Hartsell H D, Spaulding S J
Physical Therapy Graduate Program, University of Iowa, Iowa City 52242, USA.
Br J Sports Med. 1999 Aug;33(4):255-8. doi: 10.1136/bjsm.33.4.255.
The use of muscle balancing by the clinician to determine return to activity or discharge of a patient is not a well understood measure. Because of the lack of information on the poorly understood concept of eccentric/concentric (E/C) ratios at the ankle, the purpose was to determine the E/C ratios for the invertor and evertor muscles at various velocities in healthy and chronically unstable ankles.
Ten subjects with healthy ankles and 14 with chronically unstable ankles performed five maximal effort reciprocal eccentric/contraction contractions on an isokinetic dynamometer at four velocities (60, 120, 180, and 240 degrees/s) and for each physiological movement of inversion and eversion. Data were analysed using a two way mixed model analysis of variance with repeated measures, with Tukey's test used for post hoc analysis.
Although the chronically unstable ankle was significantly weaker (p < 0.05) eccentrically and concentrically for inversion and eversion, the main effect of the E/C ratios for the ankle was not significant for either joint motion. The main effect of velocity was significant (p < 0.05) for each joint motion, but no significant interaction effects were observed. As velocity increased, the E/C ratio increased, except at 180 and 240 degrees/s for either ankle group.
Chronic ankle instability and muscle weakness co-exist. Adequate E/C ratios in the chronically unstable ankle may exist in the absence of normal strength values.
临床医生利用肌肉平衡来确定患者恢复活动或出院的情况,这一措施尚未得到充分理解。由于对于踝关节离心/向心(E/C)比率这一理解不足的概念缺乏相关信息,本研究旨在确定健康和慢性不稳定踝关节在不同速度下内翻肌和外翻肌的E/C比率。
10名健康踝关节受试者和14名慢性不稳定踝关节受试者在等速测力计上以四种速度(60、120、180和240度/秒)进行五次最大努力的往复离心/收缩收缩,针对内翻和外翻的每个生理运动。数据采用重复测量的双向混合方差分析进行分析,事后分析采用Tukey检验。
尽管慢性不稳定踝关节在内翻和外翻时的离心和向心力量明显较弱(p < 0.05),但踝关节E/C比率对任何一个关节运动的主要影响均不显著。速度对每个关节运动的主要影响显著(p < 0.05),但未观察到显著的交互作用。随着速度增加,E/C比率增加,但在任一踝关节组中,180和240度/秒时除外。
慢性踝关节不稳定与肌肉无力并存。在慢性不稳定踝关节中,即使没有正常的力量值,也可能存在足够的E/C比率。