膝前十字靭帯再建術後の片脚着地動作，動的バランス，下肢筋力の非対称性に対する予防介入の効果
〔目的〕膝前十字靭帯再建術後（ACLR）の若年女性選手の片脚着地動作，動的バランス，下肢筋力の患側と健側の非対称性が，予防介入によって改善するか検証した．〔対象と方法〕ACLR後に予防リハビリテーションを行ってスポーツ復帰した女性12名とした．復帰時に片脚着地動作での膝外反・屈曲角，Modified star excursion balance test（以下，M-SEBT），下肢筋力（膝伸展・屈曲，股外転・外旋）の測定を行った．各項目の患側と健側の差を比較し，Limb symmetry index（LSI）を算出した．〔結果〕膝外反・屈曲角とM-SEBTに患健差はなかった．下肢筋力のLSIは...
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| Published in | Rigaku ryoho kagaku Vol. 33; no. 1; pp. 109 - 115 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Tokyo
理学療法科学学会
01.01.2018
Japan Science and Technology Agency |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1341-1667 2434-2807 |
| DOI | 10.1589/rika.33.109 |
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| Abstract | 〔目的〕膝前十字靭帯再建術後（ACLR）の若年女性選手の片脚着地動作，動的バランス，下肢筋力の患側と健側の非対称性が，予防介入によって改善するか検証した．〔対象と方法〕ACLR後に予防リハビリテーションを行ってスポーツ復帰した女性12名とした．復帰時に片脚着地動作での膝外反・屈曲角，Modified star excursion balance test（以下，M-SEBT），下肢筋力（膝伸展・屈曲，股外転・外旋）の測定を行った．各項目の患側と健側の差を比較し，Limb symmetry index（LSI）を算出した．〔結果〕膝外反・屈曲角とM-SEBTに患健差はなかった．下肢筋力のLSIはすべて90％以上だった．〔結語〕この予防介入によって，患側と健側の非対称性は改善すると考えられた． |
|---|---|
| AbstractList | 〔目的〕膝前十字靭帯再建術後（ACLR）の若年女性選手の片脚着地動作，動的バランス，下肢筋力の患側と健側の非対称性が，予防介入によって改善するか検証した．〔対象と方法〕ACLR後に予防リハビリテーションを行ってスポーツ復帰した女性12名とした．復帰時に片脚着地動作での膝外反・屈曲角，Modified star excursion balance test（以下，M-SEBT），下肢筋力（膝伸展・屈曲，股外転・外旋）の測定を行った．各項目の患側と健側の差を比較し，Limb symmetry index（LSI）を算出した．〔結果〕膝外反・屈曲角とM-SEBTに患健差はなかった．下肢筋力のLSIはすべて90％以上だった．〔結語〕この予防介入によって，患側と健側の非対称性は改善すると考えられた． [Purpose] The purpose of this study was to examine whether preventive rehabilitation improves the asymmetry between the involved side and the uninvolved side of single-leg landing, dynamic balance, and lower limb muscular strength of young female athletes after anterior cruciate ligament reconstruction (ACLR). [Subjects and Methods] The subjects were twelve young females who returned to sports after preventive rehabilitation after ACLR. Two-dimensional analyses of single-leg landing and lower limb muscular strength (knee extension/flexion, hip abduction/external rotation), and the modified star excursion balance test (M-SEBT) were performed at the time of the return. The difference between the involved side and the uninvolved side of each measure was compared, and the limb symmetry index (LSI) was calculated. [Results] There were no differences in knee valgus and flexion angle in single-leg landing, and in the M-SEBT. LSI of lower limb muscular strength was over 90%. [Conclusion] The asymmetry between the involved side and the uninvolved side was improved by preventive rehabilitation. 要旨: 〔目的〕膝前十字靭帯再建術後(ACLR)の若年女性選手の片脚着地動作, 動的バランス, 下肢筋力の患側と健側の非対称性が, 予防介入によって改善するか検証した. 〔対象と方法〕ACLR後に予防リハビリテーションを行ってスポーツ復帰した女性12名とした. 復帰時に片脚着地動作での膝外反・屈曲角, Modified star excursion balance test (以下, M-SEBT), 下肢筋力(膝伸展・屈曲, 股外転・外旋)の測定を行った. 各項目の患側と健側の差を比較し, Limb symmetry index (LSI) を算出した. 〔結果〕膝外反・屈曲角とM-SEBTに患健差はなかった. 下肢筋力のLSIはすべて90%以上だった. 〔結語〕この予防介入によって, 患側と健側の非対称性は改善すると考えられた. |
| Author | 広瀬, 統一 大見, 頼一 井上, 拓海 井上, 瑞穂 栗原, 智久 関, 大輔 加藤, 宗規 |
