Rein Susanne, Fabian Tobias, Zwipp Hans, Heineck Jan, Weindel Stefan
Department of Trauma and Reconstructive Surgery, University Hospital Carl Gustav Carus, Dresden, Germany.
Med Probl Perform Art. 2010 Mar;25(1):22-8.
The aim of this study was to examine the influence of extensive work-related use of the feet on functional ankle stability among musicians.
Thirty professional organists were compared to professional pianists and controls. All participants completed a questionnaire. Range of motion (ROM), peroneal reaction time, and positional sense tests of the ankle were measured. The postural balance control was investigated with the Biodex Stability System for the stable level 8 and unstable level 2. Statistical analysis was done with the Kruskal-Wallis test, Mann-Whitney test with Bonferroni-Holm correction, and Fisher's exact test.
Nine of 30 organists compared to 5 of 30 pianists and controls reported ankle sprains in their medical history. Pianists had a significant increased flexion of both ankle joints compared to organists (p < 0.01) and increased flexion of the right ankle joint compared to controls (p = 0.02). The positional sense test and postural balance control showed no significant differences among groups. The peroneal reaction time of the right peroneus longus muscle was significantly increased in pianists compared to controls (p = 0.008).
Organists have shown a high incidence of ankle sprains. Despite their extensive work-related use of the ankle joints, organists have neither increased functional ankle stability nor increased ROM of their ankle joints in comparison to controls. Pianists have increased flexion of the ankle joint, perhaps due to the exclusive motion of extension and flexion while using the pedals. To minimize injuries of the ankle and improve functional ankle stability as well as balance control, proprioceptive exercises of the ankle in daily training programs are recommended.
本研究旨在探讨音乐家工作中大量使用足部对踝关节功能稳定性的影响。
将30名专业管风琴演奏者与专业钢琴演奏者及对照组进行比较。所有参与者均完成一份问卷。测量踝关节的活动范围（ROM）、腓骨反应时间和位置觉测试。使用Biodex稳定性系统对稳定水平8和不稳定水平2进行姿势平衡控制研究。采用Kruskal-Wallis检验、经Bonferroni-Holm校正的Mann-Whitney检验和Fisher精确检验进行统计分析。
30名管风琴演奏者中有9人报告有踝关节扭伤病史，而30名钢琴演奏者和对照组中分别有5人。与管风琴演奏者相比，钢琴演奏者双踝关节的屈曲显著增加（p < 0.01），与对照组相比，右踝关节的屈曲增加（p = 0.02）。位置觉测试和姿势平衡控制在各组之间无显著差异。与对照组相比，钢琴演奏者右腓骨长肌的腓骨反应时间显著增加（p = 0.008）。
管风琴演奏者踝关节扭伤的发生率较高。尽管他们在工作中大量使用踝关节，但与对照组相比，管风琴演奏者的踝关节功能稳定性并未增加，踝关节活动范围也未增加。钢琴演奏者踝关节的屈曲增加，可能是由于使用踏板时仅进行伸展和屈曲运动。为了尽量减少踝关节损伤，提高踝关节功能稳定性和平衡控制能力，建议在日常训练计划中进行踝关节本体感觉训练。
