系统运动训练对ACL重建术后膝关节功能影响的临床研究：多中心ACL重建病例研究

Clinical Study on the Effect of Systematic Exercise Training on Knee Joint Motor Function after ACL Reconstruction: A Multi-Center ACL Reconstruction Case Study

摘要: 目的：研究系统运动训练对ACL重建术后患肢肌力及运动功能恢复的有效性，观察ACL重建术后患侧肌力与运动功能的关系和变化情况，为ACL重建术后的临床康复提供研究基础。方法：在青岛市范围内招募于2021年12月至2024年1月中采用自体腘绳肌腱重建ACL的患者，根据纳入和排除标准是否进行过规律、系统的等速运动训练选49例等速训练组患者、46例未经等速训练的患者作为对照组。收集患者术后4周、术后8周、术后12周的膝关节功能评分、疼痛VAS评分和等速肌力测试资料，分析系统运动训练对于ACL重建术后膝关节功能恢复的影响。结果：患者年龄、性别、身高、体重、BMI等一般资料比较无明显差异(P > 0.05)。两组患者疼痛VAS评分、膝关节活动度、Lysholm膝关节功能评分在术后4周无明显差异，在术后8周、12周均存在明显差异(P < 0.05)，等速训练组患者的VAS评分、活动度、膝关节功能评分结果更优。在等速运动训练前后，患者膝关节伸肌、屈肌的力矩峰值和总功都存在明显增高的趋势，差异显著(P < 0.05)。结论：ACL重建术后4周~12周期间的系统运动训练能够明显改善ACL重建术后膝关节屈伸肌的运动功能和肌肉平衡，提高患者术后的肢体控制能力。

Abstract: Objective: To study the effectiveness of systematic exercise training on the recovery of muscle strength and motor function of the affected limb after ACL reconstruction, and to observe the relationship and changes of muscle strength and motor function of the affected side after ACL reconstruction, so as to provide a research basis for clinical rehabilitation after ACL reconstruction. Methods: Patients with ACL reconstruction using autologous hamstring tendon were recruited from December 2021 to January 2024 in Qingdao, and 49 patients in the isokinetic training group and 46 patients without isokinetic training were selected as the control group according to the inclusion and exclusion criteria of whether or not they had undergone regular and systematic isokinetic exercise training. Knee function scores, pain VAS scores, and isometric muscle strength tests were collected from patients at 4 weeks, 8 weeks, and 12 weeks after surgery to analyse the effect of systematic exercise training on the recovery of knee function after ACL reconstruction. Results: There was no significant difference in the comparison of the general information of patients’ age, gender, height, weight, and BMI (P > 0.05). There was no significant difference in pain VAS score, knee mobility, and Lysholm knee function score between the two groups at 4 weeks postoperatively, and there was a significant difference at 8 and 12 weeks postoperatively (P < 0.05), and the patients in the isokinetic training group had a better VAS score, mobility, and knee function score result. After isokinetic training, there was a significant tendency for the peak moment and total work of the knee extensors and flexors of the patients to increase with significant differences (P < 0.05). Conclusion: Systematic exercise training between 4 and 12 weeks after ACL reconstruction can significantly improve the motor function and muscle balance of knee flexors and extensors, and improve the patients’ postoperative limb control ability.