共查询到20条相似文献,搜索用时 31 毫秒
1.
The purposes of this study were (i) to examine the effects of anterior cruciate ligament (ACL) status on hamstring force steadiness, peak hamstring strength, quadriceps (antagonist) activation, and physical performance, and (ii) to evaluate the associations of physical performance with hamstring steadiness and hamstring strength. Thirteen subjects with unilateral deficiency of the ACL (ACLD), 39 matched subjects with unilateral reconstructed ACL (ACLR; n = 25 with bone‐patella tendon‐bone (ACLR‐PT) graft and n = 14 with combined semitendinosus and gracilis tendon (ACLR‐STGT) graft) and 33 control subjects participated. Each subject performed maximal‐effort isokinetic knee flexion repetitions at 180° s?1 with electromyography (EMG) electrodes attached to their medial and lateral quadriceps muscles. Physical performance was assessed using the single‐limb long hop for distance. Wavelet‐derived mean instantaneous frequency (Mif) of flexor torque‐time curves was significantly (p < 0.05) higher (i.e., less smooth) in ACLR‐STGT subjects compared to the ACLD, ACLR‐PT and control subjects. No significant differences existed for peak hamstrings strength (i.e., peak torque produced) or quadriceps antagonist EMG activity. Positive correlations were identified between hamstrings force steadiness and quadriceps antagonist activity for ACLD (r = 0.797), ACLR‐PT (r = 0.467), and ACLR‐STGT (r = 0.628) subjects. For ACLR‐STGT subjects, reduced hamstrings force steadiness associated with poorer long‐hop performance (r = ?0.695). Reduced steadiness amongst ACLR‐STGT subjects may reflect motor output variability of the antagonist (i.e., quadriceps dyskinesia) and/or agonist musculature—a maladaptive feature which potentially contributes to poorer single‐limb hop performance. Measures of hamstring force steadiness in combination with traditional measures of peak hamstring strength provide valuable clinical information regarding knee joint function following ACL injury/ACLR. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 29:907–914 相似文献
2.
Lauren N. Erickson Cale A. Jacobs Darren L. Johnson Mary L. Ireland Brian Noehren 《Journal of orthopaedic research》2022,40(1):231-238
The objective of the study was to determine if psychological readiness for sport and knee self-efficacy assessed early (3 months) after anterior cruciate ligament reconstruction (ACLR) are predictive of self-reported functional outcomes, quadriceps strength, and knee mechanics while running at the time of return to sport training (6 months). Thirty athletes with unilateral ACLR completed the ACL Return to Sport after Injury (ACL-RSI) and Knee Self-Efficacy Scale (K-SES) 3 months after ACLR and completed self-reported functional outcomes, isometric quadriceps strength testing, and three-dimensional running gait analysis 6 months after ACLR. The 3-month ACL-RSI significantly correlated with the 6-month International Knee Documentation Committee (IKDC; r = 0.565, p = 0.001), Knee Injury and Osteoarthritis Outcome Score (KOOS) sport/recreational activities (KOOSSport; r = 0.548, p = 0.002) and quality of life (KOOSQoL; r = 0.431, p = 0.017), and quadriceps strength (r = 0.528, p = 0.003). The 3-month K-SES significantly correlated with the 6-month IKDC (r = 0.528, p = 0.003), KOOSSport (r = 0.430, p = 0.018), KOOSQoL (r = 0.411, p = 0.024), quadriceps strength (r = 0.465, p = 0.010), and knee flexion excursion (r = 0.472, p = 0.008). With multivariate modeling, both the ACL-RSI and K-SES were predictive of the IKDC (R2 = 0.411; p = 0.001). Only the ACL-RSI was predictive of the KOOSSport (R2 = 0.300; p = 0.002), KOOSQoL (R2 = 0.186; p = 0.017), and quadriceps strength (R2 = 0.279; p = 0.003), whereas only the K-SES was predictive of knee flexion excursion (R2 = 0.173; p = 0.022). Athletes with greater psychological readiness for sport and knee self-efficacy at 3 months demonstrated higher scores on self-reported functional outcomes, greater quadriceps strength, and greater knee flexion excursion at 6 months after ACLR. This study indicates that psychosocial measures may be important to include into early post-surgical evaluations to help guide and facilitate interventions to restore subjective and objective knee function. 相似文献
3.
