离心运动对前交叉韧带重建术后下肢功能康复疗效的Meta分析  

Meta-Analysis of the Effect of Centrifugal Exercise on Functional Rehabilitation of Lower Limbs after Anterior Cruciate Ligament Reconstruction

作　　者：孙卓璟 马国东[1] 王鹏程 马铭辰 SUN Zhuo-jing;MA Guo-dong;WANG Peng-cheng;MA Ming-chen(Jilin Sport University,Changchun 130022,China;Tiangong University,Tianjin 300387,China)

机构地区：[1]吉林体育学院,吉林长春130022 [2]天津工业大学,天津300387

出　　处：《吉林体育学院学报》2025年第1期87-99,共13页Journal of Jilin Sport University

基　　金：吉林省社会科学基金项目(项目编号:2019B122);吉林体育学院研究生科研创新基金项目(项目编号:YC2024022)。

摘　　要：目的:探讨前交叉韧带重建术后进行离心训练的影响,为术后临床康复提供循证建议。方法:检索平台包括PubMed、Web of Science、Scopus、ScienceDirect、中国知网、万方数据资源系统、维普数据库,检索时间为建库至2024年5月,使用Review Manager 5.4进行文献质量评价与分析,并生成偏倚风险图,使用R(版本4.4.1)进行基于Egger’s运算的发表偏倚检验与敏感性分析,基于亚组分析与敏感性分析探讨异质性来源与影响因素。结果:共纳入12篇文献,样本量482人。Meta分析结果显示,离心训练对主观膝功能评分(SMD=1.36,95%CI:[0.56,2.16],P<0.01,I2=91%)、肢体对称性指数(SMD=1.13,95%CI:[0.24,2.01],P<0.05,I2=87%)、屈肌峰值力矩(SMD=0.48,95%CI:[0.2,0.77],P<0.01,I2=41%)的改善达到显著水平,对伸肌峰值力矩(SMD=0.13,95%CI:[-0.15,0.4],P>0.05,I2=6%)并未达到显著改善水平;每周2次的训练频率对患者主观评价(2次:SMD=1.23;SMD=0.29)(2次:SMD=1.23;3次:SMD=0.29)、屈肌峰值力矩(2次:SMD=0.9;3次:SMD=0.24)的改善幅度更好(亚组间P<0.05),男性患者(SMD=5.24)相比女性患者(SMD=0.83)在肢体对称性指数上的改善会更加显著(亚组间P<0.01)。6周与8周产生训练效果差异不具有统计学意义(亚组间P>0.05)。结论:在未来可将离心训练作为一种康复手段加入到前交叉韧带重建术术后的康复工作,为期6~8周,每周训练2次,单次时长控制在30~60分钟,将会获得较好的临床康复效果。Objective:To explore the impact of eccentric training after anterior cruciate ligament(ACL)reconstruction surgery and provide evidence-based recommendations for postoperative clinical rehabilitation.Methods:The search platforms included PubMed,Web of Science,Scopus,ScienceDirect,CNKI,Wanfang Data Resource System,and VIP Database.The search time ranged from the establishment of the databases to May 2024.The quality of the literature was evaluated and analyzed using Review Manager 5.4,and a bias risk graph was generated.Egger's test for publication bias and sensitivity analysis were conducted using R(version 4.4.1).Subgroup analysis and sensitivity analysis were performed to explore the sources of heterogeneity and influencing factors.Results:A total of 12 articles were included,with a sample size of 482 participants.The meta-analysis results showed that eccentric training significantly improved subjective knee function scores(SMD=1.36,95%CI:[0.56,2.16],P<0.01,I 2=91%),limb symmetry index(SMD=1.13,95%CI:[0.24,2.01],P<0.05,I2=87%),and peak torque of the flexor muscles(SMD=0.48,95%CI:[0.2,0.77],P<0.01,I 2=41%),but did not significantly improve the peak torque of the extensor muscles(SMD=0.13,95%CI:[-0.15,0.4],P>0.05,I 2=6%).Training frequency of twice a week resulted in greater improvement in patients'subjective evaluation(twice a week:SMD=1.23;three times a week:SMD=0.29)and flexor peak torque(twice a week:SMD=0.9;three times a week:SMD=0.24)compared to three times a week(subgroup P<0.05).Male patients(SMD=5.24)showed more significant improvement in the limb symmetry index than female patients(SMD=0.83)(P<0.01 between subgroups).There was no statistically significant difference in training effects between 6 weeks and 8 weeks(P>0.05 between subgroups).Conclusion:In the future,eccentric training can be incorporated as a rehabilitation method into the postoperative rehabilitation of ACL reconstruction,with a duration of 6 to 8 weeks,training twice a week,and each session lasting 30 to 60 minutes,which is expected to ac

关 键 词：前交叉韧带重建术 离心训练 下肢功能 META分析 

分 类 号：G804.6[文化科学—运动人体科学]