Higher institute of sport and physical education, Ksar-Said, Tunisia; Biomechanics laboratory, national institute of orthopedics "M.T. Kassab", Tunisia.
Ann Phys Rehabil Med. 2013 Dec;56(9-10):634-43. doi: 10.1016/j.rehab.2013.08.003. Epub 2013 Sep 26.
OBJECTIVE: Our objective is to investigate the effects of proprioceptive exercises rehabilitation on isokinetic strength and postural balance in athletes with sprain ankle. MATERIALS AND METHODS: The ankles of 16 subjects were tested: eight in the functional instability (FI) group and eight non-injured (NI) subjects in the control group. Subjects were asked to take part in a testing session. The test order for the postural stability and isokinetic strength tests was randomized to avoid learning or fatigue effects. The testing session started with a 5-minute warm-up. Subjects were then instructed to perform several lower body flexibility exercises. The test procedure consisted in static assessments, where single-limb (right and left) stance postural stability was assessed. Three practice trials were allowed for each subject. The assessment quantifies postural sway velocity while the athlete stands calmly on one foot on the force plate, for each leg. They were asked to stand as still as possible for 30s, upper limbs along the body. The subjects were requested to maintain balance with eyes open and then with the eyes closed on the firm surface. The sway velocity (in degrees per second) is given for all trials. Subjects were allowed a 1-minute rest between tests. The regime of isokinetic evaluation of dorsi-plantar flexions is concentric, with three successive speeds: slow (30°/s, reps 5), average (60°/s, reps 10), and fast (120°/s, reps 15), according to the protocol established by European Group for the development and the isokinetic research and the procedural guidelines. Relative moment of strength and times of acceleration and deceleration were calculated for each set of isokinetic testing repetitions per body side, muscle group and testing speed. RESULTS: The results of tests-retest and between both groups (injured vs. healthy) show that after eight weeks of proprioceptive work, significant increase of maximal strength, decrease in times of acceleration and deceleration at the level of plantar flexors and better stability of the injured limb at slow and average (P<0.05). For the healthy limb, improvements varying from 1 to 39% were obtained between test and retest on all the variables. However, these variations were not statistically significant. CONCLUSION: Proprioceptive training exercises can effectively stabilize an unstable ankle above for muscular and postural control. However, 8 weeks does not assess whether we have achieved maximum effect. In addition, we do not know to what extent these effects will continue over time. It would be interesting to later re-evaluate the athletes for the effect of this treatment, which is based on a proprioceptive training program on a year or more.
目的:本研究旨在探讨本体感觉康复训练对踝关节扭伤运动员等速肌力和姿势平衡的影响。
材料与方法:共测试了 16 名受试者,8 名功能性不稳定(FI)组和 8 名非损伤(NI)对照组。要求受试者参加测试。为了避免学习或疲劳的影响,测试顺序为姿势稳定性和等速肌力测试。测试开始前先进行 5 分钟热身。然后指导受试者进行一些下肢柔韧性练习。测试过程包括静态评估,即单腿(右和左)姿势稳定性评估。每位受试者允许进行 3 次练习测试。评估量化了运动员单脚站立在测力板上时的姿势摆动速度,每次腿都进行测试。要求他们尽可能静止地站立 30 秒,上肢沿身体伸展。测试结果给出了所有试验的摆动速度(以每秒度数表示)。测试之间允许受试者休息 1 分钟。根据欧洲发展和等速研究小组以及程序指南制定的方案,跟腱屈肌的等速评估方案为向心收缩,有三个连续速度:慢(30°/s,重复 5 次)、中速(60°/s,重复 10 次)和快速(120°/s,重复 15 次)。计算了每组等速测试重复的相对肌力、加速和减速时间,以及每个肢体、肌肉群和测试速度。
结果:测试-再测试和损伤组与健康组(损伤与健康)之间的结果表明,经过 8 周的本体感觉训练,损伤侧的最大力量显著增加,跖屈肌的加速和减速时间减少,且损伤侧在慢和中速时的稳定性更好(P<0.05)。对于健康肢体,所有变量在测试和再测试之间的变化幅度在 1%到 39%之间。然而,这些变化没有统计学意义。
结论:本体感觉训练可以有效地稳定不稳定的踝关节,增强肌肉和姿势控制。然而,8 周的时间并不能评估我们是否已经达到了最大效果。此外,我们不知道这些效果在多长时间内会持续。有趣的是,我们以后可以对运动员进行进一步评估,以了解这种基于本体感觉训练方案的治疗效果,为期一年或更长时间。
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