摘要
目的探讨前交叉韧带(ACL)重建术后1年大腿等速肌力不对称性与步态不对称性的相关性。方法采用回顾性病例系列研究分析2014年1月至2019年1月北京大学第三医院收治的25例ACL重建患者临床资料,均为男性;年龄17~47岁[(29.4±5.2)岁]。术后进行规范的康复治疗流程。采集术后1年大腿等速肌力测试数据,分别测试伤侧和健侧的60°/s、180°/s、300°/s向心伸膝肌力和屈膝肌力,60°/s离心伸膝肌力和屈膝肌力,分析其肌力峰值。采集患者步行过程的三维运动信息及地面反作用力,通过逆向动力学分析患者步态支撑期的膝关节运动学及动力学参数,包括屈曲力矩峰值、伸展力矩峰值、内收力矩第一峰值、内收力矩第二峰值、外旋力矩峰值、内旋力矩峰值、屈曲角度峰值、步态支撑末期伸展角度峰值、足跟着地屈曲角度、外展角度最大值、步态支撑末期外旋角度最大值。通过Spearman相关性分析明确等速肌力双侧对称指数(LSI)与步态参数LSI的相关性。结果ACL重建术后1年伤侧60°/s、180°/s、300°/s向心伸膝肌力和屈膝肌力、60°/s离心伸膝肌力和屈膝肌力峰值显著低于健侧(P均<0.01)。与健侧相比,ACL重建患者术后1年伤侧步态支撑期膝关节伸展力矩峰值显著降低(P<0.01),步态支撑末期膝关节伸展角度不足(P<0.01)。伤侧与健侧膝关节屈曲力矩峰值、内收力矩第一峰值、内收力矩第二峰值、外旋力矩峰值、内旋力矩峰值、屈曲角度峰值、足跟着地屈曲角度、外展角度最大值、步态支撑末期外旋角度最大值差异无统计学意义(P均>0.05)。Spearman相关性分析结果显示,ACL重建术后1年60°/s等速向心伸膝肌力的LSI与步态支撑期膝关节内旋力矩峰值LSI显著相关(R=0.42,P<0.05);180°/s等速向心伸膝肌力LSI与屈曲力矩峰值LSI显著相关(R=0.45,P<0.05);180°/s等速向心屈膝肌力LSI与步态支撑期膝关节屈曲角度�
Objective To investigate the correlation of isokinetic thigh muscle asymmetry with gait asymmetry at one year after anterior cruciate ligament(ACL)reconstruction.Methods A retrospective case series analysis was made on 25 patients treated by ACL reconstruction in Third Hospital of Peking University from January 2014 to January 2019.All the subjects were male,aged 17-47 years[(29.4±5.2)years].Standard rehabilitation treatment procedures were conducted after surgery.The isokinetic muscle strength of the thigh was collected at one year after operation to evaluate knee extensor and flexor concentric strength at 60°/s,180°/s and 300°/s,and knee extensor and flexor eccentric strength at 60°/s.The maximum concentric and eccentric strength of the knee extensor and flexor were analysed between the injured and intact side.The three-dimensional motion information and ground reaction force was collected during the stance phase of gait,and knee kinematic and kinetic parameters were calculated by inverse dynamics analysis,including the peak flexion moment,peak extension moment,first and second peak adduction moment,peak external and internal rotation moment,peak flexion angle,peak extension angle during the terminal stance phase,flexion angle at heel strike,peak abduction angle,and peak external rotation angle during terminal stance phase.Spearman correlation analysis was used to study the correlation between limb symmetry index(LSI)of isokinetic muscle strength and LSI of gait parameters.Results One year after ACL reconstruction,the maximum concentric strength of the knee extensor and flexor at 60°/s,180°/s and 300°/s and maximum eccentric strength of the knee flexor and extensor at 60°/s on the injured side were significantly lower than those on the normal side(all P<0.01).Compared with the intact side,the peak knee extension moment on the injured side was significantly lower during the stance phase of gait(P<0.01),and the extension angle was insufficient during the terminal stance phase(P<0.01).There were no signif
作者
任爽
梁子轩
张思
于媛媛
李玳
苗欣
黄红拾
敖英芳
Ren Shuang;Liang Zixuan;Zhang Si;Yu Yuanyuan;Li Dai;Miao Xin;Huang Hongshi;Ao Yingfang(Department of Sports Medicine,Peking University Third Hospital Institute of Sports Medicine of Peking University)
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2022年第7期592-599,共8页
Chinese Journal of Trauma
基金
北京市自然科学基金(7202232)
国家自然科学基金(31900943,31900961)
2020年度北京大学第三医院创新转化基金(BYSYZHKC2020106)
北京大学医学部青年培育基金(BMU2021PY001)
北京大学第三医院优秀留学回国人员科研启动基金(BYSYLXHG2020007)
北京大学第三医院临床重点项目人才项目B类(BYSYZD2019024)。
关键词
前交叉韧带
肌力
步行
人体运动学
实用
动力学
Anterior cruciate ligament
Muscle strength
Walking
Kinesiology,applied
Kinetics
