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关节松动术可急性改善慢性踝关节不稳患者的落地运动学。

Joint mobilization acutely improves landing kinematics in chronic ankle instability.

机构信息

School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland.

出版信息

Med Sci Sports Exerc. 2013 Mar;45(3):514-9. doi: 10.1249/MSS.0b013e3182746d0a.

Abstract

PURPOSE

The objective of this study is to examine the acute effect of ankle joint mobilizations akin to those performed in everyday clinical practice on sagittal plane ankle joint kinematics during a single-leg drop landing in participants with chronic ankle instability (CAI).

METHODS

Fifteen participants with self-reported CAI (defined as <24 on the Cumberland Ankle Instability Tool) performed three single-leg drop landings under two different conditions: 1) premobilization and, 2) immediately, postmobilization. The mobilizations performed included Mulligan talocrural joint dorsiflexion mobilization with movement, Mulligan inferior tibiofibular joint mobilization, and Maitland anteroposterior talocrural joint mobilization. Three CODA cx1 units (Charnwood Dynamics Ltd., Leicestershire, UK) were used to provide information on ankle joint sagittal plane angular displacement. The dependent variable under investigation was the angle of ankle joint plantarflexion at the point of initial contact during the drop landing.

RESULTS

There was a statistically significant acute decrease in the angle of ankle joint plantarflexion from premobilization (34.89° ± 4.18°) to postmobilization (31.90° ± 5.89°), t(14) = 2.62, P < 0.05 (two-tailed). The mean decrease in the angle of ankle joint plantarflexion as a result of the ankle joint mobilization was 2.98° with a 95% confidence interval ranging from 0.54 to 5.43. The eta squared statistic (0.32) indicated a large effect size.

CONCLUSION

These results indicate that mobilization acted to acutely reduce the angle of ankle joint plantarflexion at initial contact during a single-leg drop landing. Mobilization applied to participants with CAI has a mechanical effect on the ankle joint, thus facilitating a more favorable positioning of the ankle joint when landing from a jump.

摘要

目的

本研究旨在探讨类似于日常临床实践中进行的踝关节活动对慢性踝关节不稳(CAI)患者单腿跳落地时矢状面踝关节运动学的急性影响。

方法

15 名自我报告有 CAI 的参与者(定义为 Cumberland 踝关节不稳定工具<24 分)在两种不同条件下进行了三次单腿跳落地:1)预活动,和 2)立即,活动后。所进行的活动包括 Mulligan 距下关节背屈活动伴运动、Mulligan 下胫腓关节活动和 Maitland 距下关节前后向活动。三个 CODA cx1 单元(Charnwood Dynamics Ltd.,莱斯特郡,英国)用于提供踝关节矢状面角度位移信息。研究中的因变量是在跳落地初始接触时踝关节跖屈的角度。

结果

从预活动(34.89°±4.18°)到活动后(31.90°±5.89°),踝关节跖屈的角度有统计学意义的急性下降,t(14)=2.62,P<0.05(双侧)。踝关节活动导致踝关节跖屈角度的平均下降为 2.98°,95%置信区间为 0.54°至 5.43°。eta 平方统计量(0.32)表明效应量较大。

结论

这些结果表明,活动急性地降低了单腿跳落地时初始接触时踝关节跖屈的角度。对 CAI 患者施加的活动对踝关节具有机械作用,从而在从跳跃落地时更有利于踝关节的定位。

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