渐进性抗阻运动对前交叉韧带重建患者膝关节生物力学的影响

Effects of progressive resistance exercise on biomechanics of knee joint in patients with anterior cruciate ligament reconstruction

目的 为了揭示渐进性抗阻运动对前交叉韧带重建(anterior cruciate ligament reconstruction, ACLR)患者膝关节功能、生物力学和预后的影响。方法 2022年5月至2023年11月期间,本研究共纳入80例ACLR患者,将患者随机分为常规抗阻运动组和渐进性抗阻运动组,每组40例。两组患者分别进行为期12周的常规抗阻运动和渐进性抗阻运动。通过Lysholm评分评价膝关节功能。通过等速肌力评估锻炼系统评估膝关节等速肌力,根据峰值扭矩计算计算对称性指数。通过平衡测试系统评估站立位平衡稳定性,计算双侧多轴平均轨迹差的差值(average trajectory error difference, ATED)。通过步态分析系统记录患者的步态参数。结果 与常规抗阻运动组比较,渐进性抗阻运动组的Lysholm评分升高,伸膝和屈膝对称性指数升高,ATED降低,步幅和步长升高(P<0.05)。结论 本研究表明,与常规抗阻运动相比,渐进性抗阻运动可更好地改善ACLR患者术后的膝关节功能,改善膝关节生物力学,提高平衡能力和步态表现。

Objective To explore the effects of progressive resistance exercise on knee joint function,biomechanics and prognosis in patients with anterior cruciate ligament reconstruction(ACLR).Methods From May 2022 to November 2023,80 patients with ACLR were randomly divided into two groups:conventional resistance exercise group(n=40)and progressive resistance exercise group(n=40).The patients in the two groups received conventional resistance exercise and progressive resistance exercise for 12 weeks,respectively.Knee joint function was evaluated by Lysholm score.The isokinetic muscle strength of knee joint was evaluated by isokinetic muscle strength evaluation exercise system,and the symmetry index was calculated according to the peak torque.The balance stability of standing position was evaluated by balance test system,and the difference of bilateral multi-axis average trajectory error difference(ATED)was calculated.The gait parameters were recorded by gait analysis system.Results The results showed that compared with those in the conventional resistance exercise group,the Lysholm score increased,the knee extension and flexion symmetry index increased,the ATED decreased,the stride length and step length increased in the progressive resistance exercise group(P<0.05).Conclusion This study shows that compared with conventional resistance exercise,progressive resistance exercise can better improve knee joint function,knee joint biomechanics,balance ability and gait performance in patients with ACLR.