前交叉韧带重建史运动员在场地跑步时的关节特异性机械功分析
简介
该研究纳入22名单侧ACLR男性运动员与22名健康对照，通过三维运动捕捉和测力台分析跑步支撑相髋、膝、踝关节的正负机械功。结果显示，ACLR侧膝关节正负功均显著减少，而髋关节负功和踝关节正功代偿性增加，提示跑步时存在膝关节卸载、髋踝代偿的力学策略。这一发现强调康复训练需关注整体下肢功能，而非仅恢复膝关节。
英文摘要
BACKGROUND: Individuals with anterior cruciate ligament reconstruction (ACLR) history show altered running mechanics. Mechanical work analysis is useful for identifying compensatory strategies. Negative work represents energy absorption and positive work represents energy generation. The purpose of this study was to quantify and compare the mechanical work distribution across the hip, knee, and ankle joints during running in individuals with ACLR, uninvolved limb, and healthy control group. METHODS: Twenty-two male recreational athletes with unilateral ACLR and 22 healthy-male controls ran overground at 3.3 m/s. We used 3-Dimensional motion-capture and force-plate data to calculate positive and negative mechanical work and the relative contributions of the ankle, knee, and hip joints during stance-phase of running. A mixed-design ANOVA followed by univariate ANOVAs was used to assess the effects of ACLR on the outcomes. RESULTS: ACLR limb demonstrated significantly less negative and positive work at the knee compared to the uninvolved and control limbs (pholm < 0.05). This deficit was compensated for by significantly greater negative work at the hip (pholm = 0.018 vs. uninvolved) and significantly greater positive work at the ankle (pholm < 0.001 vs. uninvolved;pholm = 0.005 vs. control). CONCLUSION: The relative contributions of the joints to total work reflected these changes, showing a shift in mechanical load away from the knee and onto the hip and ankle. Individuals with a history of ACLR exhibit significant redistribution of mechanical work during running, characterized by a knee-unloading strategy compensated for by increased hip absorption and ankle propulsion. This pattern highlights the need for whole-limb function-based rehabilitation that extends beyond isolated-knee recovery.