Thomas Birchmeier Caroline Lisee Kevin Kane Brett Brazier Ashley Triplett Christopher Kuenze 《Journal of orthopaedic research》2020,38(3):598-608
Image-based assessments of quadriceps muscle size facilitate examination of structural changes after anterior cruciate ligament (ACL) injury and reconstruction (ACLR). Understanding the effects of ACLR on muscle size measures may aid in clarifying the contribution of quadriceps atrophy toward quadriceps strength. The purpose of this study was to systematically review the literature examining the effects of ACLR on quadriceps muscle volume and cross-sectional area (CSA). An online database search was conducted using Web of Science, SportDISCUS, PubMed (Medline), CINHAL (EBSCO), and Cochrane Library limited to articles published after January 1, 1980. Means and standard deviations were extracted for the ACLR limb and the contralateral limb, and sample characteristics from relevant articles. Magnitude of between limb differences were assessed using pooled effect sizes (Hedge's g) and 95% confidence intervals. Eleven articles (five CSA, six muscle volume) were included in this systematic review. Included studies reported negative effective sizes, indicating that the ACLR limb was smaller in CSA or muscle volume compared with the contralateral limb; however, 36% of the included articles reported meaningful difference between the limbs. Quadriceps atrophy may occur following ACL injury and persist after rehabilitation, however, the magnitude of these reductions may not be clinically meaningful and may only partially explain the persistent quadriceps weakness that is ubiquitous among this patient population. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:598–608, 2020 相似文献
4.
The objective of this research was to examine the dynamic restraint mechanism by establishing the neuromuscular characteristics of lower extremity muscles in anterior cruciate ligament reconstruction (ACLR) subjects. This study also investigated neuromuscular variables that relate to post‐ACLR functional outcome. Thirteen patients having undergone ACLR using the bone patella tendon bone graft at least 6 months prior participated in this study. Knee functionality (0‐ to 100‐point scale) was rated using the Cincinnati Knee Rating System. The median frequency of the electromyographic (EMG) recordings from the vastus medialis (VM) and vastus lateralis (VL) muscles together with the isokinetic quadriceps torque generated in 10° intervals between 80° and 10° knee flexion was determined for the noninvolved and involved limbs. Lower limb musculotendinous stiffness was also assessed for the noninvolved and involved limbs. Limb symmetry indexes were calculated for each of the physiological measures. Compared to the noninvolved limb, the median frequency of the EMG from the involved limb VM and VL muscles was significantly lower as was the quadriceps torque generated at the seven knee flexion intervals. In contrast, musculotendinous stiffness was significantly higher in the involved lower limb compared to the noninvolved limb. Significant, moderate correlations were identified between knee functionality and symmetry indexes for all variables except for the isokinetic quadriceps torque produced between 80°–70° and 20°–10° knee flexion. More functional ACLR subjects demonstrated enhanced motor unit recruitment reflective of less quadriceps muscle fiber atrophy together with increased quadriceps strength and musculotendinous stiffness of the lower limb musculature. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:126–135, 2008 相似文献
5.
