1.滨州医学院 康复医学院;2.滨州医学院附属医院 康复医学科;3.滨州医学院 医学人工智能研究院
目的 分析患者前交叉韧带重建(anterior cruciate ligament reconstruction, ACLR)术后早期与术后1年在视觉因素影响下足底压力中心面积(center of pressure area, COPA)和压力中心速度(center of pressure speed, COPS)等参数的变化。方法 纳入ACLR患者17例,于术后早期和术后1年测试足底COPA和COPS等数据；匹配17例健康受试者作为正常组。进行睁、闭眼不同视觉状态站立平衡测试,对各测量状态进行相关性分析。结果 ①健侧站立时各组间差异具有统计学意义(P＜0.05),伤侧站立时各组间差异无统计学意义(P＞0.05)；②在睁眼健足站立时,长期组COPA高于短期组和正常组(P＜0.01)；③在闭眼健足站立时,短期组和长期组COPA高于正常组(P＜0.01)；④正常组与短期组,正常组与长期组比较COPS,差异具有统计学意义(P＜0.01)；⑤双足站立时短期组睁眼时的COPA和COPS少于闭眼,差异有显著性意义(P＜0.05)；长期组睁眼时COPS少于闭眼,有统计学差异(P=0.000)；⑥双足睁眼与双足闭眼之间、双足睁眼与伤侧睁眼之间、健侧睁眼和伤侧睁眼之间、健侧闭眼和伤侧闭眼之间在COPA和COPS上均呈正相关。结论 通过对ACLR患者站立位压力中心相关数据的分析,发现视觉对姿势稳定控制有重要影响。患者术后1年后双足和单足站立时对比正常人稳定性波动较大,提示要加强术后长期训练以巩固康复效果。
Objective To analyse the changes in parameters such as center of pressure area (COPA) and center of pressure speed (COPS) between the early post-operative period and 1year after anterior cruciate ligament reconstruction (ACLR) in patients under the influence of visual factors. Methods 17 patients with ACLR were included and tested for data such as COPA and COPS in the early postoperative period and 1 year after surgery, and 17 healthy subjects were matched as the normal group. The standing balance test with different visual states of open and closed eyes was performed and correlation analysis was performed for each measurement state. Results ①The difference between the groups was statistically significant (P＜0.05) when standing on the healthy side, and the difference between the groups was not statistically significant (P＞0.05) when standing on the injured side. ②When standing with eyes open, COPA was higher in the long-trem group than in the short-time and normal group (P＜0.01). ③When standing with eyes closed on the healthy side, COPA was higher in the short-term and long-term groups than the normal group (P＜0.01). ④The difference was statistically significant when comparing COPS between the normal and short-term group, and between the normal and long-term group (P＜0.01). ⑤In double feet standing, the short-term group had less COPA and COPS with eyes open than with eyes closed, and the difference was statistically significant (P＜0.05). COPS was less in the long-term group with eyes open than with eyes closed, which was statistically different (P=0.000). ⑥Positive correlations were found between eye opening and closing on two feet standing, between injured side and two feet standing with eyes opening, between healthy side and injured side standing with eyes opening, and between healthy side and injured side standing with eyes closing on both COPA and COPS. Conclusion The analyze of data related to the center of pressure in the standing position in patients with ACLR revealed that vision has an important influence on postural stability control. Patients showed greater fluctuated in stability in double and single feet standing compared to normal people at 1 year postoperatively. It suggests to strengthen the patients long-term postoperative training to consolidate the rehabilitation effect.