Lower limb stability with ACL impairment

被引:147
作者
Colby, SM
Hintermeister, RA
Torry, MR
Steadman, JR
机构
[1] Texas Scottish Rite Hosp Children, Movement Sci Lab, Dallas, TX 75219 USA
[2] Steadman Hawkins Sports Med Fdn, Vail, CO USA
[3] Steadman Hawkins Sports Med Clin, Vail, CO USA
关键词
dynamic stabilization; force plate; knee; rehabilitation;
D O I
10.2519/jospt.1999.29.8.444
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Study Design: Repeated measures (3 separate day sessions) to determine test reliability; single-session repeated measures to compare stability between limbs. Objectives: To develop a functional test measuring dynamic stability that is capable of differentiating between the injured and uninjured lower limb in 2 populations: (1) people with anterior cruciate ligament deficiency (ACLd) and (2) people with anterior cruciate ligament reconstruction (ACLr), and to establish the reliability of this test. Background: Many functional tests of the lower limb used by clinicians, such as the 1-legged hop for distance, the 1-legged hop for time, the vertical jump, the triple hop for distance, shuttle run, and single-limb standing, do not allow the clinician to discern differences between function in the injured and uninjured limbs. Methods and Measures: Twenty-five nonimpaired subjects (14 men, 11 women, aged 31.2 +/- 9.1 years), 11 subjects with ACLr (9 men, 2 women, aged 26.3 +/- 10.4 years), and 13 subjects with ACLd (5 men, 8 women, aged 40.4 +/- 12.6 years) were tested. Twelve nonimpaired subjects participated in 3 testing sessions to determine the reliability of the force plate measures. Ground reaction forces (vertical, medial-lateral, and anterior-posterior) were measured while the subjects performed 1-legged hop and step-down tests onto a force plate. Stability was defined as the ability to transfer the vertical projection of the center of gravity to the supporting base and keep the knee still. A repeated-measures analysis of variance (2-factor; limbs by trials) was used to compare the stability between limbs. Results: The majority of the measures used to calculate dynamic stability were reliable. Moreover, the data provide normal standards of functional knee stability for step-down and hop tests. In the step-down test, changes in vertical force did identify dysfunction in the injured limb (stabilization time = 1527 +/- 216 ms) compared to the uninjured limb (stabilization time = 892 +/- 498 ms) for subjects with ACLr. Conclusions: The normal standards may serve as a reference for comparing functional differences in ACLr or ACLd populations. The vertical force parameter during a step-down may be useful as an outcome measure to monitor progress during rehabilitation.
引用
收藏
页码:444 / 451
页数:8
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