Justin M. Losciale Matthew P. Ithurburn Mark V. Paterno Laura C. Schmitt 《Journal of orthopaedic research》2022,40(1):208-218
We sought to evaluate the sagittal plane knee joint loading patterns during a double-leg landing task among young athletes who passed or failed return-to-sport (RTS) criteria following anterior cruciate ligament reconstruction reconstruction (ACLR), and in uninjured athletes. Participants completed quadriceps strength testing, a hop test battery, and the International Knee Documentation Committee subjective form following medical RTS clearance. ACLR participants “passed” RTS criteria (RTS-PASS) if they met ≥90 limb symmetry (%) or score on all measures and were categorized as “failing” (RTS-FAIL) if not. All participants completed three-dimensional motion analysis testing. Sagittal plane kinematic and kinetic variables were calculated during a double-leg drop vertical jump task. Mean limb values and limb symmetry indices (LSI; %) were calculated and compared using a one-way analysis of variance (ANOVA) (for LSI) and mixed between-within ANOVA (for group × limb differences). A total of 205 participants were included, with 39 in the RTS-PASS group, 109 in the RTS-FAIL group, and 57 control groups (CTRLs). The RTS-FAIL group demonstrated lower symmetry values for peak vertical ground reaction force, peak internal knee extension moment, and peak knee flexion angle. Group × limb interactions were observed for peak vertical ground reaction force and peak internal knee extension moment. Involved limb values were reduced in the RTS-PASS and RTS-FAIL groups compared to CTRLs, while the RTS-PASS groups had lower uninvolved limb values compared to the RTS-FAIL and CTRLs. Clinical Significance: Young athletes who pass RTS criteria after ACLR land symmetrically during a double-leg task, but symmetry was achieved by reducing loading on both limbs. 相似文献
6.
Jacob J Capin Ryan Zarzycki Naoaki Ito Ashutosh Khandha Celeste Dix Kurt Manal Thomas S Buchanan Lynn Snyder‐Mackler 《Journal of orthopaedic research》2019,37(8):1743-1753
Women after anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) are more likely than men to exhibit asymmetric movement patterns, which are associated with post‐traumatic osteoarthritis. We developed the ACL specialized post‐operative return‐to‐sports (ACL‐SPORTS) randomized control trial to test the effect of strength, agility, plyometric, and secondary prevention (SAPP) training with and without perturbation training (SAPP + PERT) on gait mechanics in women after ACLR. We hypothesized that movement symmetry would improve over time across both groups but more so among the SAPP + PERT group. Thirty‐nine female athletes 3–9 months after primary ACLR were randomized to SAPP or SAPP + PERT training. Biomechanical testing during overground walking occurred before (Pre‐training) and after (Post‐training) training and one and 2 years post‐operatively. Hip and knee kinematic and kinetic variables were compared using repeated measures analysis of variance with Bonferroni corrections for post hoc comparisons (α = 0.05). There was a time by limb interaction effect (p = 0.028) for peak knee flexion angle (PKFA), the primary outcome which powered the study, characterized by smaller PKFA in the involved compared to uninvolved limbs across treatment groups at Pre‐training, Post‐training, and 1 year, but not 2 years. Similar findings occurred across sagittal plane knee excursions and kinetics and hip extension excursion at midstance. There were no meaningful interactions involving group. Neither SAPP nor SAPP + PERT training improved walking mechanics, which persisted 1 but not 2 years after ACLR. Statement of clinical significance: Asymmetrical movement patterns persisted long after participants achieved symmetrical strength and functional performance, suggesting more time is needed to recover fully after ACLR. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1743–1753, 2019 相似文献
7.
Conte A Belvisi D Bologna M Ottaviani D Fabbrini G Colosimo C Williams DR Berardelli A 《Cerebral cortex (New York, N.Y. : 1991)》2012,22(3):693-700
No study has yet investigated whether cortical plasticity in primary motor area (M1) is abnormal in patients with progressive supranuclear palsy (PSP). We studied M1 plasticity in 15 PSP patients and 15 age-matched healthy subjects. We used intermittent theta-burst stimulation (iTBS) to investigate long-term potentiation (LTP) and continuous TBS (cTBS) to investigate long-term depression (LTD)-like cortical plasticity in M1. Ten patients underwent iTBS again 1 year later. We also investigated short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) in M1 with paired-pulse transcranial magnetic stimulation, tested H reflex from upper limb flexor muscles before and after iTBS, and measured motor evoked potential (MEP) input-output (I/O) curves before and after iTBS. iTBS elicited a significantly larger MEP facilitation after iTBS in patients than in healthy subjects. Whereas in healthy subjects, cTBS inhibited MEP, in patients it significantly facilitated MEPs. In patients, SICI was reduced, whereas ICF was normal. H reflex size remained unchanged after iTBS. Patients had steeper MEP I/O slopes than healthy subjects at baseline and became even more steeper after iTBS only in patients. The iTBS-induced abnormal MEP facilitation in PSP persisted at 1-year follow-up. In conclusion, patients with PSP have abnormal M1 LTP/LTD-like plasticity. The enhanced LTP-like cortical synaptic plasticity parallels disease progression. 相似文献
8.
