Correlation Study Between SEMG And Return To Play Indicators In Patients After ACLR

Objective:In this study,the ACL reconstruction(ACLR)patients —— hip bridge,lunge,squat,Y-balance,step-down and RTP test results were compared with the healthy group,and the contrast of the affected and healthy side within the ACLR group,to explore the differences in knee motor function indicators and EMG signals in patients and healthy people after ACLR.And the RTP related test index and the EMG results,to explore the relationship between muscle activation and RTP in patients after ACLR,clinical guidance for the patient RTP after ACLR,and provide data reference and theoretical support.Methods:A total of 15 patients after ACLR(from 6 months to 12 months)and 15 healthy adults were included,serving as ACLR group and healthy controls,respectively,for a series of RTP indicators and EMG signals,each group only once.Pre-injury and current motor performance were first scored for the ACLR and healthy control groups using the Tegner scale,and those with 7 or above were enrolled.After both groups of surface EMG test and RTP index test,and record the two groups,the surface EMG signal is rectus femoris(RF),medius(VM),lateral vastus(VL),biceps(BF),tendon(ST),analyze the root square amplitude of each muscle(RMS),each movement of RMS of each muscle under the movement,and calculate the common contraction rate of active muscle and antagonistic muscle(each action of CCI).For the measurement of RTP indicators,the ACLR group used the Lysholm and IKDC scales to assess knee function;the ACL-RSI,psychological assessment;the hop-test series to quantitatively assess the motor capacity and the function of both lower limbs of patients;the Y-balance test to quantitatively assess the stability,balance and proprioception of both lower limbs;the healthy control group only performed hop-test test and Y-balance test without scale assessment.Result:1.For the variability in the motor function testsBetween the ACLR group and healthy controls:(1)Y-balance test: posterior medial direction(PMD)distance(p=0.006,CI=-0.303,-0.054,d=1.074),posterior laterial direction(PLD)distance(p=0.001,CI=-0.068,-0.083,d=1.421)and total score(p=0.003,CI=-0.237,-0.054,-1.188,d=-1.188).(2)The results of the up-down test(p=0.033,Z=-2.137)were statistically different,and the ACLR group was better than the healthy control group.(3)The scores of Figure 8 hop test(p=0.001,Z=-3.153)were extremely significant,and the ACLR group was better than the healthy control group.The uninjured side of the ACLR group and healthy controls advantage side:(1)Ybalance test: posterior laterial direction(PLD)(p=0.000,CI=0.954,1.065,d=1.209),posterior medial direction(PMD)distance(p=0.000,CI=0.931,1.088,d=1.049),Y-balance total score(p=0.000,CI=0.878,0.972,d=1.065)were also extremely significant.(2)The performance of the up-down test was statistically different(p=0.021,Z=-2.303).(3)The Figure 8 hop test score was significantly different(p=0.004,Z=-2.821),and the ACLR group was better than the control group.Group comparison between the ACLR group and healthy controls:(1)the Carioca test(p=0.005,CI=2.228,10.426,d=1.199),and the ACLR group was better than the control group.(2)The results of the return run test(p=0.000,CI=1.323,3.498,d=1.658)were statistically different,and the ACLR group was better than the control group.2.For the variability of the surface EMG signalsThe difference between the ACLR group:(1)Y-balance test: The root mean square amplitude(RMS)difference of VL at PMD was statistically significant(p=0.037,Z=2.095).(2)The difference in RMS and RMS proportion of VL during squatting was statistically significant(p=0.037,CI=-0.140,-0.005,d=0.798),(p=0.020,CI=-0.179,-0.016,d=0.899).The uninjuried side side of the ACLR group and healthy controls:(1)Y-balance test:the difference in the RMS proportion of RF at anterior direction(AD)was significant(p=0.029,Z=2.178),and the difference in the proportion of RF at PLD was significant(p=0.019,Z=2.344).(2)The proportion of RMS of VM at step-down was statistically different(p=0.016,Z=-2.385),and the ACLR group was better than the control group.ACLR group:(1)hip bridge: the RMS proportion of RF was statistically different(p=0.045,Z=-2.012),and the RMS proportion of RF on the affected side was larger,but there was no significant difference in RMS.(2)lunge RMS(RF: p=0.019,Z=-2.344;ST:p=0.041,Z=-2.053)was statistically different,and the signal on the affected side was stronger than that of the healthy side.The proportion of lunge RMS(VL: p=0.028,CI=-0.254,-0.016,d=0.847)was also statistically different,with the healthy side more than the affected side.(3)Squat RMS(RF: p=0.045,Z=-0.850)was statistically different and the signal was stronger than the healthy side;squat RMS ratio(RF: p=0.001,CI=0.076,0.269,d=1.341;VL: p=0.020,CI=-0.194,-0.018,d=0.905)was also statistically different.VL accounted more for the healthy side than the affected side,but the affected side was more than the affected side.(4)In step-down,the RMS of ST(p=0.005,CI=0.008,0.042,d=1.121)showed significant difference,and the signal on the affected side was stronger than that of the healthy side.3.For the correlation of Y-balance test scores and EMG signalsPMD scores and the RMS ratio of BF(p=0.020,r=0.593),but not with RMS.The RMS of ST at p=0.028 in healthy controls(p = 0.028,ρ =-0.564)produced a negative correlation with AD performance.A moderate positive correlation between PLD scores and the proportion of RMS in VM(p=0.000,r=0.548).4.For hop-test test score correlation with the scaleThe lateral jump on the healthy side of the ACLR group was positively associated with the "risk" part of the ACL-RSI(p=0.016,ρ =0.607).Conclusion:1.ACLR surgery has greater effects on VL and ST on the affected side: after ACLR,the affected side VL decreased,the healthy side RF decreased in the quadriceps muscle,and the healthy side ST decreased in the hamstring muscle than the affected side,resulting in reduced dynamic postural control,especially the balance of the lateral and forward movements.BF and VM also play an important role in maintaining the balance of forward and lateral movement in health conditions.The higher the activation ratio of these two muscles is,the stronger the dynamic postural control ability is.2.Due to the protective compensatory mechanism generated after ACLR and the focus on the affected side practice,the risk of healthy side injury will be increased,and the exercise performance is better than that of healthy people.3.Lateral jumping ability can enhance patient confidence in RTP and reduce concerns about reinjury.