Effects of Sex on Compensatory Landing Strategies Upon Return to Sport After Anterior Cruciate Ligament Reconstruction
Effects of Sex on Compensatory Landing Strategies Upon Return to Sport After Anterior Cruciate Ligament Reconstruction
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DOI：
10.2519/jospt.2011.3591
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发表时间：
2011-08-01
影响因子：
6.1
通讯作者：
Hewett, Timothy E.
中科院分区：
文献类型：
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作者：
Paterno, Mark V.;Schmitt, Laura C.;Hewett, Timothy E.
研究设计：对照实验室、横断面、队列设计。目的：确定在前交叉韧带(ACL)重建后恢复运动时，下垂垂直跳跃(DVJ)动作中是否存在性别特异性的下肢不对称模式。背景：重建后第二个前交叉韧带损伤的发生率很高；然而，这种损伤的潜在机制尚不清楚。虽然在女性运动员重建前交叉韧带2年后观察到健康女性运动员的不对称动态负荷模式，但尚不清楚男性运动员重建后的前交叉韧带在恢复运动时是否也存在类似的不对称。方法：本研究共纳入98名参与者，其中56人接受单侧前交叉韧带重建，其中56人(女性35人，男性21人)已被释放，重返无限制水平的第二项运动，42人为无损伤，活动匹配的对照组参与者(29人，男性13人)。分析了从31厘米的盒子中进行双侧垂直下落跳跃动作时的腿部运动数据。计算垂直落地阶段的最大垂直地面反力(VGRF)，并将其归一化为体重(BW)。用2×2×2的方差分析来确定峰值VGRF的侧(患侧与非患侧)、组(前交叉韧带重建与对照组)和性别(女性与男性)之间的差异。结果：在整个队列中，在下降垂直跳跃的着陆阶段观察到了显著的组间交互作用(P=0.002)。前交叉韧带重建组患肢VGRF(平均+/-SD，1.77+/-0.35BW)显著低于健侧(2.2+/-0.4BW，P
STUDY DESIGN: Controlled laboratory, cross-sectional, cohort design.OBJECTIVE: To determine if a sex-specific pattern of lower limb asymmetries is present during a drop vertical jump (DVJ) maneuver at the time of return to sport after anterior cruciate ligament (ACL) reconstruction.BACKGROUND: A high incidence of second ACL injury is reported after reconstruction; however, the underlying mechanisms of this injury are unclear. While asymmetrical dynamic loading patterns predictive of primary ACL injury in healthy female athletes were observed in female ath etes 2 years after ACL reconstruction, it is unknown if similar asymmetries are present in male athletes after ACL reconstruction at the time of return to sport.METHODS: A total of 98 participants were included in the study, 56 of whom had unilateral ACL reconstruction (35 female, 21 male) and had been released to return to unrestricted level land 2 sports, and 42 of whom were uninjured, activity-matched control participants (29 female, 13 male). Lower extremity kinetic data were analyzed during a bilateral drop vertical jump maneuve from a 31-cm box. Peak vertical ground reaction force (VGRF) was calculated during the landing phase of the drop vertical jump and normalized to body weight (BW). A 2-by-2-by-2 analysis of variance was used to determine differences between side (involved versus uninvolved), group (ACL reconstruction versus control), and sex (female versus male) for the peak VGRF.RESULTS: A significant side-by-group interaction for peak VGRF (P=.002) was observed during the landing phase of the drop vertical jump in the entire cohort. The involved limb of the ACL reconstructed group displayed significantly lower VGRF (mean +/- SD, 1.77 +/- 0.35 BW) than the uninvolved limb (2.2 +/- 0.4 BW, P