《Arthroscopy》2021,37(9):2858-2859
The average revision rate is between 3.2% and 11.1%following primary anterior cruciate ligament (ACL) reconstructions,1 and an objective failure rate of 13.7% has been reported for revision ACLR.2 Prior implants, positioning of tunnels, and muscle weakness from the prior reconstruction present challenges. Additionally, graft choice for the revision reconstruction is restricted, depending on the primary reconstruction. Revision ACL reconstruction with the all-soft tissue quadriceps tendon autograft is a viable option with 83.3% of the patients surpassing the minimally clinically significant difference for International Knee Documentation Committee (IKDC) scores, which is similar to outcomes for revision ACL reconstruction (ACLR) using bone-patella-bone and hamstring tendon autografts. Furthermore, objective strength data suggest that it is possible to achieve equal limb symmetry index strength ratios even in the setting of prior bone-patella tendon-bone autograft. However, although I am cautiously optimistic regarding soft tissue quadriceps autograft in revision ACLR, I would be hesitant to recommend it for all comers. In my experience, young high school/collegiate female athletes with primary reconstruction using BPTB autograft may not be able to tolerate a secondary insult to the extensor mechanism via quadriceps tendon (QT) autograft harvest, where hematoma and arthrofibrosis could be concerns. Furthermore, increased posterior tibial slope may require evaluation and treatment, and the addition of a lateral extra-articular tenodesis may reduce residual rotatory laxity in ACL revision patients. 相似文献
9.
Meredith Chaput James A. Onate Janet E. Simon Cody R. Criss Steve Jamison Michael McNally Dustin R. Grooms 《Journal of orthopaedic research》2022,40(1):95-104
Visual cognitive ability has previously been associated with anterior cruciate ligament injury and injury risk biomechanics in healthy athletes. Neuroimaging reports have identified increased neural activity in regions corresponding to visual-spatial processing, sensory integration, and visual cognition in individuals after anterior cruciate ligament reconstruction (ACLR), indicating potential neural compensatory strategies for motor control. However, it remains unclear whether there is a relationship between visual cognition, neural activity, and metrics of neuromuscular ability after ACLR. The purpose of this study was to (1) evaluate the relationship between visual cognitive function and measurements of neuromuscular control (proprioception and time to stability [TTS]), isokinetic strength, and subjective function, and (2) examine the neural correlates of visual cognition between ACLR (n = 16; time since surgery 41.4 ± 33.0 months) and demographically similar controls (n = 15). Visual cognition was assessed by the ImPACT visual motor and visual memory subscales. Outcome variables of proprioception to target knee angle 20°, landing TTS, strength, and subjective function were compared between groups, and visual cognition was correlated within groups to determine the relationship between visual cognition and outcome variables controlled for time from surgery (ACLR group). The control group had better IKDC scores and strength. Visual memory and visual motor ability were negatively associated with proprioception error (r = ?0.63) and TTS (r = ?0.61), respectively, in the ACLR group but not controls. Visual cognition was associated with increased neural activity in the precuneus and posterior cingulate cortex in the ACLR group but not control participants. These data suggest the neural strategy in which ACLR participants maintain proprioception and stability varies, and may depend on visual cognition and sensory integration neural activity. 相似文献
10.
Longitudinal changes in knee gait mechanics between 2 and 8 years after anterior cruciate ligament reconstruction
下载免费PDF全文
![点击此处可从《Journal of orthopaedic research》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Jennifer C. Erhart‐Hledik Constance R. Chu Jessica L. Asay Thomas P. Andriacchi 《Journal of orthopaedic research》2018,36(5):1478-1486
11.
