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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >ACL-RSI and KOOS Measures Predict Normal Knee Function after ACL-SPORTS Training
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ACL-RSI and KOOS Measures Predict Normal Knee Function after ACL-SPORTS Training

机译：ACL-RSI和KOOS措施可预测ACL-SPORTS训练后的正常膝盖功能

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Objectives: After anterior cruciate ligament reconstruction (ACLR) athletes commonly report increased fear of re-injury and below normal knee function. Implementing a post-operative training protocol (ACL-SPORTS Training) to improve patient perceived knee function, may improve short term outcomes after surgery. Identifying pre-training measures that predict normal knee function after training may allow us to determine who may respond to the treatment intervention. The purpose of this study was to identify which pre-training patient reported measures of fear of re-injury and knee function predict normal knee function after ACL-SPORTS Training. Methods: Thirty subjects (13 normal knee function, 17 below normal knee function) with an isolated ACLR, who participated in jumping, cutting and pivoting activities ≥ 50 hrs/yr prior to their injury, were included in this study. Study enrollment required ≥ 80% quadriceps strength, minimal knee joint effusion and ≥ 12 weeks after surgery. Subjects were randomized to two treatment groups. The standard care group received 10 training sessions including quadriceps strengthening exercises, ACL injury prevention exercises and agility drills. The perturbation group received all standard care exercises augmented with perturbation training. Pre-training patient reported measures of fear of re-injury included the Tampa Scale of Kinesiophobia (TSK-11) and the ACL-Return to Sport after Injury (ACL-RSI). Knee function was measured with the Knee injury and Osteoarthritis Outcome Score (KOOS4), as a mean of the pain, symptoms, sports and recreation, and quality of life subscales. Each subscale (KOOS-pain, KOOS-symptoms, KOOS-ADLs, KOOS-sport/rec, KOOS-QoL) was also assessed individually. After the training program was completed, self-reported knee function was measured with the International Knee Documentation Committee subjective knee form (IKDC 2000). Age- and sex-matched normative values were determined based on the top 15th percentile of healthy measures. A binary logistic regression was used to determine which variables significantly predicted normal knee function after training. Results: There was no difference between those who achieved normal knee function and those with below normal knee function for age at the time of surgery (p=0.78), BMI at post-training testing (p=0.71), sex (p=0.13) or time from surgery to post-training testing (p=0.12) and treatment group did not significantly predict normal knee function after training (p=0.96). Higher pre-training ACL-RSI and KOOS4 scores significantly predicted 37.5% and 38.6% of the variance of achieving normal knee function, respectively. Together higher pre-training scores predicted 49.5% of the variance. Of the individual KOOS subscales, higher pre-training KOOS-pain, KOOS-symptoms, KOOS-ADLs, and KOOS-QoL scores significantly predicted 23.8%, 35.9%, 39.5% and 35.6% of the variance of achieving normal knee function, respectively. Conclusion: Prior to this ACL-SPORTS training protocol higher ACL-RSI, KOOS4, KOOS-pain, KOOS-symptoms, KOOS-ADLs and KOOS-QoL subscales were able to predict which individuals achieved normal knee function after this treatment protocol. Identifying individuals who do not achieve normal knee function after training may allow us to identify a subgroup of patients that require additional interventions to achieve normal knee function.
机译：目标：前十字韧带重建（ACLR）后，运动员通常报告对再受伤的恐惧增加，并且膝关节功能低于正常水平。实施术后培训协议（ACL-SPORTS培训）以改善患者的感知膝关节功能，可能会改善术后的短期预后。确定可以预测出训练后膝盖功能正常的训练前措施，可以使我们确定谁可能对治疗干预产生反应。这项研究的目的是确定哪些接受过ACL-SPORTS训练的训练前患者报告了担心再次受伤和膝盖功能恐惧的措施，可以预测正常的膝盖功能。方法：本研究纳入了三十名受试者（膝关节正常功能13项，膝关节功能以下17项），其孤立的ACLR在受伤前参与了≥50小时/年的跳跃，切割和枢转活动。研究入组要求股四头肌力量≥80％，膝关节积液最少，手术后≥12周。将受试者随机分为两个治疗组。标准护理小组接受了10次培训，包括四头肌强化锻炼，ACL预防伤害锻炼和敏捷训练。摄动组接受了所有标准的护理练习，并增加了摄动训练。训练前患者报告的害怕再伤害的措施包括坦帕运动恐惧症量表（TSK-11）和ACL受伤后恢复运动状态（ACL-RSI）。膝关节功能通过膝关节损伤和骨关节炎结果评分（KOOS4）来衡量，作为疼痛，症状，运动和休闲以及生活质量量表的平均值。还分别评估了每个分量表（KOOS疼痛，KOOS症状，KOOS-ADL，KOOS-sport / rec，KOOS-QoL）。培训计划完成后，使用国际膝关节文献委员会主观膝关节形式（IKDC 2000）测量自我报告的膝关节功能。根据健康指标的前15个百分位数确定年龄和性别匹配的标准值。使用二进制逻辑回归分析确定训练后哪些变量可显着预测正常的膝盖功能。结果：手术时年龄（p = 0.78），训练后BMI（p = 0.71），性别（p = 0.13）达到正常膝关节功能和膝关节功能低于正常膝关节的患者之间无差异。 ）或从手术到训练后测试的时间（p = 0.12），而治疗组在训练后没有明显预测正常的膝盖功能（p = 0.96）。较高的训练前ACL-RSI和KOOS4分数分别显着预测了实现正常膝关节功能的方差的37.5％和38.6％。更高的培训前分数共同预测了49.5％的差异。在各个KOOS分量表中，较高的训练前KOOS疼痛，KOOS症状，KOOS-ADL和KOOS-QoL分数分别显着预测了实现正常膝关节功能的方差的23.8％，35.9％，39.5％和35.6％。 。结论：在此ACL-SPORTS训练方案之前，较高的ACL-RSI，KOOS4，KOOS疼痛，KOOS症状，KOOS-ADL和KOOS-QoL量表能够预测该治疗方案后哪些个体的膝关节功能正常。识别出训练后未达到正常膝关节功能的个体可以使我们确定需要额外干预才能实现正常膝关节功能的患者亚组。

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