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踝关节背屈在随机对照试验中的应用(ABrCt):支具与神经肌肉训练在踝关节扭伤二级预防中的应用。一项随机对照试验的设计。

Ankles back in randomized controlled trial (ABrCt): braces versus neuromuscular exercises for the secondary prevention of ankle sprains. Design of a randomised controlled trial.

机构信息

EMGO Institute for Health and Care Research, Department of Public & Occupational Health, VU University Medical Center, Amsterdam, the Netherlands.

出版信息

BMC Musculoskelet Disord. 2011 Sep 27;12:210. doi: 10.1186/1471-2474-12-210.


DOI:10.1186/1471-2474-12-210
PMID:21951559
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3195211/
Abstract

BACKGROUND: Ankle sprains are the most common sports and physical activity related injury. There is extensive evidence that there is a twofold increased risk for injury recurrence for at least one year post injury. In up to 50% of all cases recurrences result in disability and lead to chronic pain or instability, requiring prolonged medical care. Therefore ankle sprain recurrence prevention in athletes is essential. This RCT evaluates the effect of the combined use of braces and neuromuscular training (e.g. proprioceptive training/sensorimotor training/balance training) against the individual use of either braces or neuromuscular training alone on ankle sprain recurrences, when applied to individual athletes after usual care. METHODS/DESIGN: This study was designed as three way randomized controlled trial with one year follow-up. Healthy individuals between 12 and 70 years of age, who were actively participating in sports and who had sustained a lateral ankle sprain in the two months prior to inclusion, were eligible for inclusion. After subjects had finished ankle sprain treatment by means of usual care, they were randomised to any of the three study groups. Subjects in group 1 received an eight week neuromuscular training program, subjects in group 2 received a sports brace to be worn during all sports activities for the duration of one year, and group 3 received a combination of the neuromuscular training program and a sports brace to be worn during all sports activities for the duration of eight weeks. Outcomes were assessed at baseline and every month for 12 months therafter. The primary outcome measure was incidence of ankle sprain recurrences. Secondary outcome measures included the direct and indirect costs of recurrent injury, the severity of recurrent injury, and the residual complaints during and after the intervention. DISCUSSION: The ABrCt is the first randomized controlled trial to directly compare the secondary preventive effect of the combined use of braces and neuromuscular training, against the use of either braces or neuromuscular training as separate secondary preventive measures. This study expects to identify the most effective and cost-efficient secondary preventive measure for ankle sprains. The study results could lead to changes in the clinical guidelines on the prevention of ankle sprains, and they will become available in 2012. TRIAL REGISTRATION: Netherlands Trial Register (NTR): NTR2157.

摘要

背景:踝关节扭伤是最常见的运动和身体活动相关损伤。有大量证据表明,至少在受伤后一年,受伤复发的风险增加一倍。在所有情况下,多达 50%的复发导致残疾,并导致慢性疼痛或不稳定,需要长期医疗护理。因此,运动员踝关节扭伤复发的预防至关重要。这项 RCT 评估了联合使用支具和神经肌肉训练(例如本体感觉训练/感觉运动训练/平衡训练)与单独使用支具或神经肌肉训练对个体运动员的踝关节扭伤复发的影响,这些个体运动员在接受常规治疗后应用。 方法/设计:这是一项三向随机对照试验,随访时间为一年。12 至 70 岁的健康个体,积极参与运动,在纳入前两个月内发生过外侧踝关节扭伤,有资格纳入。在受试者通过常规治疗完成踝关节扭伤治疗后,他们被随机分配到三个研究组中的任何一个。组 1 受试者接受 8 周的神经肌肉训练计划,组 2 受试者在一年的所有运动活动中佩戴运动护具,组 3 受试者在 8 周的所有运动活动中佩戴神经肌肉训练计划和运动护具。在基线和之后的 12 个月内每月评估结果。主要结局指标是踝关节扭伤复发的发生率。次要结局指标包括复发损伤的直接和间接成本、复发损伤的严重程度以及干预期间和之后的残留投诉。 讨论:ABrCt 是第一项直接比较联合使用支具和神经肌肉训练与单独使用支具或神经肌肉训练作为单独二级预防措施的二级预防效果的随机对照试验。本研究旨在确定最有效和最具成本效益的踝关节扭伤二级预防措施。研究结果可能会改变踝关节扭伤预防的临床指南,并于 2012 年公布。 试验注册:荷兰试验注册处(NTR):NTR2157。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a504/3195211/16e629a06e8b/1471-2474-12-210-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a504/3195211/6cfc7c9cbc24/1471-2474-12-210-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a504/3195211/55a44bca9b59/1471-2474-12-210-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a504/3195211/89488041fa08/1471-2474-12-210-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a504/3195211/16e629a06e8b/1471-2474-12-210-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a504/3195211/6cfc7c9cbc24/1471-2474-12-210-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a504/3195211/55a44bca9b59/1471-2474-12-210-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a504/3195211/89488041fa08/1471-2474-12-210-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a504/3195211/16e629a06e8b/1471-2474-12-210-4.jpg

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本文引用的文献

[1]
The impact of adherence on sports injury prevention effect estimates in randomised controlled trials: looking beyond the CONSORT statement.

J Sci Med Sport. 2011-3-22

[2]
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Br J Sports Med. 2010-11-3

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BMC Med. 2010-3-24

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Effect of unsupervised home based proprioceptive training on recurrences of ankle sprain: randomised controlled trial.

BMJ. 2009-7-9

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Am J Sports Med. 2008-2

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An economic evaluation of a proprioceptive balance board training programme for the prevention of ankle sprains in volleyball.

Br J Sports Med. 2005-2

[10]
The effect of a proprioceptive balance board training program for the prevention of ankle sprains: a prospective controlled trial.

Am J Sports Med. 2004-9

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