Nardone R Bergmann J Kunz A Caleri F Seidl M Tezzon F Gerstenbrand F Trinka E Golaszewski S 《Journal of neurotrauma》2011,28(7):1165-1171
Although chronic sleepiness is common after head trauma, the cause remains unclear. Transcranial magnetic stimulation (TMS) represents a useful complementary approach in the study of sleep pathophysiology. We aimed to determine in this study whether post-traumatic sleep-wake disturbances (SWD) are associated with changes in excitability of the cerebral cortex. TMS was performed 3 months after mild to moderate traumatic brain injury (TBI) in 11 patients with subjective excessive daytime sleepiness (EDS; defined by the Epworth Sleepiness Scale ≥10), 12 patients with objective EDS (as defined by mean sleep latency <5 on multiple sleep latency tests), 11 patients with fatigue (defined by daytime tiredness without signs of subjective or objective EDS), 10 patients with post-traumatic hypersomnia "sensu strictu," and 14 control subjects. Measures of cortical excitability included central motor conduction time, resting motor threshold (RMT), short-latency intracortical inhibition (SICI), and intracortical facilitation to paired-TMS. RMT was higher and SICI was more pronounced in the patients with objective EDS than in the control subjects. In the other patients all TMS parameters did not differ significantly from the controls. Similarly to that reported in patients with narcolepsy, the cortical hypoexcitability may reflect the deficiency of the excitatory hypocretin/orexin-neurotransmitter system. These observations may provide new insights into the causes of chronic sleepiness in patients with TBI. A better understanding of the pathophysiology of post-traumatic SWD may also lead to better therapeutic strategies in these patients. 相似文献
12.
Quadriceps weakness preferentially predicts detrimental gait compensations among common impairments after total knee arthroplasty
下载免费PDF全文
![点击此处可从《Journal of orthopaedic research》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Jesse C. Christensen Ryan L. Mizner Kenneth Bo Foreman Robin L. Marcus Christopher E. Pelt Paul C. LaStayo 《Journal of orthopaedic research》2018,36(9):2355-2363
13.
Christopher M. Kuenze Silvia S. Blemker Joseph M. Hart 《Journal of orthopaedic research》2016,34(9):1656-1662
It remains unclear what role reduced volume and cross‐section area (CSA) of individual quadriceps muscles may play in persistent quadriceps weakness and more global dysfunction following ACL reconstruction (ACLR). The purpose of this investigation was to establish the relationship between cross‐sectional area of the quadriceps muscle group and measures of knee related and quadriceps function following ACLR. Thirty participants with a history of primary, unilateral ACLR experiencing persistent quadriceps activation failure participated in this cohort study. Clinical factors including International Knee Documentation Committee (IKDC) score, normalized knee extension MVIC torque (Nm/kg) and quadriceps central activation ratio (CAR, %) were assessed in addition to CSA. Quadriceps CSA was measured via magnetic resonance imaging (MRI; Siemens Avanto 1.5T). Quadriceps CSA (cm2) and quadriceps volume (cm3) as well as individual muscle estimates were identified within a 10 cm mid‐thigh capture area. Pearson's product‐moment correlation coefficients (r) established relationships between CSA and all other variables. Stepwise linear regression established which CSA factors were able to successfully predict clinical factors. Knee extension MVIC torque was strongly correlated with Vastus Intermedius (VI; r = 0.857, p < 0.001) CSA as well as partial VI (r = 0.849, p < 0.001) and quadriceps (r = 0.830, p < 0.001) volume. Partial VI (r = 0.365, p = 0.047) volume was weakly correlated with IKDC score. Knee extension MVIC torque was strongly predicted using VI CSA alone (R2 = 0.725) or in combination with Vastus Medialis CSA (VM; R2 = 0.756). Statement of Clinical Significance: Atrophy of the VI and VM muscles negatively impacts knee extension strength following ACLR. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1656–1662, 2016. 相似文献
14.
No difference between mechanical perturbation training with compliant surface and manual perturbation training on knee functional performance after ACL rupture
下载免费PDF全文
![点击此处可从《Journal of orthopaedic research》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Zakariya Nawasreh David Logerstedt Mathew Failla Lynn Snyder‐Mackler 《Journal of orthopaedic research》2018,36(5):1391-1397
15.