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| References | 10) 古賀英之：膝靱帯損傷の受傷機転に対するビデオ分析．MB Med Reha, 2013, 154: 13-20. 21) Ithurburn MP, Paterno MV, Ford KR, et al.: Young athletes with quadriceps femoris strength asymmetry at return to sport after anterior cruciate ligament reconstruction demonstrate asymmetric single-leg drop-landing mechanics. Am J Sports Med, 2015, 43: 2727-2737. 23) Hewett TE, Myer GD, Ford KR, et al.: Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med, 2005, 33: 492-501. 16) Aramaki H, Katoh M, Hiiragi Y, et al.: Validity and reliability of isometric muscle strength measurements of hip abduction and abduction with external hip rotation in a bent-hip position using a handheld dynamometer with a belt. J Phys Ther Sci, 2016, 28: 2123-2127. 20) Ithurburn MP, Paterno MV, Ford KR, et al.: Young athletes after anterior cruciate ligament reconstruction with single-leg landing asymmetries at the time of return to sport demonstrate decreased knee function 2 years later. Am J Sports Med, 2017, 45: 2604-2613. 19) 栗原智久，大見頼一，川島達宏・他：大学女子選手とトップレベル女子選手の股関節周囲筋筋力について～膝前十字靭帯再建術後の股関節周囲筋筋力の指標作成を目的として～．日本臨床スポーツ医学会誌，2015, 23: 5246. 25) Malloy PJ, Morgan AM, Meinerz CM, et al.: Hip external rotator strength is associated with better dynamic control of the lower extremity during landing tasks. J Strength Cond Res, 2016, 30: 282-291. 28) 井上拓海，関 大輔，大見頼一・他：Modified Star Excursion Balance Testを用いた膝前十字靭帯再建術後の動的バランス能力の検討．日本臨床スポーツ医学会誌，2016, 24: 5195. 3) Orishimo KF, Kremenic IJ, Mullaney MJ, et al.: Adaptations in single-leg hop biomechanics following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2010, 18: 1587-1593. 5) Delahunt E, Chawke M, Kelleher J, et al.: Lower limb kinematics and dynamic postural stability in anterior cruciate ligament-reconstructed female athletes. J Athl Train, 2013, 48: 172-185. 26) Devita P, Skelly WA: Effect of landing stiffness on joint kinetics and energetics in the lower extremity. Med Sci Sports Exerc, 1992, 24: 108-115. 24) Jacobs CA, Uhl TL, Mattacola CG, et al.: Hip abductor function and lower extremity landing kinematics: sex differences. J Athl Train, 2007, 42: 76-83. 12) 野口 恵，大見頼一，尹 成祚・他：大学女子バスケットボール選手における膝前十字靭帯損傷予防トレーニングが片脚着地動作に与える影響．日本臨床スポーツ医学会誌，2013, 21: 180. 22) Kvist J: Rehabilitation following anterior cruciate ligament injury: current recommendations for sports participation. Sports Med, 2004, 34: 269-280. 2) Paterno MV, Schmitt LC, Ford KR, et al.: Biomechanical measures during landing and postural stability predict second anterior cruciate ligament injury after anterior cruciate ligament reconstruction and return to sport. Am J Sports Med, 2010, 38: 1968-1978. 13) 大見頼一，尹 成祚，長妻香織・他：膝前十字靭帯損傷予防プログラムのトレーニング効果～三次元動作解析による片脚着地動作と下肢筋力評価～．日本臨床スポーツ医学会誌，2012, 20: 56-65. 17) 金子雅志，大見頼一，尹 成祚・他：大腿骨前捻角が片脚着地時の膝外反角度に与える影響：二次元解析法を用いて．日本臨床スポーツ医学会誌，2015, 23: 50-57. 18) 関 大輔，井上拓海，大見頼一・他：Star Excursion Balance Testを用いた膝前十字靭帯損傷者の動的バランス能力の検討．日本臨床スポーツ医学会誌，2015, 23: 5185. 15) Herrington L, Hatcher J, Hatcher A, et al.: A comparison of Star Excursion Balance Test reach distances between ACL deficient patients and asymptomatic controls. Knee, 2009, 16: 149-152. 6) Hewett TE, Di Stasi SL, Myer GD: Current concepts for injury prevention in athletes after anterior cruciate ligament reconstruction. Am J Sports Med, 2013, 41: 216-224. 4) Paterno MV, Ford KR, Myer GD, et al.: Limb asymmetries in landing and jumping 2 years following anterior cruciate ligament reconstruction. Clin J Sport Med, 2007, 17: 258–262. 8) Sugimoto D, Myer GD, Foss KD, et al.: Specific exercise effects of preventive neuromuscular training intervention on anterior cruciate ligament injury risk reduction in young females: meta-analysis and subgroup analysis. Br J Sports Med, 2015, 49: 282-289. 