前交叉韧带重建术后康复中的运动控制：基于领域的系统综述与机制特异性效应的叙述性综合
简介
ACL重建术后运动控制障碍持续存在，提示传统康复未能解决潜在的神经认知和感觉运动机制。本研究系统综述了针对运动控制的康复干预，将其分为运动学习、神经肌肉训练、认知与双重任务、反馈干预和环境调节五个机制领域。纳入7项研究，发现各领域干预效果具有特异性：运动学习改善下肢运动学和动作表现，认知与双重任务影响生物力学和姿势控制，神经肌肉训练提升本体感觉，反馈和环境干…
英文摘要
BACKGROUND: Persistent deficits in motor control following anterior cruciate ligament reconstruction suggest that conventional rehabilitation approaches fail to address underlying neurocognitive and sensorimotor mechanisms. However, how different rehabilitation strategies influence these mechanisms remains unclear. METHODS: A systematic review with narrative synthesis was conducted in accordance with PRISMA guidelines. Studies evaluating motor control targeted rehabilitation interventions in anterior cruciate ligament reconstruction or relevant populations were included. Interventions were classified into five domains based on their primary mechanisms: motor learning, neuromuscular training, cognitive and dual task approaches, feedback based interventions, and environment mediated strategies. Outcomes were synthesized across biomechanical, sensorimotor, and functional domains. RESULTS: Seven studies were included. Interventions demonstrated domain specific effects, with no single approach producing consistent improvements across all outcomes. Motor learning interventions improved movement performance and lower extremity kinematics, while cognitive and dual task approaches influenced both biomechanical and postural control outcomes. Neuromuscular training improved proprioception, whereas feedback based and environment mediated interventions showed more context specific effects. Improvements in objective outcomes were not consistently associated with patient reported measures. CONCLUSION: Motor control rehabilitation following anterior cruciate ligament reconstruction is mechanism dependent rather than intervention dependent. A domain-based framework provides a structured basis for aligning rehabilitation strategies with specific functional targets and may enhance the precision and effectiveness of rehabilitation.