Adam Grinberg Andrew Strong Sebastian Buck Jonas Selling Charlotte K. Hger 《Journal of orthopaedic research》2022,40(1):105-116
Sensorimotor deficits, particularly proprioceptive, are often reported following rupture of the anterior cruciate ligament (ACL). High secondary injury rates and long-term negative consequences suggest that these deficits are not properly identified using current assessment methods. We explored a novel obstacle clearance test to evaluate sensorimotor control in individuals following ACL reconstruction (ACLR) and rehabilitation. Thirty-seven post-ACLR individuals, 23 nonathletic asymptomatic controls (CTRL), and 18 elite athletes stepped over a hurdle-shaped obstacle, downward vision occluded, aiming for minimal clearance. Kinematic outcomes (3D motion capture) for the leading and trailing legs, for two unpredictably presented obstacle heights, were categorized into Accuracy: vertical foot clearance and minimal distance from the obstacle; Variability: end-point and hip/knee trajectory; and Symmetry: trunk/hip/knee crossing angles, hip–knee–ankle movement, and velocity curves. Accuracy was worse for CTRL compared with both other groups. ACLR had less leading and trailing vertical foot clearance with their injured compared with their noninjured leg. ACLR and athletes had less crossing knee flexion in their injured/nondominant legs compared with their contralateral leg, both leading and trailing. ACLR showed greater trunk flexion when crossing with their injured leg, both leading and trailing. For the leading leg, ACLR showed greater asymmetry for the hip–knee–ankle velocity curve compared with elite athletes. Trailing leg trajectory variability was lower for ACLR compared with CTRL and athletes for higher obstacles. Clinical significance: Sensorimotor deficits in individuals post-ACLR were reflected by greater asymmetry and less variable (more stereotypical) trajectories rather than limb positioning ability. This consideration should be addressed in clinical evaluations. 相似文献
16.
Recently, 2 physiologically distinct phases of short-interval intracortical inhibition (SICI) have been identified, a larger phase at interstimulus interval (ISI) 3 ms and a smaller phase at ISI 1 ms. While the former is mediated by synaptic processes, the mechanisms underlying the first phase of SICI remain a matter of debate. Separately, it is known that fatiguing hand exercise reduces SICI, a measure of cortical excitability. Consequently, the present study assessed effects of fatiguing hand exercise on the 2 SICI phases, using threshold tracking transcranial magnetic stimulation techniques, to yield further information on underlying mechanisms. Studies were undertaken on 22 subjects, with SICI assessed at baseline, after each voluntary contraction (VC) period of 120 s and 5, 10, and 20 min after last VC, with responses recorded over abductor pollicis brevis. Exercise resulted in significant reduction of SICI at ISI 1 ms (SICI(baseline) 9.5 ± 2.7%; SICI(MAXIMUM REDUCTION) 2.5 ± 2.5%, P < 0.05) and 3 ms (SICI(baseline) 16.8 ± 1.7%; SICI(MAXIMUM REDUCTION) 11.6 ± 2.1%, P < 0.05), with the time course of reduction being different for the 2 phases. Taken together, findings from the present study suggest that synaptic processes were the predominant mechanism underlying the different phases of SICI. 相似文献
17.
