Functional and Patient-Reported Outcomes Improve Over the Course of Rehabilitation: A Secondary Analysis of the ACL-SPORTS Trial
Functional and Patient-Reported Outcomes Improve Over the Course of Rehabilitation: A Secondary Analysis of the ACL-SPORTS Trial
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DOI：
10.1177/1941738118779023
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发表时间：
2018-09-01
影响因子：
3.3
通讯作者：
Snyder-Mackler, Lynn
中科院分区：
文献类型：
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作者：
Arundale, Amelia J. H.;Capin, Jacob J.;Snyder-Mackler, Lynn
背景资料：前交叉韧带专用术后恢复运动（ACL-SPORTS）随机对照试验旨在解决功能缺陷和患者报告结局。该试验检查了二级ACL预防计划的效果，该计划包括渐进式强化，敏捷性训练，运动测量学（SAP）和当前一级预防方案的其他组成部分，有扰动训练（SAP + PERT组）和无PERT（SAP组）。本研究的次要目的是检查研究结果是否在男性和女性之间存在差异。假设：（1）SAP和SAP + PERT组的运动员从训练前到训练后的膝关节功能和患者报告的结果指标都将得到改善，（2）SAP + PERT组的结果评分将高于SAP组，（3）结果将因性别而异。研究设计：随机对照试验（NCT 01773317）。证据等级：2级。方法：将79名运动员（39名女性）随机分为SAP组和SAP + PERT组。所有运动员均接受了初次ACL重建术，并实现了80%的股四头肌力量肢体对称性（QI），全活动度，积液最少，并且没有疼痛。此外，所有人都重新开始跑步。在训练计划之前和之后，对运动员的QI、跳跃和患者报告的结果进行了评估。重复测量方差分析用于确定组间是否存在差异。随后，SAP和SAP + PERT组被折叠，以分析性别之间的差异。结果：有显着增加的所有变量，除QI。SAP和SAP + PERT组之间无差异。男性和女性在所有膝关节功能和患者报告的结局指标（QI除外）方面均有显著改善。男性取得了显着的改善QI，而女性doesn 't.Conclusion：所有运动员接受的训练计划（10届会议的逐步加强，敏捷性训练，运动测量学，和二级预防）的共同要素可能是一个有益的除了返回到运动阶段的ACL重建康复。结果表明，妇女可能需要进一步加强股四头肌，以保持和改善QI，一个重要的焦点，鉴于QI和风险reinjuriation.Clinical相关性之间的关系：在返回到运动阶段的ACL重建康复，临床医生往往会转移他们的重点从加强更先进的运动相关的任务。这些结果表明，妇女特别需要继续关注股四头肌加强。
Background: The Anterior Cruciate Ligament-Specialized Post-Operative Return to Sports (ACL-SPORTS) randomized controlled trial was designed to address deficits in functional and patient-reported outcomes. The trial examined the effects of a secondary ACL prevention program that included progressive strengthening, agility training, plyometrics (SAP), and other components of current primary prevention protocols, with perturbation training (SAP + PERT group) and without PERT (SAP group). A secondary purpose of this study was to examine whether study outcomes differed between men and women.Hypotheses: (1) Athletes in both the SAP and SAP + PERT groups will have improved knee function and patient-reported outcome measures from pre- to posttraining, (2) the SAP + PERT group would have higher outcome scores than the SAP group, and (3) outcomes will differ by sex.Study Design: Randomized controlled trial (NCT01773317).Level of Evidence: Level 2.Methods: A total of 79 athletes (39 women) were randomized into the SAP and SAP + PERT groups. All athletes had undergone primary ACL reconstruction and achieved 80% quadriceps strength limb symmetry (QI), full range of motion, had minimal effusion, and had no pain. Additionally, all had begun running again. Prior to and after the training program, athletes' QI, hopping, and patient-reported outcomes were assessed. Repeated-measures analyses of variance were used to determine whether there were differences between groups. Subsequently, the SAP and SAP + PERT groups were collapsed to analyze differences between sexes.Results: There were significant increases for all variables, with the exception of QI. There were no differences between the SAP and SAP + PERT groups. Both men and women made significant improvements in all knee function and patient-reported outcome measures except QI. Men made significant improvements in QI, whereas women did not.Conclusion: The common elements of the training program that all athletes received (10 sessions of progressive strengthening, agility training, plyometrics, and secondary prevention) may be a beneficial addition to the return-to-sport phase of ACL reconstruction rehabilitation. The results suggest that women may require further quadriceps strengthening to maintain and improve QI, an important focus given the relationship between QI and risk for reinjury.Clinical Relevance: During the return-to-sport phase of ACL reconstruction rehabilitation, clinicians tend to shift their focus away from strengthening toward more advanced sports-related tasks. These results indicate that women in particular need continued focus on quadriceps strengthening.