Department of Physical Therapies, Australian Institute of Sport, Leverier Crescent, Australian Capital Territory 2617, Canberra, Australia.
Br J Sports Med. 2012 Jun;46(7):515-23. doi: 10.1136/bjsports-2011-090137. Epub 2011 Dec 14.
BACKGROUND: A history of ankle injury is known to be associated with an increased risk of future injuries. Prevention of a first-time injury to an ankle will also prevent subsequent re-injury; yet these participants are often overlooked in reports of preventive testing. Determining the functional deficits which promote injury risk in all ankles, through studies inclusive of previously injured and never injured ankles, will enable training to be directed at improving known deficits in all sports participants. OBJECTIVE: To review studies investigating the measurement of intrinsic functions in healthy ankles and assess their predictive value for injury. METHOD: Systematic review and meta-analysis of journal articles from selected electronic databases. Using all papers that included sufficient data for extraction in any paradigm, the authors pooled results for measures of strength, postural control, proprioception, muscle reaction time in response to perturbation, range of movement and ligament stability. RESULTS: Thirteen papers were found with adequate data reporting to allow calculation of pooled standardised mean difference (SMD) or pooled RR. The following are all associated with an increased risk of ankle injury: higher postural sway (SMD=0.693, 95% CI=0.151 to 1.235, p=0.012), being in the lower postural stability group (RR=2.06, 95% CI=1.364 to 3.111, p=0.001), lower inversion proprioception (0.573, 0.244 to 0.902, <0.001), higher concentric plantar flexion strength at faster speeds (0.372, 0.092 to 0.652, 0.009) and lower eccentric eversion strength at slower speeds (0.337, 0.117 to 0.557, 0.003). CONCLUSION: There is a set of intrinsic functional and structural ankle deficits associated with significantly increased risk of ankle injury. These findings will enable clinicians and sports trainers to measure and train specific deficits in sports people for the prevention of ankle injury.
背景:已知踝关节受伤史与未来受伤风险增加有关。预防首次踝关节受伤也将防止随后的再受伤;然而,这些参与者在预防性测试报告中经常被忽视。通过包括以前受伤和从未受伤的踝关节在内的研究,确定所有踝关节中导致受伤风险的功能缺陷,将使训练能够针对所有运动参与者的已知缺陷进行。 目的:回顾研究健康踝关节内在功能测量的研究,并评估其对损伤的预测价值。 方法:从选定的电子数据库中对期刊文章进行系统评价和荟萃分析。使用包含任何范式中足够数据进行提取的所有论文,作者汇总了力量、姿势控制、本体感觉、肌肉对扰动的反应时间、运动范围和韧带稳定性的测量结果。 结果:发现了 13 篇具有足够数据报告的论文,允许计算汇总标准化均数差(SMD)或汇总 RR。以下所有指标均与踝关节受伤风险增加相关:较高的姿势摆动(SMD=0.693,95%CI=0.151 至 1.235,p=0.012)、处于较低姿势稳定性组(RR=2.06,95%CI=1.364 至 3.111,p=0.001)、较低的内翻本体感觉(0.573,0.244 至 0.902,<0.001)、更快速度下的更高的跖屈向心收缩力(0.372,0.092 至 0.652,0.009)和较慢速度下的更低的外翻离心收缩力(0.337,0.117 至 0.557,0.003)。 结论:存在一组与踝关节受伤风险显著增加相关的内在功能和结构踝关节缺陷。这些发现将使临床医生和运动教练能够测量和训练运动员的特定缺陷,以预防踝关节受伤。
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