功能性与机械性踝关节不稳患者在姿势控制方面的差异。
Difference in postural control between patients with functional and mechanical ankle instability.
作者信息
Chen Henry, Li Hong-Yun, Zhang Jian, Hua Ying-Hui, Chen Shi-Yi
机构信息
Department of Sports Medicine and Arthroscopy Surgery, Sports Medicine Center of Fudan University, Huashan Hospital, Shanghai, China.
Department of Sports Medicine and Arthroscopy Surgery, Sports Medicine Center of Fudan University, Huashan Hospital, Shanghai, China
出版信息
Foot Ankle Int. 2014 Oct;35(10):1068-74. doi: 10.1177/1071100714539657. Epub 2014 Jun 18.
BACKGROUND
Lateral ankle sprain is one of the most common injuries. Since the structural and pathological differences in mechanical ankle instability (MAI) and functional ankle instability (FAI) may not be the same, it may be better to treat these as separate groups. The purpose of this study was to compare the difference in postural sway between MAI and FAI in patients with chronic ankle instability (CAI).
METHODS
Twenty-six patients with CAI and 14 healthy control participants were included in the study. The CAI patients were subdivided into MAI (15 patients) and FAI (11 patients) groups. Patients who were diagnosed with lateral ankle ligaments rupture by magnetic resonance imaging and ultrasonography were assigned to the MAI group. All participants performed single-limb postural sway tests 3 times on each leg with eyes closed and open. The average distances from the mean center of pressure position in the mediolateral and anteroposterior directions were recorded and compared among the 3 groups.
RESULTS
The unstable ankles in the MAI group showed significantly greater postural sway in the anterior, posterior, and medial directions compared with those in the control group with eyes closed. With eyes open, significantly greater postural sway was found in the anterior direction. In the FAI group, no difference was found in postural sway compared with those in the control group. The MAI group showed significantly greater postural sway in the anterior direction compared with the FAI group with eyes closed and open. No significant difference in postural sway was found between the unstable and stable ankles in the MAI or FAI groups, with or without vision.
CONCLUSIONS
Patients with MAI have deficits in postural control, especially in anterior-posterior directions. However, no difference was found in postural sway in patients with FAI compared with healthy people.
CLINICAL RELEVANCE
As MAI patients suffer from deficits in postural control, balance training should be applied in those patients. In addition, special training should also include the contralateral side after a unilateral ankle ligament injured.
背景
外侧踝关节扭伤是最常见的损伤之一。由于机械性踝关节不稳(MAI)和功能性踝关节不稳(FAI)在结构和病理上的差异可能不同,将它们作为不同的组别进行治疗可能更好。本研究的目的是比较慢性踝关节不稳(CAI)患者中MAI和FAI在姿势摆动方面的差异。
方法
本研究纳入了26例CAI患者和14名健康对照者。CAI患者被分为MAI组(15例患者)和FAI组(11例患者)。通过磁共振成像和超声诊断为外侧踝关节韧带断裂的患者被分配到MAI组。所有参与者每条腿闭眼和睁眼时各进行3次单腿姿势摆动测试。记录并比较三组在内外侧和前后方向上与平均压力中心位置的平均距离。
结果
与闭眼时的对照组相比,MAI组的患侧踝关节在前后和内侧方向上的姿势摆动明显更大。睁眼时,在前方向上发现姿势摆动明显更大。在FAI组中,与对照组相比,姿势摆动没有差异。与FAI组相比,MAI组在闭眼和睁眼时在前方向上的姿势摆动明显更大。MAI或FAI组中患侧和健侧踝关节在有或无视觉情况下的姿势摆动没有显著差异。
结论
MAI患者在姿势控制方面存在缺陷,尤其是在前后方向上。然而,与健康人相比,FAI患者在姿势摆动方面没有差异。
临床意义
由于MAI患者存在姿势控制缺陷,应在这些患者中应用平衡训练。此外,特殊训练还应包括单侧踝关节韧带损伤后的对侧。