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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Judging return-to-sport after ACL reconstruction using acyclic as well as cyclic neuromuscular performance tests
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Judging return-to-sport after ACL reconstruction using acyclic as well as cyclic neuromuscular performance tests

机译：使用无循环和循环神经肌肉性能测试判断ACL重建后的返回运动

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Aims and Objectives: Most athletes expect to return to their pre-injury sport without restrictions after a reconstruction of their torn anterior cruciate ligament (ACLR). Different indicators for a safe and successful return to sport have been identified. Very recent results revealed that indicators of absolute performance were superior to e.g. limb symmetry. Thus, the primary aim of this investigation was to compare neuromuscular performance of athletes returned to sport after ACLR with uninjured athletes. The secondary aim was to relate overall performance to symmetry in both groups. Materials and Methods: Eighty-four athletes (age: 24 (SD 5) years; 21 women; handball: 33, soccer: 25, volleyball: 15, ice hockey: 5, track and field: 3, judo: 2, swimming: 1) participated in this cross-sectional design. The sample consisted of 17 patients after primary ACL reconstruction (ACLR, 5 women) eleven (6-23) months after return to sport clearance. Participants performed acyclic as well as cyclic neuromuscular tests on a SpeedCourt device (GlobalSpeed GmbH). Unilaterally performed squat jump (SJ) and drop jump (DJ) heights were measured as an indicator of lower extremity explosive or reactive strength under acyclic concentric or fast stretch-shortening muscle action conditions, respectively. The 15 s vertical foot tapping (FT) test was applied to measure cyclic lower extremity performance. The results of each test were converted into z-scores. Z-scores indicate how many standard deviations an individual’s score is away from the mean. Accordingly, a z-score of zero equals the sample’s mean. Athlete’s z-scores were summed up, resulting in the performance score (PS) which indicates overall performance. The participants were ranked based on their PS. Further, for the unilaterally performed tests (SJ, DJ) limb symmetry indices (LSIs) were calculated by dividing the smaller by the larger value and multiplying by 100. LSIs were related to the PS separately for the whole sample as well as for the ACLR subgroup. Effect size is given as Cohen’s d. Results: Uninjured athletes revealed higher values for the PS (t(82) = 3.5, p & 0.001; d & 0.9) and for the LSIs (t(82) & 5.1, p & 0.001; d & 1.4) as compared to ACLR athletes. For the subgroup of uninjured athletes, no significant relationship was found between the overall performance and the LSIs (SJ: r = -0.2, p = 0.15; DJ: r = -0.1, p = 0.43) as well as within both LSIs (r = 0.1, p = 0.41). In athletes after ACLR, in contrast, the LSIs between SJ and DJ showed a strong and significant association (r & 0.73, p & 0.001). Interestingly, neither the overall performance nor the LSIs could be related to the time after injury (0.17 & r & 0.37, p & 0.14). Conclusion: Based on the tests utilized in this study, the ACLR athletes underperformed the uninjured group. Independent from time since injury or surgery, function was not reestablished. Results of functional tests should be an integrative part of the return-to-sport decision process.
机译：目标与目标：大多数运动员预计在重建前皱纹韧带（ACLR）后，无需限制就会恢复受伤前的运动。已经确定了安全和成功返回运动的不同指标。最近的结果表明，绝对性能指标优于如例如。肢体对称性。因此，这项调查的主要目的是比较ACLR与未经控制的运动员在ACLR后返回运动的神经肌肉表现。二次目的是将两个群体对称性的整体性能相关。材料和方法：八十四名运动员（年龄：24（SD 5）岁; 21个女性;手球：33，足球：25，排球：15，冰球：5，田径：3，柔道：2，游泳： 1）参加了这种横断面设计。该样品由17名患者组成，原发性ACL重建（ACLR，5名女性）十一（6-23）个月回到体育间隙后。参与者在SpeedCourt设备（Globalspeed GmbH）上进行了无循环和循环神经肌肉试验。单侧执行的蹲下跳跃（SJ）和下降跳跃（DJ）高度分别被测量为下肢同心或快速拉伸缩短肌动作条件下的下肢爆炸或反应强度的指示。施加了15秒的垂直脚攻丝（FT）测试以测量循环下肢性能。将每种测试的结果转化为Z分数。 z分数表示个人分数远离平均值的标准偏差有多少。因此，Z分数为零等于样本的平均值。运动员的Z分数总结，导致表现出整体性能的性能评分（PS）。参与者根据他们的ps排名。此外，对于单方面执行的测试（SJ，DJ）肢体对称指标（LSI）通过将较大的值除以较大的值并将100乘以100. LSI与PS分别用于整个样本以及ACLR。子组。效果大小为Cohen的d。结果：未加注运动员揭示了PS（T（82）= 3.5，P <0.001; d＆ 0.9）和LSIS（T（82）＆ 5.1，P <0.001; D＆ 1.4 ）与ACLR运动员相比。对于缺陷运动员的子组，整体性能和LSI之间没有发现显着的关系（SJ：R = -0.2，P = 0.15; DJ：R = -0.1，P = 0.43）以及LSI（R = 0.1，p = 0.41）。在ACLR后的运动员中，相比之下，SJ和DJ之间的LSIS显示出强大而显着的关联（R> 0.73，P <0.001）。有趣的是，整体性能和LSI既不与损伤后的时间有关（0.17＆ 0.37，P＆ 0.14）。结论：基于本研究中使用的测试，ACLR运动员表现不足的群体。独立于伤害或手术的时间，无法重新建立功能。功能试验的结果应是返回体育决策过程的一体化部分。

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