优势侧与非优势侧前交叉韧带重建对下肢功能及单脚跳跃落地动作生物力学特征的影响
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1.山东体育学院 运动与健康学院;2.宁波大学 体育学院

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Effect of ACL reconstruction in the dominant or nondominant limb on lower limb function and mechanics during single-leg jump landing
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1.College of Sports and Health,Shandong Sport University;2.Faculty of Physical Education, Ningbo University

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    摘要:

    目的:明确在优势与非优势肢体进行前交叉韧带(Anterior Cruciate Ligament,ACL)重建(ACL reconstruction,ACLR)对患者单脚跳跃落地生物力学特征、膝关节等速肌力、动态姿势控制以及跳跃功能的影响。方法:招募49名受试者,包括优势重建组(ACLR on dominant limb,ACLR-D)、非优势重建组(ACLR on nondominant limb,ACLR-ND)和健康对照组(Control,CON)。对其双侧肢体进行单脚跳跃落地、膝关节等速肌力、Y平衡和单脚跳跃距离测试。通过红外动作捕捉系统、测力台采集单脚跳跃落地中的运动学、动力学数据,使用IsoMed2000等速肌力测试系统采集膝关节肌力。采用双因素混合设计方法分析观察肢体与组别对各项测试结果的影响。结果:ACLR-D组健侧相较于ACLR-ND组健侧,在单脚跳跃落地中存在更大的膝外翻角(ACLR-D:3.8±1.8°,ACLR-ND:1.7±1.3°)、外旋角(ACLR-D:4.8±2.3°,ACLR-ND:1.2±1.8°)和膝外翻力矩(ACLR-D:0.11±0.18 Nm/kg,ACLR-ND:0.08±0.22 Nm/kg),且ACLR-D组双侧膝屈角(健侧:12.7±6.1°,患侧:11.4±7.3°)小于对照组(优势侧:17.2±9.0°,非优势侧:18.0±6.5°)。两组ACLR患者间的膝关节肌力、Y平衡得分和单脚跳跃距离无差异,但ACLR-ND组双侧Y平衡得分(健侧:92.8±8.5%,患侧:89.9±4.8%)小于对照组(优势侧:97.8±6.6%,非优势侧:98.1±6.3%)。结论:优势与非优势侧ACLR对患者术后膝关节肌力、动态姿势控制以及单脚跳跃功能并无影响,但优势侧ACLR患者的健侧较非优势侧ACLR患者存在更大的膝外翻、外旋角和膝外翻力矩,提示其可能存在更高的ACL损伤风险。

    Abstract:

    Objective To determine the effect of limb dominance on landing biomechanics and lower limb functional outcomes in patients with anterior cruciate ligament (ACL) reconstruction (ACLR). Methods Forty-nine participants were recruited and divided into the ACLR on dominant limb (ACLR-D) group, ACLR on nondominant limb (ACLR-ND) group and healthy control group. Single-leg jump landing, knee isometric muscle strength, Y balance, and single-leg hop for distance tests were performed on both limbs of all participants. Kinematics and kinetics data during the single-leg jump landing were collected by an infrared motion capture system and a force platform, and knee joint muscle strength was collected using the IsoMed2000 isokinetic muscle strength testing system. Two-way mixed-design ANOVAs were used to observe the effects of limb and group on the outcomes of each test. Results The non-surgical limbs had greater knee valgus (3.8±1.8°vs 1.7±1.3°), knee external rotation angles (4.8±2.3°vs 1.2±1.8°) and knee valgus moments (0.11±0.18 Nm/kg vs 0.08±0.22 Nm/kg) in single-leg jump landing in the ACLR-D group compared with the ACLR-ND group, and the bilateral knee flexion angles were significantly smaller in the ACLR-D group than in the control group (non-surgical limb: 12.7±6.1°vs 17.2±9.0°, surgical limb: 11.4±7.3°vs 18.0±6.5°). There were no differences in knee muscle strength, Y-balance composite scores and single-leg hop distance between ACLR-D and ACLR-ND groups, but the Y balance scores in ACLR-ND group were smaller than those in the control group (non-surgical limb: 92.8±8.5% vs 97.8±6.6%, surgical limb: 89.9±4.8% vs 98.1±6.3%). Conclusions Limb dominance has no effect on knee muscle strength, dynamic postural control, and single-leg hop function in ACLR patients. The non-surgical limbs of ACLR-D patients are at a higher risk of ACL injury due to the presence of more abnormal landing movement patterns.

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  • 收稿日期:2024-10-14
  • 最后修改日期:2024-11-18
  • 录用日期:2024-11-20
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