ACL断裂患者下肢运动学的变化与步态代偿机制：一项横断面对照研究
简介
这项横断面研究纳入22例近期ACL断裂患者和18名健康人，佩戴17个惯性传感器在4 km/h跑台行走，比较双侧髋、膝、踝步态运动学。ACL断裂者出现双侧髋外旋和髋内收减少、双侧踝内旋减少，患侧最大膝屈曲低于健康对照和对侧，提示双侧步态代偿。临床评估与康复应兼顾双下肢，重点恢复功能性步态。
英文摘要
BACKGROUND: Anterior cruciate ligament (ACL) rupture is associated with knee instability and compensatory gait adaptations, which are relevant to rehabilitation planning. HYPOTHESIS: Patients with ACL rupture would show altered bilateral hip, knee, and ankle gait kinematics. STUDY DESIGN: Cross-sectional study. LEVEL OF EVIDENCE: Level 3. METHODS: A total of 40 participants were enrolled, including 22 patients with recent ACL ruptures and 18 healthy subjects. Participants walked on a treadmill at 4 km/h while wearing 17 inertial sensors. Ten normalized gait cycles were used to compare bilateral hip, knee, and ankle kinematics. RESULTS: Patients with ACL rupture demonstrated altered lower-extremity kinematics compared with healthy subjects. Hip external rotation was reduced bilaterally (P < 0.01), and hip adduction was reduced on both the affected (P < 0.05) and nonaffected (P < 0.01) sides. Maximum knee flexion was lower on the affected side than in healthy subjects (P < 0.01) and the nonaffected side (P < 0.05). Maximum ankle internal rotation was reduced bilaterally (affected side P < 0.05; nonaffected side P < 0.01), suggesting bilateral gait adaptations after ACL rupture. CONCLUSION: ACL rupture was associated with gait alterations involving both lower extremities, with bilateral hip and ankle kinematic changes and reduced maximum knee flexion mainly on the affected side. CLINICAL RELEVANCE: Recognition of bilateral kinematic changes after ACL rupture may help clinicians assess both limbs and guide rehabilitation focused on restoring functional gait patterns.