Gribble Phillip A, Robinson Richard H
University of Toledo Athletic Training Research Laboratory, University of Toledo, Toledo, Ohio, USA.
J Strength Cond Res. 2009 Mar;23(2):395-400. doi: 10.1519/JSC.0b013e31818efbb2.
There is some debate in the literature as to whether strength deficits exist at the ankle in individuals with chronic ankle instability (CAI). Additionally, there is evidence to suggest that knee and hip performance is altered in those with CAI. Therefore, the purpose of this study was to determine whether CAI is associated with deficits in ankle, knee, and hip torque. Fifteen subjects with unilateral CAI and fifteen subjects with healthy ankles participated. Subjects reported to the laboratory for one session during which the torque production of ankle plantar flexion/dorsiflexion, knee flexion/extension, and hip flexion/extension were measured with an isokinetic device. Subjects performed 5 maximum-effort repetitions of a concentric/concentric protocol at 60 degrees .s for both extremities. Average peak torque (APT) values were calculated. The subjects with CAI demonstrated significantly less APT production for knee flexion (F1,28 = 5.40; p = 0.03) and extension (F1,28 = 5.34; p = 0.03). Subjects with CAI exhibited significantly less APT for ankle plantar flexion in the injured limb compared with their noninjured limb (F1,28 = 6.51; p = 0.02). No significant difference in ankle dorsiflexion or hip flexion/extension APT production existed between the 2 groups. Individuals with CAI, in addition to deficits in ankle plantar flexion torque, had deficits in knee flexor and extensor torque, suggesting that distal joint instability may lead to knee joint neuromuscular adaptations. There were no similar deficits at the hip. Future research should determine what implications this has for prevention and rehabilitation of lower-extremity injury. Clinicians may need to consider including rehabilitation efforts to address these deficits when rehabilitating patients with CAI.
关于慢性踝关节不稳(CAI)患者的踝关节是否存在力量不足,文献中有一些争议。此外,有证据表明CAI患者的膝关节和髋关节功能会发生改变。因此,本研究的目的是确定CAI是否与踝关节、膝关节和髋关节扭矩不足有关。15名单侧CAI患者和15名踝关节健康的受试者参与了研究。受试者到实验室进行一次测试,期间使用等速装置测量踝关节跖屈/背屈、膝关节屈伸和髋关节屈伸的扭矩产生情况。受试者在60°/s的速度下,对双下肢进行5次最大努力的向心/向心运动重复测试。计算平均峰值扭矩(APT)值。CAI患者的膝关节屈曲(F1,28 = 5.40;p = 0.03)和伸展(F1,28 = 5.34;p = 0.03)的APT产生明显较少。与未受伤肢体相比,CAI患者受伤肢体的踝关节跖屈APT明显较少(F1,28 = 6.51;p = 0.02)。两组之间的踝关节背屈或髋关节屈伸APT产生没有显著差异。CAI患者除了踝关节跖屈扭矩不足外,膝关节屈伸肌扭矩也不足,这表明远端关节不稳可能导致膝关节神经肌肉适应性改变。髋关节没有类似的不足。未来的研究应该确定这对下肢损伤的预防和康复有什么影响。临床医生在为CAI患者进行康复治疗时,可能需要考虑包括针对这些不足的康复措施。