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运动疗法对慢性踝关节不稳患者背屈活动度、动态平衡及自我报告功能的影响。

The effects of mobilization with movement on dorsiflexion range of motion, dynamic balance, and self-reported function in individuals with chronic ankle instability.

作者信息

Gilbreath Julie P, Gaven Stacey L, Van Lunen L, Hoch Matthew C

出版信息

Man Ther. 2014 Apr;19(2):152-7. doi: 10.1016/j.math.2013.10.001.

Abstract

Previous studies have examined the effectiveness of a manual therapy intervention known as Mobilization with Movement (MWM) to increase dorsiflexion range of motion (ROM) in individuals with chronic ankle instability (CAI). While a single talocrural MWM treatment has increased dorsiflexion ROM in these individuals, examining the effects of multiple treatments on dorsiflexion ROM, dynamic balance, and self-reported function would enhance the clinical application of this intervention. This study sought to determine if three treatment sessions of talocrural MWM would improve dorsiflexion ROM, Star Excursion Balance Test (SEBT) reach distances, and self-reported function using the Foot and Ankle Ability Measure (FAAM) in individuals with CAI. Eleven participants with CAI (5 Males, 6 Females, age: 21.5 ± 2.2 years, weight: 83.9 ± 15.6 kg, height: 177.7 ± 10.9 cm, Cumberland Ankle Instability Tool: 17.5 ± 4.2) volunteered in this repeated-measures study. Subjects received three MWM treatments over one week. Weight-bearing dorsiflexion ROM (cm), normalized SEBT reach distances (%), and self-reported function (%) were assessed one week before the intervention (baseline), prior to the first MWM treatment (pre-intervention), and 24–48 h following the final treatment (post-intervention). No significant changes were identified in dorsiflexion ROM, SEBT reach distances, or the FAAM-Activities of Daily Living scale (p > 0.05). Significant changes were identified on the FAAM-Sport (p = 0.01). FAAM-Sport scores were significantly greater post-intervention (86.82 ± 9.18%) compared to baseline (77.27 ± 11.09%; p = 0.01) and pre-intervention (79.82 ± 13.45%; p = 0.04). These results indicate the MWM intervention did not improve dorsiflexion ROM, dynamic balance, or patient-centered measures of activities of daily living. However, MWM did improve patient-centered measures of sport-related activities in individuals with CAI.

摘要

以往的研究探讨了一种名为运动中松动术(MWM)的手法治疗干预措施对增加慢性踝关节不稳(CAI)患者背屈活动度(ROM)的有效性。虽然单次距小腿关节MWM治疗增加了这些患者的背屈ROM,但研究多次治疗对背屈ROM、动态平衡和自我报告功能的影响将增强该干预措施的临床应用。本研究旨在确定距小腿关节MWM的三次治疗是否会改善CAI患者的背屈ROM、星形偏移平衡测试(SEBT)的伸展距离以及使用足踝能力测量量表(FAAM)的自我报告功能。11名CAI患者(5名男性,6名女性,年龄:21.5±2.2岁,体重:83.9±15.6kg,身高:177.7±10.9cm,坎伯兰踝关节不稳工具评分:17.5±4.2)自愿参与这项重复测量研究。受试者在一周内接受了三次MWM治疗。在干预前一周(基线)、第一次MWM治疗前(干预前)以及最后一次治疗后24 - 48小时(干预后)评估负重背屈ROM(厘米)、标准化SEBT伸展距离(%)和自我报告功能(%)。在背屈ROM、SEBT伸展距离或FAAM日常生活活动量表中未发现显著变化(p>0.05)。在FAAM - 运动量表中发现了显著变化(p = 0.01)。与基线(77.27±11.09%;p = 0.01)和干预前(79.82±13.45%;p = 0.04)相比,干预后FAAM - 运动量表得分显著更高(86.82±9.18%)。这些结果表明,MWM干预并未改善背屈ROM、动态平衡或以患者为中心的日常生活活动测量指标。然而,MWM确实改善了CAI患者以患者为中心的与运动相关活动的测量指标。

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