遵吾言而非行吾行：前交叉韧带重建术后临床医生重返跑步标准、首次跑步特征及跑步评估与文献比较——来自国际ACL康复会议的见解
简介
一项面向参加国际ACL康复大会的177名临床医生的横断面调查显示，ACL重建术后重返跑步决策标准与文献推荐存在明显差异：36%不使用患者报告结局指标，多数以肢体对称指数≥80%作为力量阈值，仅3%采集动力学数据评估跑步生物力学缺陷。作者提示，需在康复实践中引入更客观的动力学评估工具以优化重返跑步决策。
英文摘要
OBJECTIVES: To (1) explore clinician practices related to return-to-running (RTR) decision making, (2) define the characteristics of a first run after anterior cruciate ligament (ACL) reconstruction, and (3) examine the use of running assessment during rehabilitation. DESIGN: Cross-sectional survey study. METHODS: A 71-item online survey was distributed to clinicians who were attending the 2023 Aspetar International ACL Rehabilitation Conference. The survey covered patient-reported outcome measures (PROMs); time postsurgery; and clinical, strength, and functional criteria. Responses were compared to current recommendations from the literature. Data on the characteristics of a first run and the use of running assessment and variables measured were also collected. RESULTS: One hundred seventy-seven clinicians from 51 countries completed the survey. Of the 177 clinicians, many aligned with core clinical criteria (eg, full extension, minimal effusion), 64 (36%) did not use PROMs, 28 (16%) used the International Knee Documentation Committee Subjective Knee Form, most favored strength thresholds ≥80% limb symmetry index, 51 (29%) selected time postsurgery of 12-14 weeks, and 44 (25%) did not use a timeline as a criterion. The first run was typically described as a dynamic run lasting 5-10 minutes or covering 500-1000 m, reflecting the most selected responses across clinicians, at self-selected or controlled speeds of 8-10 km/h. Interval running was used by 90 clinicians (51%) for a first run. Running assessment was used by 102 clinicians (58%) during rehabilitation. Six clinicians (3%) collected kinetic data despite knee extension moments being the most common deficit reported in the literature. CONCLUSION: We found heterogeneity of compliance among ACL clinicians with RTR recommendations in the literature. Although over 50% of clinicians reported using running assessment, less than 5% used devices capable of measuring kinetics to detect the most reported biomechanical running deficits. JOSPT Open 2026;4(3):328-339. Epub 9 April 2026. doi:10.2519/josptopen.2026.0195.