ACL重建后重返运动人群落地任务中肌肉激活模式持续改变：肌电研究的系统综述与Meta分析
简介
该系统综述/Meta分析纳入32项肌电研究，比较556例重返运动的ACLR患者与501名健康对照的落地肌肉激活。多数无差异或证据有限；中等证据显示单腿落地反应期内侧腘绳肌、臀大肌激活增高，单腿跳远时股直肌激活更早。ACLR后重返运动者存在任务特异性激活改变，单腿落地更易检出，临床意义待明确。
英文摘要
PURPOSE: To categorize landing tasks in electromyography (EMG) studies and compare muscle activity during landing between patients with anterior cruciate ligament reconstruction (ACLR) reported as having returned to sport and healthy controls. METHODS: We systematically searched seven databases (PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, SPORTDiscus) from inception to 10 December 2025. Studies using EMG to assess muscle activity during landing tasks were included when they compared the reconstructed limb of ACLR patients reported as having returned to sport with limbs from healthy controls. Random-effects meta-analyses evaluated between-group differences using standardized mean differences (SMDs) with 95% confidence intervals (CIs), with findings categorized using an internal evidence classification. RESULTS: Thirty-two studies were included, comprising 556 individuals with ACLR from return-to-sport cohorts and 501 healthy controls. Thirteen landing tasks were analysed, involving fifteen lower-limb muscles and four EMG outcome measures. Each pooled comparison included 2-5 studies. Three findings were classified as moderate evidence: greater activation of the medial hamstrings during the reactive phase of single-leg drop landing (based on five studies, SMD = 0.35, 95% CI [0.01, 0.69], I2 = 0%), greater gluteus maximus activation during the reactive phase of single-leg drop vertical jump (based on three studies, SMD = 0.63, 95% CI [0.22, 1.03], I2 = 0%) and earlier rectus femoris onset in single-leg hop for distance (based on three studies, SMD = -0.64, 95% CI [-1.13, -0.14], I2 = 19%). Most other findings showed no between-group differences or were classified as limited or very limited evidence. CONCLUSION: ACLR patients reported as having returned to sport may exhibit task-specific alterations in muscle activation patterns compared with healthy controls, and these alterations may be more readily detected during certain single-leg landing tasks. Further prospective and interventional studies are needed to clarify their clinical relevance. LEVEL OF EVIDENCE: Level IV.