Background

In the current study changes in lower-limb motor flexibility of patients undergoing Anterior Cruciate Ligament Reconstruction were evaluated in relation to fear of harm.

Methods

Fourteen patients were measured pre- and post-surgery, and data were compared to those of a single measurement in fifteen controls. Lower-limb motor-flexibility was assessed in treadmill-walking and a cyclic leg-amplitude differentiation task augmented with haptic or visual feedback. Flexibility was captured by determining the between-leg coordination-variability (SD of relative phase) and each leg's temporal variability (sample entropy). Patients were post hoc divided into a higher-fear-group (pre-surgery: n = 6, post-surgery: n = 7) and a lower-fear-group (pre-surgery: n = 6, post-surgery: n = 7) by means of a median split of their scores on a self-reported fear of harm scale. Differences in flexibility-measures between the higher-fear-group and the lower-fear-group were also assessed.

Findings

No pre- and post-surgery differences, nor differences with the control group, were found in motor-flexibility during treadmill-walking but the post-surgery higher-fear-group did show lower values of SD relative phase. In the leg-amplitude differentiation task the SD of the relative phase decreased but sample entropy increased post-surgery towards levels of the control-group. The pre-surgery higher-fear-group showed lower values of sample entropy in visual conditions.

Interpretation

While gait kinematics may not show motor-flexibility changes following anterior cruciate ligament reconstruction, a leg-amplitude differentiation task does show such changes. Differentiating patients on a fear-of-harm scale revealed subtle differences in motor-flexibility. Challenging patients with non-preferred movements such as amplitude differentiation may be a promising tool to evaluate motor-flexibility following ACLR.

中文翻译：

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前交叉韧带重建后运动灵活性的变化，通过具有触觉和视觉反馈的腿幅度微分任务测量

背景

在当前的研究中，评估了前交叉韧带重建患者下肢运动灵活性的变化，以评估其对伤害的恐惧程度。

方法

在手术前后对14例患者进行了测量，并与15例对照中的单次测量的数据进行了比较。在跑步机上行走时评估下肢的运动灵活性，并通过触觉或视觉反馈来增强循环腿幅度的分化任务。通过确定腿间协调可变性（相对相位的SD）和每条腿的时间可变性（样本熵）来捕获灵活性。患者被特设为高恐惧组（手术前：n  = 6，手术后：n = 7）和较低的恐惧组（手术前：n = 6，手术后：n = 7），根据自我报告的对伤害量表的恐惧程度，通过评分的中位数进行划分。还评估了较高恐惧组和较低恐惧组之间的灵活性测量方法差异。

发现

在跑步机行走过程中，运动灵活性没有发现手术前和手术后的差异，也没有与对照组的差异，但是手术后较高的恐惧组确实显示出较低的SD相对相位值。在腿部振幅微分任务中，手术后相对相的SD降低，但样本熵增加，达到对照组的水平。在视觉条件下，术前较高恐惧组的样本熵值较低。

解释

尽管步态运动学可能不会显示前十字韧带重建后的运动灵活性变化，但腿部幅度差异化任务确实会显示出这种变化。在对伤害的恐惧量表上进行区分的患者显示出运动灵活性的细微差别。挑战诸如幅度差异之类的非首选运动的患者可能是评估ACLR后运动灵活性的有前途的工具。