Running Biomechanics Before Injury and 1 Year After Anterior Cruciate Ligament Reconstruction in Division I Collegiate Athletes.
Running Biomechanics Before Injury and 1 Year After Anterior Cruciate Ligament Reconstruction in Division I Collegiate Athletes.
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DOI：
10.1177/03635465211026665
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Heiderscheit BC
中科院分区：
文献类型：
--
作者：
Knurr KA;Kliethermes SA;Stiffler-Joachim MR;Cobian DG;Baer GS;Heiderscheit BC
损伤前跑步生物力学是量化前交叉韧带重建（ACLR）后跑步生物力学恢复的理想比较指标，可用于手术和非手术肢体的评估。然而，受伤前跑步生物力学的可用性是罕见的，只有在个案研究中报道。确定大学生运动员在ACLR后的第一年内跑步生物力学是否恢复到受伤前的水平。我们假设手术膝关节生物力学在ACLR后不久会显著降低，并且在12个月内不会恢复到损伤前水平，并且非手术肢体力学会从损伤前发生显著变化。分析常规收集的运动表现数据;证据等级，3。2015年至2020年间，确定了13名一级学院运动员（6名女性; 20.7±1.3岁），在ACL受伤之前，在跑步机跑步期间记录了全身运动学和地面反作用力（3.7 ± 0.6 m/s）。在ACLR后4（4 M）、6（6 M）、8（8 M）和12（12 M）个月重复运行分析。使用线性混合效应模型评估每个肢体内ACLR后时间点与损伤前之间的跑步生物力学差异，报告为Tukey调整的p值。与损伤前相比，手术肢体在所有术后评估中都显示出明显的缺陷（p值<0.01，报告为最小二乘均值差±标准误差）：峰值膝关节屈曲角（4个月：13.2°±1.4，6个月：9.8°±1.4，8个月：9.7°±1.4，12个月：9.0°±1.5）;峰值膝关节伸肌力矩（4个月：1.32±0.13，6个月：1.04±0.13，8个月：1.04±0.13，12个月：0.87±0.15 Nm/kg; 38 - 57%缺陷）;和膝关节伸肌力矩速率（4 M：22.7±2.4，6 M：17.9±2.3，8 M：17.5±2.4，12 M：16.1±2.6 Nm/kg/s; 33 - 46%不足）。在非手术肢体中，这些变量与损伤前相比没有变化（p值> 0.88）。ACLR后，手术肢体膝关节跑步生物力学在12个月内未恢复到损伤前状态，而非手术肢体力学与损伤前相比保持不变。与受伤前相比，ACLR后的大学生运动员在跑步力学方面表现出严重的缺陷，这些缺陷持续超过典型的恢复运动时间范围。非手术膝关节似乎是一个有效的参考恢复手术膝关节力学在跑步过程中，由于非手术肢体内缺乏变化。
Pre-injury running biomechanics are an ideal comparator for quantifying recovery of running biomechanics following anterior cruciate ligament reconstruction (ACLR), allowing for assessments within both the surgical and non-surgical limbs. However, availability of pre-injury running biomechanics is rare and has only been reported in case studies. To determine if running biomechanics return to pre-injury levels within the first year post-ACLR among collegiate athletes. We hypothesized that surgical knee biomechanics would be significantly reduced shortly after ACLR and not return to pre-injury levels by 12 months, and non-surgical limb mechanics would change significantly from pre-injury. Analysis of routinely collected athletic performance data; Level of Evidence, 3. Thirteen Division I collegiate athletes were identified between 2015 and 2020 (6 female; 20.7±1.3 years old) who had whole body kinematics and ground reaction forces recorded during treadmill running (3.7 ± 0.6 m/s) prior to sustaining an ACL injury. Running analyses were repeated at 4 (4M), 6 (6M), 8 (8M), and 12 (12M) months post-ACLR. Linear mixed effects models were used to assess differences in running biomechanics between post-ACLR time-points and pre-injury within each limb, reported as Tukey-adjusted p-values. Compared to pre-injury, the surgical limb displayed significant deficits at all post-operative assessments (p-values <0.01, reported as least square mean difference ± standard error): peak knee flexion angle (4M: 13.2°±1.4, 6M: 9.8°±1.4, 8M: 9.7°±1.4, 12M: 9.0°±1.5); peak knee extensor moment (4M: 1.32±0.13, 6M: 1.04±0.13, 8M: 1.04±0.13, 12M: 0.87±0.15 Nm/kg; 38 to 57% deficit); and rate of knee extensor moment (4M: 22.7±2.4, 6M: 17.9±2.3, 8M: 17.5±2.4, 12M: 16.1±2.6 Nm/kg/s; 33 to 46% deficit). No changes for these variables from pre-injury (p-values > 0.88) were identified in the non-surgical limb. Following ACLR, surgical limb knee running biomechanics were not restored to the pre-injury state by 12M, while non-surgical limb mechanics remained unchanged compared to pre-injury. Collegiate athletes post-ACLR demonstrate substantial deficits in running mechanics compared to pre-injury that persist beyond the typical return-to-sport timeframe. The non-surgical knee appears to be a valid reference for recovery of the surgical knee mechanics during running, due to the lack of change within the non-surgical limb.
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