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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Eccentric Strengthening at Long Muscle Lengths Reduces Hamstring Strain Recurrences: Results of Long Term Follow-up
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Eccentric Strengthening at Long Muscle Lengths Reduces Hamstring Strain Recurrences: Results of Long Term Follow-up

机译：在长肌肉长度处进行偏心强化可减少腿筋拉伤的复发：长期随访的结果

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Objectives: Hamstring injuries are among the most common injuries in sports involving sprinting and have a high recurrence rate (20-33% recurrence rates reported in the literature). Rehabilitation protocols that can prevent recurrences are needed. The purpose of this study was to determine if a protocol emphasizing eccentric strength training with the hamstrings in a stretched position resulted in a low recurrence rate after return to play. Methods: Forty-eight athletes (age 35±16 yr; 31 men, 17 women) with unilateral hamstring strains (3 G1, 41 G2, 4 G3; 27 recurrent injuries) followed a 3-phase rehabilitation protocol (phase 1: isometric and isotonic strengthening at short to intermediate muscle lengths; phase 2: eccentric strengthening at short to intermediate lengths; phase 3: eccentric strengthening in a stretched position). Athletes progressed to the next phase when pain free with maximum contractions and were discharged to sports when pain free with maximal eccentric contractions in a stretched position and with functional tests. Prior to discharge, isometric strength was assessed bilaterally at 80o, 60o, 40o and 20o knee flexion in sitting with the thigh flexed to 40o above horizontal. Eight athletes chose to return to play prior to completing the rehabilitation and were categorized as noncompliant (5 completed phase 2, 3 completed phase 1). Reinjury rates and hamstring strength were compared between compliant and noncompliant athletes using Fisher exact tests and analysis of variance. Results: None of the 40 compliant athletes had sustained a reinjury at an average of 20±13 months after returning to sports (18>2 yr, 7 1-2 yr, 15<1 yr). Three of the 8 noncompliant athletes sustained reinjuries between 3 and 5 months after return to play (P<0.01 vs. compliant athletes). At time of return to sport, noncompliant athletes had significant hamstring weakness, which was progressively worse at longer muscle lengths (20% deficit at 80o, 23% at 60o, 31% at 40o, 43% at 20o; Angle effect P<0.001). Compliant athletes had symmetrical strength at all angles (P=0.99). Compliant athletes averaged 17±7 treatments over 11±7 wks versus 12±7 treatments over 13±11 wks for noncompliant athletes (P=0.11, P=0.53). Conclusion: Rehabilitation with an emphasis on eccentric strength training with the hamstrings in a stretched position resulted in zero recurrent injuries at an average of 1.7 years after return to play.
机译：目的：Ham绳肌损伤是短跑运动中最常见的损伤之一，复发率很高（文献报道复发率20-33％）。需要可以预防复发的康复方案。这项研究的目的是确定强调以腿筋处于伸展位置的偏心力量训练的方案是否导致重返比赛后的低复发率。方法：四十八名运动员（年龄35±16岁;男31名，女17名），单侧string绳肌拉伤（3 G1、41 G2、4 G3; 27例反复受伤），遵循3期康复方案（1期：等距和在肌肉中短至中等长度时等渗强化;阶段2：中短至中等长度时偏心强化;阶段3：在伸展位置时偏心强化）。当无痛并最大收缩时，运动员进入下一阶段，而当无痛时在伸展位置和功能测试中最大偏心收缩时，运动员退出运动。出院前，在大腿屈曲至水平上方40o的情况下，双侧评估膝关节屈曲强度，分别为80o，60o，40o和20o。八名运动员选择在完成康复之前重返赛场，并被归类为不合格（5名完成了第2阶段，3名完成了第1阶段）。使用费舍尔精确测试和方差分析比较了合规和不合规运动员的再损伤率和绳肌力量。结果：40名符合要求的运动员在重返运动后（18> 2年，7 1-2年，15 <1年）平均没有再受伤。 8名违规运动员中的3名在恢复比赛后的3到5个月内持续受伤（相对于遵规运动员，P <0.01）。恢复运动时，不合规的运动员的绳肌无力明显，在更长的肌肉长度上逐渐恶化（80o时20％赤字，60o时23％，40o 31％，20o 43％;角度效应P <0.001） 。合格的运动员在所有角度上都有对称的力量（P = 0.99）。符合条件的运动员在11±7周内平均进行17±7次治疗，而对于不遵守标准的运动员，在13±11周内进行12±7次治疗（P = 0.11，P = 0.53）。结论：进行康复训练时，尤其是在大腿筋处于伸展位置时，要进行偏心力量训练，平均可以使重返赛场后1.7年实现零次复发伤。

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