前交叉韧带重建后的落地力学：前向单腿跳测试的信度与临床启示
简介
本研究纳入57名单侧ACLR术后6–12个月的运动员，采用单腿向前跳落地错误评分系统（SHD-LESS）评估落地质量。结果显示，SHD-LESS总分具有良好评估者间信度（ICC 0.77–0.80），且患侧肢体落地错误显著多于健侧，表现为多关节运动链协调缺陷（如矢状面减震不足、额状面动态外翻及躯干-髋代偿模式）。该工具可超越跳远距离，为ACLR后重返运动决策…
英文摘要
OBJECTIVES: To evaluate inter-rater reliability of the Single-leg Hop for Distance Landing Error Scoring System (SHD-LESS), compare landing mechanics between limbs, examine associations with strength and functional performance, and identify coordinated movement patterns following anterior cruciate ligament reconstruction (ACLR). DESIGN: Cross-sectional. SETTING: University hospital. PARTICIPANTS: Fifty-seven athletes (mean age 25.5 ± 6.2 years) assessed 6-12 months post-primary unilateral ACLR. MAIN OUTCOME MEASURES: Bilateral isokinetic strength (60°/s) and single-leg hop distance were assessed. Two blinded raters independently scored landing quality using the SHD-LESS (13 items, maximum score 16) from 120 fps video recordings. Inter-rater reliability was assessed using ICC and Cohen's κ, with limb comparisons via McNemar's and Wilcoxon signed-rank tests. RESULTS: SHD-LESS total score demonstrated good inter-rater reliability (ICC 0.77-0.80), with variable item-level agreement. The operated limb showed greater landing errors. Inter-item correlations revealed coordinated multi-joint kinematic deficits encompassing sagittal load absorption, frontal-plane dynamic valgus, and trunk-hip compensatory patterns. Higher pre-injury activity level and muscle strength were associated with lower SHD-LESS scores, while return-to-running status was the sole predictor of interlimb asymmetry. CONCLUSIONS: SHD-LESS is a reliable, clinically feasible tool revealing landing quality deficits beyond hop distance alone, relevant to return-to-sport decision-making after ACLR.