前交叉韧带重建术后膝外翻本体感觉、肌肉活动、患者报告结局和动态平衡控制：一项横断面病例对照研究
简介
本研究纳入32例ACL重建患者与31例健康对照，采用负重位膝外翻判别任务（Knee-VEDA）评估本体感觉，并同步采集下肢7块肌肉的sEMG。结果显示该工具信度（ICC=0.84）和判别效度（AUC=0.835）可接受，ACL重建侧本体感觉显著差于健侧及对照组，且Knee-VEDA评分与Y-Balance及KOOS评分相关，但两组肌肉活动无显著差异。Knee…
英文摘要
BACKGROUND: Proprioceptive deficits following anterior cruciate ligament reconstruction (ACLR) are commonly assessed using sagittal-plane, nonweight-bearing tasks that may not reflect the demands of functional activities. This study evaluated the test-retest reliability and discriminative validity of a weight-bearing knee valgus discrimination task (Knee-VEDA) and compared proprioceptive acuity, muscle activity, dynamic balance, and patient-reported outcomes between individuals with ACLR and healthy controls. METHODS: Sixty-three participants (32 ACLR, 31 controls) performed the Knee-VEDA with concurrent surface electromyography (sEMG) of seven lower-limb muscles. Test-retest reliability was assessed. Dynamic balance and patient-reported outcomes were evaluated using the Y-Balance Test, International Knee Documentation Committee (IKDC) form, and Knee injury and Osteoarthritis Outcome Score (KOOS). RESULTS: The Knee-VEDA demonstrated acceptable-to-good test-retest reliability (ACLR ICC = 0.84; controls ICC = 0.64) and acceptable discriminative validity (AUC = 0.835, p < 0.001). The ACLR group exhibited significantly poorer proprioception in the operated limb compared with their intact limb and controls (p < 0.001). sEMG analysis revealed not statistically significant between-group differences in lower-limb muscle activity. ACLR participants also demonstrated inferior Y-Balance performance compared with controls (p = 0.02). In the ACLR group, better Knee-VEDA scores correlated with better Y-Balance (r = 0.50, p < 0.001), and better KOOS symptoms scores (r = 0.55, p = 0.001). CONCLUSIONS: The Knee-VEDA may be a useful tool for assessing weight-bearing knee proprioception after ACLR, showing acceptable test-retest reliability and discriminative validity. After ACL reconstruction, operated-limb proprioceptive acuity was found to be reduced during the valgus task. Further validation is needed before clinical application.