9) Bahr R, Krosshaug T: Understanding injury mechanisms: a key component of preventing injuries in sport. Br J Sports Med, 2005, 39: 324-329. 11) 大見頼一，川島達宏，栗山節郎：バスケットボールにおけるACL損傷予防の取り組みと成果．臨床スポーツ医学，2014, 31: 1036-1042. 14) Koga H, Nakamae A, Shima Y, et al.: Mechanisms for noncontact anterior cruciate ligament injuries: knee joint kinematics in 10 injury situations from female team handball and basketball. Am J Sports Med, 2010, 38: 2218-2225. 7) Schmitt LC, Paterno MV, Hewett TE: The impact of quadriceps femoris strength asymmetry on functional performance at return to sport following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther, 2012, 42: 750-759. 27) Risberg MA, Holm I, Myklebust G, et al.: Neuromuscular training versus strength training during first 6 months after anterior cruciate ligament reconstruction: a randomized clinical trial. Phys Ther, 2007, 87: 737-750. 1) Wiggins AJ, Grandhi RK, Schneider DK, et al.: Risk of secondary injury in younger athletes after anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Am J Sports Med, 2016, 44: 1861-1876. |
| References_xml | – reference: 6) Hewett TE, Di Stasi SL, Myer GD: Current concepts for injury prevention in athletes after anterior cruciate ligament reconstruction. Am J Sports Med, 2013, 41: 216-224. – reference: 21) Ithurburn MP, Paterno MV, Ford KR, et al.: Young athletes with quadriceps femoris strength asymmetry at return to sport after anterior cruciate ligament reconstruction demonstrate asymmetric single-leg drop-landing mechanics. Am J Sports Med, 2015, 43: 2727-2737. – reference: 12) 野口 恵，大見頼一，尹 成祚・他：大学女子バスケットボール選手における膝前十字靭帯損傷予防トレーニングが片脚着地動作に与える影響．日本臨床スポーツ医学会誌，2013, 21: 180. – reference: 22) Kvist J: Rehabilitation following anterior cruciate ligament injury: current recommendations for sports participation. Sports Med, 2004, 34: 269-280. – reference: 8) Sugimoto D, Myer GD, Foss KD, et al.: Specific exercise effects of preventive neuromuscular training intervention on anterior cruciate ligament injury risk reduction in young females: meta-analysis and subgroup analysis. Br J Sports Med, 2015, 49: 282-289. – reference: 4) Paterno MV, Ford KR, Myer GD, et al.: Limb asymmetries in landing and jumping 2 years following anterior cruciate ligament reconstruction. Clin J Sport Med, 2007, 17: 258–262. – reference: 27) Risberg MA, Holm I, Myklebust G, et al.: Neuromuscular training versus strength training during first 6 months after anterior cruciate ligament reconstruction: a randomized clinical trial. Phys Ther, 2007, 87: 737-750. – reference: 9) Bahr R, Krosshaug T: Understanding injury mechanisms: a key component of preventing injuries in sport. Br J Sports Med, 2005, 39: 324-329. – reference: 18) 関 大輔，井上拓海，大見頼一・他：Star Excursion Balance Testを用いた膝前十字靭帯損傷者の動的バランス能力の検討．日本臨床スポーツ医学会誌，2015, 23: 5185. – reference: 20) Ithurburn MP, Paterno MV, Ford KR, et al.: Young athletes after anterior cruciate ligament reconstruction with single-leg landing asymmetries at the time of return to sport demonstrate decreased knee function 2 years later. Am J Sports Med, 2017, 45: 2604-2613. – reference: 7) Schmitt LC, Paterno MV, Hewett TE: The impact of quadriceps femoris strength asymmetry on functional performance at return to sport following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther, 2012, 42: 750-759. – reference: 17) 金子雅志，大見頼一，尹 成祚・他：大腿骨前捻角が片脚着地時の膝外反角度に与える影響：二次元解析法を用いて．