前交叉韧带重建术后股四头肌力量：无力机制与循证康复策略
简介
这篇叙述性综述总结ACL损伤及重建后股四头肌无力的机制与康复证据，指出无力涉及肌肉、神经、手术和康复相关因素，并非仅由肌肉萎缩所致；即使关节稳定性恢复，股四头肌无力仍可持续，并延迟功能恢复、降低重返运动的准备度。文中主张评估应整合临床检查、客观等长或等速力量测试、发力率、功能表现、动作质量、影像检查以及患者报告和心理测量。康复从术前开始并延续至术后，重点包括…
英文摘要
Impairment of quadriceps strength is a frequent and clinically important problem after anterior cruciate ligament (ACL) injury and reconstruction. This dysfunction reflects muscular, neural, surgical, and rehabilitation-related mechanisms and is not solely attributable to muscle atrophy. Despite restoration of joint stability, quadriceps weakness can persist and contribute to delayed functional recovery and reduced readiness to return to sport. A comprehensive assessment should integrate clinical examination, objective isometric or isokinetic strength testing, rate of force development, functional performance, quality of movement, imaging investigations, and patient-reported and psychological measures. Rehabilitation should be initiated preoperatively and continue postoperatively with a focus on control of effusion and restoration of extension, early quadriceps activation, progressive resistance exercise, appropriate open-chain loading followed by eccentric, plyometric, and sport-specific training. Neuromuscular electrical stimulation has supportive evidence as an adjunct, and blood-flow restriction training may be useful when higher loads may not yet be tolerated. This narrative review summarizes current evidence on the mechanisms and rehabilitation of quadriceps weakness after ACL injury and ACL reconstruction, highlighting clinically relevant strategies for restoring strength and neuromuscular function.