膝關節貼紮對前十字韌帶缺損者側向跳躍矢狀面落地運動力學的影響

The influence of knee taping on the sagittal landing mechanics during side hops in anterior cruciate ligament deficient individuals

緒論：前十字韌帶貼紮在臨床上被廣泛使用於提供受傷後的關節穩定，預防再次受傷，但是前十字韌帶貼紮對下肢對於緩衝地面反作用力能力的影響，與改善前十字韌帶缺損者的高受傷風險的代償落地模式的效果尚須釐清。因此本研究的目的為探討前十字韌帶貼紮對於前十字韌帶缺損者在功能性側向跳躍（side hops）落地時運動學與動力學的影響。方法：實驗參與者為17名前十字韌帶缺損者（年齡24.65±6.32歲、身高167.97±9.51公分與體重68.50±13.63公斤），實驗參與者在前十字韌帶貼紮前後分別進行側向跳躍測試，利用Vicon動作分析系統（200Hz）、Kistler測力板（1000Hz）同步收集側向跳躍落地期間的髖、膝和踝關節矢狀面角度、垂直下肢勁度、與落地後100毫秒內的矢狀面膝關節力矩和地面反作用力。統計方式以成對樣本t檢定進行統計檢定。結果：本研究結果發現前十字韌帶貼紮前後，落地瞬間的膝關節角度與落地緩衝期的髖、膝和踝關節矢狀面角度範圍、垂直下肢勁度、落地後100毫秒內的矢狀面關節最大力矩、最大垂直和向後地面反作用力，與其出現的時間點與相應的膝關節屈曲角度，皆無顯著差異（p＞.05）。與貼紮前相比，貼紮後前十字韌帶缺損者，以較小的膝關節屈曲力矩落地（p＜.05）。結論：前十字韌帶貼紮並不會限制功能性跳躍落地時髖、膝和踝關節的矢狀面的運動學，也對垂直下肢勁度、最大受力與力矩與其出現的時間點和膝關節屈曲角度無負面影響。並且可以改善前十字韌帶缺損患者落地時的代償模式，以較小的膝關節屈曲力矩、較安全的方式落地。建議臨床工作者可使用前十字韌帶貼紮，協助前十字韌帶缺損運動員預防未來的下肢傷害。

Introduction: The anterior cruciate ligament (ACL) taping technique has been widely used clinically in sports to provide external support for improving joint stability and injury prevention following an ACL injury. However, the effects of ACL taping on shock absorption and landing mechanics for correcting compensatory landing strategies in ACL-deficient (ACLD) individuals were still unknown. Therefore, the purpose of this study was to investigate the effects of ACL taping on the landing kinematics and kinetics during side hops in ACLD individuals. Methods: Seventeen ACLD (Age: 24.65 ± 6.32 years, Height:167.97 ± 9.51cm, Mass: 68.50 ± 13.63 kg) participated in the study. Participants were instructed to perform side hops for 30 seconds during pre-taping and post-taping conditions. During side hops, their knees' kinematic and the kinetic data between initial contact and 100 milliseconds after initial contact were collected via a Vicon 3D motion analysis system (200 Hz) interfaced with two Kislter force plates (1000 Hz). Paired sample t-tests were utilized to analyze the statistical difference in each kinematics and kinetics variable between pre-taping and post-taping conditions with an alpha level of .05. Results: Compared to the pre-taping condition, ACLD individuals landed with a net smaller knee flexion moment at initial contact in the post-taping condition (p < .05). Knee flexion at initial contact, knee flexion excursion, peak vertical and posterior ground reaction forces and peak internal knee moment, the time to peak vertical and posterior ground reaction forces and peak internal knee moments, and the knee flexion angles at peak vertical and posterior ground reaction forces and peak internal knee moment were not significantly different between pre-taping and post-taping conditions (p > .05). Conclusion: ACL taping facilitated ACLD individuals in utilizing a safer landing strategy with respect to their ACL injury risk by landing with a smaller net knee flexion moment at initial contact during side hops. In addition, ACL taping did not restrict the shock absorption mechanism. Clinicians should consider employing the ACL taping technique for sequential lower extremity injury prevention in ACLD individuals.