视觉因素对前交叉韧带重建患者足底压力中心的影响
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国家自然科学基金项目(82171521)


Effects of Visual Factors on Plantar Center of Pressure in Patients with Anterior Cruciate Ligament Reconstruction
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    摘要:

    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 例健康受试者作为对照组。 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 双足站立测试时,短期组 COPA 和 COPS 在睁眼和闭眼对比均有统计学差异(P<0. 05);长期组 COPS 睁眼和闭眼对比有统计学差异(P<0. 001)。 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)。 健侧站立睁眼条件下,长期组 COPA 高于短期组和对照组,对照组 COPS 低于短期组和长期组(P<0. 01)。 健侧站立闭眼条件下,对照组 COPA 低于短期组和长期组,对照组 COPS 低于长期组(P<0. 01)。 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。 术后 1 年患者双足和单足站立时对比正常人稳定性波动较大,提示在临床上要加强术后长期训练以巩固康复效果,并对开展长期评估和制定精准训练计划具有一定的指导作用,以防止术后长时间功能退化和降低再次损伤的风险。

    Abstract:

    Objective To analyze the changes in parameters such as center of pressure area (COPA) and center of pressure speed (COPS) under the influence of visual factors in patients at early stage after anterior cruciate ligament reconstruction (ACLR) and 1 year after the surgery. Methods A total of 17 patients with ACLR were included and tested for data such as COPA and COPS in early postoperative period and 1 year after the surgery, and 17 healthy subjects were matched as control group. The standing balance test with different visual states of open and closed eyes was performed and correlation analysis was conducted for each measurement state. Results During the double-foot standing test, there were significantly difference in COPA and COPS between the eyes-open and eyes-closed states in short-term group (P<0. 05). There were statistically differences in COPS between the eyes-open and eyes-closed states in long-term group (P<0. 001). The difference between the groups was statistically significant during standing on the healthy side (P<0. 05), and the difference between the groups was not statistically significant during standing on the injured side (P<0. 05). During standing on the healthy side with eyes open, COPA was higher in long-term group than that in the short-term and control groups, and COPS was lower in control group than that in short-term and long-term groups (P<0. 01). During standing on the healthy side with eyes closed, COPA was lower in control group than that in short-term and long-term groups, and COPS was lower in control group than that in long-term group (P< 0. 01). Positive correlations in COPA and COPS were found between eyes-open and eyes-closed states during double-foot standing, between injured side and double-foot standing with eyes open, between healthy side and injured side during standing with eyes open, and between healthy side and injured side during standing with eyes closed. Conclusions The analysis on COP-related data for patients with ACLR in standing position indicates that the vision has an important influence on postural stability control. The patients at 1 year after ACLR surgery show greater fluctuation in stability during double-foot and single feet standing compared with normal people. In clinical practice, it is suggested that long-term postoperative training should be strengthened to consolidate the rehabilitation effect, which also has a certain guiding role in carrying out long-term assessments and developing precise training plans, so as to prevent prolonged functional deterioration and reduce the risk of reinjury after surgery.

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裴文斌,张 皓,王珊珊,吴熙芃,薛志东,李 伟.视觉因素对前交叉韧带重建患者足底压力中心的影响[J].医用生物力学,2023,38(6):1139-1145

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  • 收稿日期:2023-03-20
  • 最后修改日期:2023-04-12
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  • 在线发布日期: 2023-12-25
  • 出版日期: 2023-12-25
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