Muscle atrophy contributes to quadriceps weakness after anterior cruciate ligament reconstruction.
Muscle atrophy contributes to quadriceps weakness after anterior cruciate ligament reconstruction.
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DOI：
10.1016/j.jsams.2014.12.009
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发表时间：
2016-01
影响因子：
4
通讯作者：
Palmieri-Smith RM
中科院分区：
文献类型：
--
作者：
Thomas AC;Wojtys EM;Brandon C;Palmieri-Smith RM
前交叉韧带重建后股四头肌无力持续存在。肌肉萎缩和激活失败可能是原因之一。本研究探讨了前交叉韧带重建后股四头肌无力与萎缩和激活失败的关系。案件系列。前交叉韧带重建术后6个月患者20例。萎缩以磁共振图像中股四头肌的峰值横截面积为标准。股四头肌的激活通过中枢激活率来量化，而肌肉力量则是等长测量的。所有的测试都是双侧进行的。采用分层线性回归和单因素方差分析方法分析肌力与肌力激活和萎缩的关系。横截面积(R2=0.307；p=0.011)比中心激活率(R2<；0.001；p=0.987)更能解释股四头肌力量的差异。损伤肢体的力量和横截面积(强度：2.03±0.51 Nm/kg；横截面积：68.81±17.80cm2)低于健肢(强度：2.89±0.81 Nm/kg；横截面积：81.10±21.58cm2；p<；0.001)。中枢激活率两侧无差异，但双侧股四头肌激活失败(损伤：0.87±0.12；未损伤：0.85±0.14；p=0.571)。股四头肌横截面积与前交叉韧带重建后6个月的肌肉力量有很强的相关性，在力量和横截面积方面，损伤的肢体与未损伤的肢体相比存在明显的缺陷。患者可以从旨在改善术后股四头肌横截面积的锻炼中受益。
Quadriceps weakness persists after anterior cruciate ligament reconstruction. Muscle atrophy and activation failure may contribute. This study examined the roles of atrophy and activation failure in quadriceps weakness after anterior cruciate ligament reconstruction. Case series. Twenty patients six months post-anterior cruciate ligament reconstruction participated. Atrophy was determined as peak quadriceps cross sectional area from magnetic resonance images. Quadriceps activation was quantified via the central activation ratio, while muscle strength was measured isometrically. All testing was performed bilaterally. Hierarchical linear regression and one-way ANOVAs were performed to examine the relation of muscle strength with activation and atrophy. Cross sectional area (R2=0.307; p=0.011) explained more of the variance in quadriceps strength than central activation ratio (R2<0.001; p=0.987). Strength and cross sectional area were lower in the injured (strength: 2.03±0.51Nm/kg; cross sectional area: 68.81±17.80cm2) versus uninjured limb (strength: 2.89±0.81Nm/kg; cross sectional area: 81.10±21.58cm2; p<0.001). There were no side-to-side differences in central activation ratio; however, quadriceps activation failure was present bilaterally (injured: 0.87±0.12; uninjured: 0.85±0.14; p=0.571). Quadriceps cross sectional area was strongly related to muscle strength six months after anterior cruciate ligament reconstruction and substantial injured versus uninjured limb deficits were demonstrated for strength and cross sectional area. Patients may benefit from exercises aimed at improving quadriceps cross sectional area post-operatively.