等速肌力训练联合早期功能锻炼对膝关节交叉韧带重建术后关节功能的影响
简介
该回顾性队列研究经倾向性评分匹配后纳入252例交叉韧带重建患者，比较术后第4周开始的等速肌力训练联合早期功能锻炼与单纯早期功能锻炼的效果。结果显示，联合训练组在术后8、12、24周时的IKDC及KOOS评分均显著高于对照组，且关节活动度、伸屈肌峰力矩和腘绳肌/股四头肌比值改善更优。提示等速肌力训练联合早期功能锻炼可更有效地促进韧带重建术后的关节功能与肌力恢复…
英文摘要
AIM: The purpose of this study was to evaluate and analyze the influence of isokinetic muscle strength training combined with early functional exercise on joint function after knee cruciate ligament reconstruction. METHODS: A total of 294 patients undergoing knee cruciate ligament reconstruction from January 2023 to June 2025 were retrospectively selected. Based on different exercise methods, 155 patients who received early functional exercise for 24 weeks were included in a control group (CG), and the other 139 patients receiving isokinetic muscle strength training (starting from the 4th week after surgery) combined with early functional exercise were enrolled as an experimental group (EG). After propensity score matching (PSM), 252 patients were retained for analysis, including 126 cases in the EG and 126 cases in the CG. The primary clinical outcomes encompassed International Knee Documentation Committee Subjective Knee Form (IKDCSKF) and Knee Injury and Osteoarthritis Outcome Score (KOOS) before training (T0) and at 8 weeks (T1), 12 weeks (T2) and 24 weeks (T3) after surgery, and the secondary outcomes included joint range of motion (ROM) and isokinetic muscle strength test results involving extensor peak torque (EPT), flexor peak torque (FPT) and hamstrings/quadriceps (H/Q). RESULTS: Repeated measures analysis of variance (ANOVA) revealed significant group × time interaction effects for both IKDCSKF and KOOS scores (both p < 0.001), indicating different improvement trajectories between the two groups. Significant time effects and group effects were also observed for both outcomes (both p < 0.001). Post hoc analysis with Bonferroni correction demonstrated that the EG group had significantly higher IKDCSKF and KOOS scores than the CG group at T1, T2, and T3 (p < 0.05 or p < 0.001), with more pronounced differences observed at T2 and T3 (all p < 0.001). At T3, EG had higher ROM, EPT, FPT and H/Q than CG (p < 0.001, p < 0.001, p < 0.001, p = 0.001). No significant difference was found in the proportion of patients with normal H/Q between the two groups (χ2 = 0.06, p = 0.798). The β (95% CI) for EG on IKDCSKF score was 4.35 (2.82~5.87), and the β (95% CI) on KOOS score was 5.22 (3.91~6.53). CONCLUSIONS: Isokinetic muscle strength training combined with early functional exercise was associated with greater improvement in joint function and knee flexor and extensor muscle strength in patients undergoing knee cruciate ligament reconstruction. In addition, the intervention protocol may be independently associated with the patient's joint function.