Brown Cathleen, Padua Darin, Marshall Stephen W, Guskiewicz Kevin
Department of Kinesiology, Biomechanics Laboratory, University of Georgia, 330 River Road, Athens, GA 30602, USA.
Clin Biomech (Bristol). 2008 Jul;23(6):822-31. doi: 10.1016/j.clinbiomech.2008.02.013. Epub 2008 Apr 8.
Chronic ankle instability commonly develops after lateral ankle sprain, but differences in movement patterns between subtypes of ankle instability have not been determined. We hypothesized mechanically and functionally unstable ankle subjects would demonstrate different kinematics and kinetics compared to a group of ankle sprain injury "copers".
Sixty-three recreational athletes, 21 in each of 3 groups (11 males, 10 females) matched for gender, age, height, mass, and limb dominance were tested. Knee and ankle sagittal and frontal plane motion, peak ground reaction forces, and time to peak ground reaction forces were measured during 5 tasks (walk, step down, run, drop jump, and stop jump).
Using 5 one-way Analyses of Variance with Tukey post hoc testing at alpha=0.05, the mechanically unstable group displayed at least one difference in sagittal and/or frontal plane ankle motion at initial contact, maximum, and/or in displacement than the functionally unstable and coper groups in each task except the run (P<0.05). The greatest number of differences occurred in the drop jump and stop jump tasks. The mechanically unstable group exhibited greater frontal plane displacement and maximum eversion, and decreased sagittal plane displacement and maximum plantar flexion in several tasks.
The mechanically unstable group demonstrated altered ankle motion patterns when compared to functionally unstable and coper groups. The landing pattern may help avoid ankle sprains, but may also increase risk of ankle joint degeneration. Unstable ankle groups exhibit different movement patterns and may require different treatment regimens.
慢性踝关节不稳通常在外侧踝关节扭伤后出现，但踝关节不稳各亚型之间的运动模式差异尚未明确。我们假设，与一组踝关节扭伤“代偿者”相比，机械性和功能性不稳定的踝关节受试者会表现出不同的运动学和动力学特征。
对63名休闲运动员进行测试，3组每组21人（男性11人，女性10人），在性别、年龄、身高、体重和肢体优势方面进行匹配。在5项任务（行走、下台阶、跑步、纵跳和急停跳）过程中，测量膝关节和踝关节矢状面和额状面的运动、地面反作用力峰值以及达到地面反作用力峰值的时间。
使用5次单因素方差分析，并采用Tukey事后检验（α = 0.05），除跑步任务外，在每项任务的初始接触、最大程度和/或位移时，机械性不稳定组在矢状面和/或额状面的踝关节运动方面，与功能性不稳定组和代偿组相比至少存在一处差异（P < 0.05）。差异最多的是纵跳和急停跳任务。在多项任务中，机械性不稳定组表现出更大的额状面位移和最大外翻角度，以及矢状面位移和最大跖屈角度减小。
与功能性不稳定组和代偿组相比，机械性不稳定组表现出踝关节运动模式改变。着地模式可能有助于避免踝关节扭伤，但也可能增加踝关节退变的风险。不稳定的踝关节组表现出不同的运动模式，可能需要不同的治疗方案。
