前交叉韧带重建后肌肉等长发力率及与功能表现的关系  

Rate of force development and its relationship with functional performance in patients after anterior cruciate ligament reconstruction

作　　者：李奇[1] 高明威 李世浩 褚晓蕾 李亚杰 丁宁 刘敏琦 Li Qi;Gao Mingwei;Li Shihao;Chu Xiaolei;Li Yajie;Ding Ning;Liu Minqi(Department of Rehabilitation Medicine,Tianjin University Tianjin Hospital,Tianjin 300211,China;Sports and Health College of Tianjin Sport University,Tianjin 301617,China)

机构地区：[1]天津大学天津医院康复医学科,天津市300211 [2]天津体育学院运动健康学院,天津市301617

出　　处：《中国组织工程研究》2024年第34期5536-5543,共8页Chinese Journal of Tissue Engineering Research

基　　金：2021年度中国民族区药学会科研项目(2021Z1063-520701),项目负责人:李奇;天津市科技计划项目(22JCYBJC00210),项目负责人:李奇。

摘　　要：背景:前交叉韧带重建后肌肉功能的恢复通常评估肌肉的最大力量,最近的研究认为还应考虑神经肌肉功能,比如肌肉等长发力率,即在肌肉等长收缩条件下测量不同时间间隔的力-时间曲线斜率。目的:阐述前交叉韧带重建后患者肌肉等长发力率的研究现状与不足,分析术后不同时间内股四头肌和腘绳肌等长发力率的缺陷程度;等长发力率对术后患者功能表现的影响,为优化前交叉韧带重建后康复、减少患者二次损伤以及降低膝骨关节炎发生率提供重要信息。方法:检索中国知网、维普、万方和PubMed数据库,以“前交叉韧带,发力率”为中文检索词,以“anterior cruciate ligament,rate of force development,rate of torque development”为英文检索词,按照纳入和排除标准最终纳入69篇文献。结果与结论:(1)大多数研究发现前交叉韧带重建后半年内患者双侧肌肉等长发力率存在缺陷,双侧腘绳肌早期等长发力率(即肌肉收缩100 ms时间段内任意时间间隔的力-时间曲线斜率)在半年后有显著改善,但双侧股四头肌早期等长发力率长期缺陷,表明术后股四头肌神经肌肉功能长期受损。(2)有关晚期等长发力率(肌肉收缩100 ms后时间段内任意时间间隔的力-时间曲线斜率)的相关研究较少,无法得出确切结论。(3)关于着陆运动(跳跃落地和侧切等)和日常生活活动(走、跑),股四头肌早期等长发力率比等长峰值力矩相关性更强,运动过程中生物力学的异常改变被认为是患者二次损伤以及创伤性膝骨关节炎发生的重要风险因素,积极改善股四头肌早期等长发力率可能会降低二次损伤以及创伤性膝骨关节炎的发生率。(4)目前仅有很少的证据表明,全身振动训练能改善前交叉韧带重建后患者股四头肌早期等长发力率,建议今后在术后早期阶段应用神经肌肉电刺激干预股四头肌和腘绳肌,而在术后晚期阶段实施BACKGROUND:The maximum muscle strength is typically used for evaluating the recovery of muscle function after anterior cruciate ligament reconstruction.Recent studies have suggested that neuromuscular function should also be considered,such as rate of force development,which measures the slope of the force time curve at different time intervals under conditions of isometric muscle contraction.OBJECTIVE:To elaborate on the current research status and shortcomings of muscle isometric rate of force development in patients undergoing anterior cruciate ligament reconstruction surgery,and analyze the degree of defects in quadriceps femoris and hamstring isometric rate of force development at different times after surgery;to analyze the effect of isometric rate of force development on postoperative functional performance,thereby providing important information for optimizing postoperative rehabilitation following anterior cruciate ligament reconstruction,reducing secondary injury to patients,and reducing the incidence of knee osteoarthritis.METHODS:Literature retrieval of CNKI,VIP,WanFang and PubMed was performed using“anterior cruciate ligament,rate of force development”as Chinese search terms and“anterior cruciate ligament,rate of force development,rate of torque development”as English search terms.Finally,69 articles were included according to inclusion and exclusion criteria.RESULTS AND CONCLUSION:Most studies have found defects in bilateral muscle isometric rate of force development in patients undergoing anterior cruciate ligament reconstruction within 6 months.Early isometric rate of force development of the bilateral hamstring muscles(i.e.the slope of the force time curve at any time interval during muscle contraction of 100 ms)showed significant improvement after 6 months.However,long-term defects in early isometric rate of force development of the bilateral quadriceps indicate long-term damage to the neuromuscular function of the quadriceps after surgery.There is limited research on late isometric rate

关 键 词：发力率 等长收缩 前交叉韧带重建 神经肌肉功能 功能表现 二次损伤 股四头肌 综述 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R605