Fitzgerald GK Piva SR Irrgang JJ 《The Journal of orthopaedic and sports physical therapy》2003,33(9):492-501
STUDY DESIGN: Randomized clinical trial, single-masked. OBJECTIVES: To determine the effectiveness of using a modified neuromuscular electrical stimulation (NMES) training program as an adjunct treatment for improving quadriceps strength and physical function in rehabilitation following anterior cruciate ligament reconstruction (ACLR). BACKGROUND: NMES training for quadriceps strengthening has previously been shown to be an effective adjunct treatment following ACLR when performed against isometric resistance using a dynamometer with the knee positioned in flexion. We developed a modified version of published NMES protocol because some patients have difficulty tolerating the existing protocol and many clinics may not have instrumented dynamometers. There is a need to determine the effectiveness of this modified protocol. METHODS AND MEASURES: Forty-three subjects who had undergone ACLR were randomly assigned to either a group that received (NMES group) or did not receive (comparison group) the NMES treatment in conjunction with their rehabilitation. Group means for quadriceps strength and self-reported measures of knee function were compared after 12 and 16 weeks of rehabilitation. The proportion of subjects in each group achieving clinical criteria to initiate ambulation without crutches, treadmill running, and agility training at selected times during rehabilitation were also compared. RESULTS: The NMES group demonstrated moderately greater quadriceps strength at 12 weeks (effect size, 0.48), and moderately higher levels of self-reported knee function at both 12 (effect size, 0.72) and 16 (effect size, 0.65) weeks of rehabilitation compared to the comparison group. A greater proportion of subjects in the NMES group achieved clinical criteria for advancing to agility training at 16 weeks. CONCLUSIONS: The modified NMES quadriceps training protocol can be a useful adjunct to ACLR rehabilitation programs, but the treatment effect is smaller than what has been reported in previous studies. 相似文献
18.
目的 比较股神经阻滞(FNB)与收肌管阻滞(ACB)用于前交叉韧带重建(ACLR)术后镇痛效果。
方法 检索Pubmed、Embase、Web of Science、Cochrane Library、Cochrane Controlled Trials Register、万方、知网、维普数据库,检索时间为建库至2021年3月,收集股神经阻滞(FNB组)与收肌管阻滞(ACB组)用于ACLR术后镇痛效果比较的随机对照试验(RCT),按照Cochrane手册选择文献、提取资料、对纳入文献的方法学质量进行评价,采用RevMan 5.4软件进行Meta分析。
结果 共纳入9篇发表于2014—2021年的RCT研究,共计患者719例,FNB组359例,ACB组360例。FNB组和ACB组术后0~3、6、12、24、48 h疼痛评分差异无统计学意义。FNB组与ACB组术后24、48 h阿片类药物用量、患者满意度差异无统计学意义。5篇文献认为ACB组能更好地保留患者股四头肌肌力,3篇文献认为ACB组与FNB组患者术后股四头肌肌力差异无统计学意义。
结论 ACB与FNB在ACLR术后疼痛评分、阿片类药物用量、患者满意度方面无显著差异,ACB在保留患者股四头肌肌力方面可能更具优势,但还需后续更多研究进一步验证。 相似文献
19.
Kristen E. Renner Christopher T. Franck Thomas K. Miller Robin M. Queen 《Journal of orthopaedic research》2018,36(7):1887-1893
20.
Erin Hartigan Michael J. Axe Lynn Snyder-Mackler 《Journal of orthopaedic research》2009,27(6):724-729
We investigated whether preoperative perturbation training would help anterior cruciate ligament (ACL) deficient individuals who complain of knee instability (“non-copers”) regain quadriceps strength and walk normally after ACL reconstruction. Nineteen non-copers with acute ACL injury were randomly assigned into a perturbation group (PERT) or a strengthening group (STR). The PERT group received specialized neuromuscular training and progressive quadriceps strength training, whereas the STR group received progressive quadriceps strength training only. We compared quadriceps strength indexes and knee excursions during the mid-stance phase of gait preoperatively to data collected 6 months after ACL reconstruction. Analyses of Variance with repeated measures (time/limb) were conducted to compare quadriceps strength index values over time (time × group) and differences in knee excursions in limbs between groups over time (limb × time × group). If significance was found, post hoc analyses were performed using paired and independent t-tests. Quadriceps strength indexes before intervention (Pert: 87.2%; Str: 75.8%) improved 6 months after ACL reconstruction in both groups (Pert: 97.1%; Str: 94.4%). Non-copers who received perturbation training preoperatively had no differences in knee excursions between their limbs 6 months after ACL reconstruction (p = 0.14), whereas those who received just strength training continued to have smaller knee excursions during the mid-stance phase of gait (p = 0.007). Non-copers strength and knee excursions were more symmetrical 6 months postoperatively in the group that received perturbation training and progressive quadriceps strength training than the group who received strength training alone. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27: 724–729, 2009 相似文献