. This is critical to establish in order to develop more directed and effective interventions.Hypothesis: As compared to healthy control subjects, ACLR subjects will demonstrate increased erector spinae and rectus abdominis co-contraction, greater rectus abdominis force and greater hamstring force that is correlated to increased forward trunk lean.Study design: Cross-sectional study, Level of Evidence: 3.Methods: Eleven healthy and eleven ACLR subjects were matched for age, mass and height. Subjects were asked to run at a self-selected speed while instrumented gait analysis was performed. An anthropometrically scaled OpenSim model was created for each subject. Trunk and hamstring muscle forces from Static Optimization were analyzed at impact peak. Additionally, directed co-contraction ratios were calculated for the erector spinae and erector spinae/rectus abdominis combinations.Results: ACLR subjects showed more balanced erector spinae co-contraction [p < 0.01], and greater hamstring force [biceps femoris long head (p = 0.02), semimembranosus (0.01), semitendinosus (0.01)]. There was no statistical difference for any other muscle group.Conclusion: Despite release to return to sport, ACLR subjects are continuing to increase the stiffness of their trunk as well increase their hamstring force to potentially reduce anterior tibial translation.