步态实验室效应：前交叉韧带重建术后对称性恢复策略在自然环境中与步态实验室不同
简介
该研究利用惯性测量单元（IMU）对26例ACL重建患者术后3个月和9个月进行长达7天的自然环境下步态监测，并与实验室评估对比。结果显示，自然环境中膝关节伸展活动度（KEE）不对称性从7.7°显著降至2.6°，主要通过对侧肢体KEE减少4.3°实现，而实验室仅观察到2.2°的改善且主要依赖患侧KEE增加。提示ACL术后康复评估应纳入自然环境数据，以更全面反映真…
英文摘要
Inertial measurement units (IMUs) offer a promising pathway to extend functional-recovery assessment after anterior cruciate ligament reconstruction (ACLR) beyond laboratory or in-clinic evaluations. Yet, it remains unclear how joint kinematics change in natural environments over time. In this study, 26 participants wore five sticker-like IMUs on the pelvis, thighs, and shanks for up to seven days, three and nine months after their surgery. They also participated in a laboratory assessment at each timepoint using standard marker- and inertial-based motion capture systems. Knee extension excursion (KEE) was estimated, and inter-limb KEE asymmetry was used as the primary outcome. Median KEE asymmetry decreased significantly from 7.7° at three months to 2.6° at nine months post-surgery, through a modest, 1.0° increase in the reconstructed KEE and a more salient reduction of 4.3° in the contralateral KEE. In the laboratory, however, only a 2.2° decrease in KEE asymmetry was observed, attributed to a 3.3° increase in reconstructed KEE and no significant change in the contralateral KEE. Sensitivity analyses revealed that findings were robust to walking-bout duration and number of days included in the analysis, and all reported group changes in KEE asymmetry exceeded disagreement between IMU- vs. marker-based tracking. Participant compliance to remote monitoring was high, with nearly 95% of the sessions completed. Together, these findings demonstrate that joint-level biomechanics can be captured longitudinally in natural environments after ACLR and that ecologically valid monitoring outside the laboratory can reveal aspects of functional recovery not observed in controlled settings.