Doherty Cailbhe, Bleakley Chris, Hertel Jay, Caulfield Brian, Ryan John, Delahunt Eamonn
School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland.
Sport and Exercise Sciences Research Institute, Ulster Sports Academy, University of Ulster, Newtownabbey, Co. Antrim, Northern Ireland, United Kingdom.
Clin Biomech (Bristol). 2014 Jun;29(6):643-9. doi: 10.1016/j.clinbiomech.2014.04.012. Epub 2014 May 2.
Single-limb stance is maintained via the integration of visual, vestibular and somatosensory afferents. Musculoskeletal injury challenges the somatosensory system to reweight distorted sensory afferents. This investigation supplements kinetic analysis of eyes-open and eyes-closed single-limb stance tasks with a kinematic profile of lower limb postural orientation in an acute lateral ankle sprain group to assess the adaptive capacity of the sensorimotor system to injury.
Sixty-six participants with first-time acute lateral ankle sprain completed a 20-second eyes-open single-limb stance task on their injured and non-injured limbs (task 1). Twenty-three of these participants successfully completed the same 20-second single-limb stance task with their eyes closed (task 2). A non-injured control group of 19 participants completed task 1, with 16 completing task 2. 3-dimensional kinematics of the hip, knee and ankle joints, as well as associated fractal dimension of the center-of-pressure path were determined for each limb during these tasks.
Between trial analyses revealed significant differences in stance limb kinematics and fractal dimension of the center-of-pressure path for task 2 only. The control group bilaterally assumed a position of greater hip flexion compared to injured participants on their side-matched "involved"(7.41 [6.1°] vs 1.44 [4.8]°; η(2)=.34) and "uninvolved" (9.59 [8.5°] vs 2.16 [5.6°]; η(2)=.31) limbs, with a greater fractal dimension of the center-of-pressure path (involved limb=1.39 [0.16°] vs 1.25 [0.14°]; uninvolved limb=1.37 [0.21°] vs 1.23 [0.14°]).
Bilateral impairment in postural control strategies present following a first time acute lateral ankle sprain.
单腿站立通过视觉、前庭和体感传入信息的整合来维持。肌肉骨骼损伤对体感系统提出挑战,要求其重新权衡失真的感觉传入信息。本研究通过对急性外侧踝关节扭伤组下肢姿势定向的运动学特征进行分析,补充了睁眼和闭眼单腿站立任务的动力学分析,以评估感觉运动系统对损伤的适应能力。
66名首次发生急性外侧踝关节扭伤的参与者在受伤和未受伤的肢体上完成了一项20秒的睁眼单腿站立任务(任务1)。其中23名参与者成功完成了相同的20秒闭眼单腿站立任务(任务2)。19名未受伤的对照组参与者完成了任务1,16名完成了任务2。在这些任务中,测定了每个肢体的髋、膝和踝关节的三维运动学,以及压力中心路径的相关分形维数。
试验间分析显示,仅任务2的站立肢体运动学和压力中心路径的分形维数存在显著差异。与受伤参与者在侧匹配的“患侧”(7.41[6.1°]对1.44[4.8]°;η(2)=0.34)和“未患侧”(9.59[8.5°]对2.16[5.6°];η(2)=0.31)肢体相比,对照组双侧髋关节屈曲程度更大,压力中心路径的分形维数也更大(患侧肢体=1.39[0.16°]对1.25[0.14°];未患侧肢体=1.37[0.21°]对1.23[0.14°])。
首次急性外侧踝关节扭伤后,姿势控制策略存在双侧损害。