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临床检查结果在功能性踝关节不稳定和踝关节扭伤适应者个体中。

Clinical examination results in individuals with functional ankle instability and ankle-sprain copers.

机构信息

Whitworth University, Spokane, WA.

出版信息

J Athl Train. 2013 Sep-Oct;48(5):581-9. doi: 10.4085/1062-6050-48.3.15. Epub 2013 Aug 2.

Abstract

CONTEXT

Why some individuals with ankle sprains develop functional ankle instability and others do not (ie, copers) is unknown. Current understanding of the clinical profile of copers is limited.

OBJECTIVE

To contrast individuals with functional ankle instability (FAI), copers, and uninjured individuals on both self-reported variables and clinical examination findings.

DESIGN

Cross-sectional study.

SETTING

Sports medicine research laboratory.

PATIENTS OR OTHER PARTICIPANTS

Participants consisted of 23 individuals with a history of 1 or more ankle sprains and at least 2 episodes of giving way in the past year (FAI: Cumberland Ankle Instability Tool [CAIT] score = 20.52 ± 2.94, episodes of giving way = 5.8 ± 8.4 per month), 23 individuals with a history of a single ankle sprain and no subsequent episodes of instability (copers: CAIT score = 27.74 ± 1.69), and 23 individuals with no history of ankle sprain and no instability (uninjured: CAIT score = 28.78 ± 1.78).

INTERVENTION(S): Self-reported disability was recorded using the CAIT and Foot and Ankle Ability Measure for Activities of Daily Living and for Sports. On clinical examination, ligamentous laxity and tenderness, range of motion (ROM), and pain at end ROM were recorded.

MAIN OUTCOME MEASURE(S): Questionnaire scores for the CAIT, Foot and Ankle Ability Measure for Activities of Daily Living and for Sports, ankle inversion and anterior drawer laxity scores, pain with palpation of the lateral ligaments, ankle ROM, and pain at end ROM.

RESULTS

Individuals with FAI had greater self-reported disability for all measures (P < .05). On clinical examination, individuals with FAI were more likely to have greater talar tilt laxity, pain with inversion, and limited sagittal-plane ROM than copers (P < .05).

CONCLUSIONS

Differences in both self-reported disability and clinical examination variables distinguished individuals with FAI from copers at least 1 year after injury. Whether the deficits could be detected immediately postinjury to prospectively identify potential copers is unknown.

摘要

背景

为什么有些踝关节扭伤患者会出现功能性踝关节不稳定,而有些患者(即适应者)则不会,目前对此知之甚少。目前对适应者的临床特征的了解有限。

目的

对比功能性踝关节不稳定(FAI)患者、适应者和无损伤个体在自我报告变量和临床检查结果方面的差异。

设计

横断面研究。

设置

运动医学研究实验室。

患者或其他参与者

参与者包括 23 名有 1 次或多次踝关节扭伤病史且过去 1 年内至少有 2 次失稳发作的患者(FAI:Cumberland 踝关节不稳定工具[CAIT]评分=20.52±2.94,每月失稳发作=5.8±8.4 次)、23 名有单次踝关节扭伤病史且无后续不稳定发作的患者(适应者:CAIT 评分=27.74±1.69)和 23 名无踝关节扭伤和不稳定病史的患者(无损伤者:CAIT 评分=28.78±1.78)。

干预措施

使用 CAIT 和踝关节活动日常和运动能力量表记录自我报告的残疾情况。在临床检查中,记录韧带松弛度和压痛、关节活动度(ROM)和末端 ROM 处的疼痛。

主要观察指标

CAIT、踝关节活动日常和运动能力量表、踝关节内翻和前抽屉松弛度评分、外侧韧带触诊时的疼痛、踝关节 ROM 和末端 ROM 处的疼痛的问卷评分。

结果

FAI 患者在所有测量指标上的自我报告残疾程度均更高(P<0.05)。在临床检查中,FAI 患者的距骨倾斜松弛度更大、内翻时疼痛更明显且矢状面 ROM 受限更明显,这些均高于适应者(P<0.05)。

结论

在受伤至少 1 年后,自我报告的残疾程度和临床检查变量的差异可将 FAI 患者与适应者区分开来。是否可以在受伤后立即检测到这些缺陷,从而前瞻性地识别潜在的适应者,目前尚不清楚。

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