日本臨床スポーツ医学会誌，2015, 23: 50-57. – reference: 16) Aramaki H, Katoh M, Hiiragi Y, et al.: Validity and reliability of isometric muscle strength measurements of hip abduction and abduction with external hip rotation in a bent-hip position using a handheld dynamometer with a belt. J Phys Ther Sci, 2016, 28: 2123-2127. – reference: 26) Devita P, Skelly WA: Effect of landing stiffness on joint kinetics and energetics in the lower extremity. Med Sci Sports Exerc, 1992, 24: 108-115. – reference: 10) 古賀英之：膝靱帯損傷の受傷機転に対するビデオ分析．MB Med Reha, 2013, 154: 13-20. – reference: 19) 栗原智久，大見頼一，川島達宏・他：大学女子選手とトップレベル女子選手の股関節周囲筋筋力について～膝前十字靭帯再建術後の股関節周囲筋筋力の指標作成を目的として～．日本臨床スポーツ医学会誌，2015, 23: 5246. – reference: 28) 井上拓海，関 大輔，大見頼一・他：Modified Star Excursion Balance Testを用いた膝前十字靭帯再建術後の動的バランス能力の検討．日本臨床スポーツ医学会誌，2016, 24: 5195. – reference: 5) Delahunt E, Chawke M, Kelleher J, et al.: Lower limb kinematics and dynamic postural stability in anterior cruciate ligament-reconstructed female athletes. J Athl Train, 2013, 48: 172-185. – reference: 13) 大見頼一，尹 成祚，長妻香織・他：膝前十字靭帯損傷予防プログラムのトレーニング効果～三次元動作解析による片脚着地動作と下肢筋力評価～．日本臨床スポーツ医学会誌，2012, 20: 56-65. – reference: 1) Wiggins AJ, Grandhi RK, Schneider DK, et al.: Risk of secondary injury in younger athletes after anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Am J Sports Med, 2016, 44: 1861-1876. – reference: 11) 大見頼一，川島達宏，栗山節郎：バスケットボールにおけるACL損傷予防の取り組みと成果．臨床スポーツ医学，2014, 31: 1036-1042. – reference: 14) Koga H, Nakamae A, Shima Y, et al.: Mechanisms for noncontact anterior cruciate ligament injuries: knee joint kinematics in 10 injury situations from female team handball and basketball. Am J Sports Med, 2010, 38: 2218-2225. – reference: 2) Paterno MV, Schmitt LC, Ford KR, et al.: Biomechanical measures during landing and postural stability predict second anterior cruciate ligament injury after anterior cruciate ligament reconstruction and return to sport. Am J Sports Med, 2010, 38: 1968-1978. – reference: 25) Malloy PJ, Morgan AM, Meinerz CM, et al.: Hip external rotator strength is associated with better dynamic control of the lower extremity during landing tasks. J Strength Cond Res, 2016, 30: 282-291. – reference: 24) Jacobs CA, Uhl TL, Mattacola CG, et al.: Hip abductor function and lower extremity landing kinematics: sex differences. J Athl Train, 2007, 42: 76-83. – reference: 23) Hewett TE, Myer GD, Ford KR, et al.: Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med, 2005, 33: 492-501. – reference: 3) Orishimo KF, Kremenic IJ, Mullaney MJ, et al.: Adaptations in single-leg hop biomechanics following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2010, 18: 1587-1593. – reference: 15) Herrington L, Hatcher J, Hatcher A, et al.: A comparison of Star Excursion Balance Test reach distances between ACL deficient patients and asymptomatic controls. Knee, 2009, 16: 149-152. |
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| Snippet | 〔目的〕膝前十字靭帯再建術後（ACLR）の若年女性選手の片脚着地動作，動的バランス，下肢筋力の患側と健側の非対称性が，予防介入によって改善するか検証した．〔対象と方... 要旨: 〔目的〕膝前十字靭帯再建術後(ACLR)の若年女性選手の片脚着地動作, 動的バランス, 下肢筋力の患側と健側の非対称性が, 予防介入によって改善するか検証した. 〔対象と... [Purpose] The purpose of this study was to examine whether preventive rehabilitation improves the asymmetry between the involved side and the uninvolved side... |
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| Title | 膝前十字靭帯再建術後の片脚着地動作，動的バランス，下肢筋力の非対称性に対する予防介入の効果 |
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