Hopkins J Ty, Palmieri Riann
Department of Physical Education, Brigham Young University, Provo, UT 84602-2070, USA.
Clin J Sport Med. 2004 Jan;14(1):1-7. doi: 10.1097/00042752-200401000-00001.
Inversion ankle sprains are among the most frequently encountered injuries in and outside of sport. Altered feedback from joint damage and/or edema may negatively affect dynamic stabilization, thereby increasing the patients' susceptibility to further injury. In order to understand better how the sensorimotor system responds to the presence of ankle edema during a functional task, further examination is warranted.
To quantify muscle activation in the peroneal, tibialis anterior, and soleus musculature as well as to determine ankle joint peak torque, peak power, and root mean square (RMS) power during a closed kinetic chain activity following artificial ankle effusion.
Dependent variables were compared within subjects across time intervals and between groups.
All data were collected in the biomechanics laboratory.
Subjects were 20 healthy, neurologically sound volunteers (age 21.9 +/- 2.1 y, height 174.5 +/- 9.3 cm, mass 79.3 +/- 15.9 kg) with no lower extremity injuries.
Subjects were prepared for surface electrodes on the peroneus longus (PL), tibialis anterior (TA), soleus (Sol), and medial malleolus (ground). Anthropometric measures for the lower extremity were recorded for use by the Omnikinetic closed chain dynamometer. Measurements were taken prior to ankle effusion (baseline), immediately following effusion (post), and again at 30 minutes.
Testing consisted of 6 repetitions at 35% of 1-repetition max and a constant speed of 1.5 Hz. Separate two-way MANOVAs with repeated measures on time intervals were used to detect differences between groups (effusion and control) over time for torque, power, and RMS power and for peak and average EMG.
An overall time x group interaction was detected for EMG (F4,72=3.878; P=0.007) and kinetic variables (F6,70=5.55; P=0.0001). Average and peak PL EMG decreased immediately following effusion (Sidak's; P=0.048), and average EMG remained depressed 30 minutes following effusion (Sidak's; P=0.02). Immediately posteffusion, a decrease in ankle torque was detected (Sidak's; P=0.007). No differences in TA or Sol EMG, power, or RMS power were detected (P>0.05).
Decreases in ankle plantarflexion torque and PL EMG indicate that a neuromuscular deficit exists in the presence of edema that could increase the susceptibility for further ankle injury.
内翻型踝关节扭伤是运动内外最常见的损伤之一。关节损伤和/或水肿引起的反馈改变可能会对动态稳定产生负面影响，从而增加患者再次受伤的易感性。为了更好地了解感觉运动系统在功能任务中对踝关节水肿的反应，有必要进行进一步检查。
量化腓骨肌、胫骨前肌和比目鱼肌的肌肉激活情况，并确定人工造成踝关节积液后在闭链活动期间的踝关节峰值扭矩、峰值功率和均方根（RMS）功率。
在受试者内跨时间间隔以及在组间比较因变量。
所有数据均在生物力学实验室收集。
受试者为20名健康、神经系统健全的志愿者（年龄21.9±2.1岁，身高174.5±9.3厘米，体重79.3±15.9千克），无下肢损伤。
为受试者准备好用于测量腓骨长肌（PL）、胫骨前肌（TA）、比目鱼肌（Sol）和内踝（接地）的表面电极。记录下肢的人体测量数据，供Omnikinetic闭链测力计使用。在踝关节积液前（基线）、积液后立即（术后）以及30分钟后再次进行测量。
测试包括以1次重复最大值的35%进行6次重复，速度恒定为1.5赫兹。使用具有时间间隔重复测量的独立双向多变量方差分析来检测组间（积液组和对照组）在扭矩、功率和RMS功率以及峰值和平均肌电图方面随时间的差异。
在肌电图方面检测到总体时间×组交互作用（F4,72 = 3.878；P = 0.007）以及动力学变量方面（F6,70 = 5.55；P = 0.0001）。积液后立即出现平均和峰值PL肌电图下降（西德克检验；P = 0.048），积液后30分钟平均肌电图仍处于较低水平（西德克检验；P = 0.02）。积液后立即检测到踝关节扭矩下降（西德克检验；P = 0.007）。未检测到TA或Sol肌电图、功率或RMS功率的差异（P>0.05）。
踝关节跖屈扭矩和PL肌电图的下降表明在存在水肿的情况下存在神经肌肉缺陷，这可能会增加踝关节再次受伤的易感性。
