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慢性踝关节不稳患者、代偿者和未受伤对照者在有和无认知负荷情况下的足底皮肤敏感性

Plantar Cutaneous Sensitivity With and Without Cognitive Loading in People With Chronic Ankle Instability, Copers, and Uninjured Controls.

作者信息

Burcal Christopher J, Wikstrom Erik A

出版信息

J Orthop Sports Phys Ther. 2016 Apr;46(4):270-6. doi: 10.2519/jospt.2016.6351. Epub 2016 Jan 26.

Abstract

STUDY DESIGN

Controlled laboratory study.

BACKGROUND

Deficits in light touch have recently been identified on the plantar surface of the foot in those with chronic ankle instability (CAI) but not in uninjured controls. It is unknown whether copers display similar deficits. Similarly, cognitive loading has been shown to impact postural control in different populations, but it is unclear how it may impact sensory perception.

OBJECTIVES

To evaluate the difference in cutaneous sensation thresholds at rest and under cognitive loading, using Semmes-Weinstein monofilaments (SWMs), among uninjured controls, copers, and those with CAI.

METHODS

A total of 45 participants (mean ± SD age, 20.2 ± 2.8 years; height, 167.6 ± 9.9 cm; mass, 66.3 ± 14.7 kg) were recruited and categorized to a CAI, coper, or control group, based on Ankle Instability Instrument scores. Participants were assessed with SWMs for cutaneous thresholds using a 4-2-1 stepping algorithm at the head of the first metatarsal, base of the fifth metatarsal, calcaneus, and sinus tarsi. Each participant was then retested while generating random digits to the beat of a metronome in order to simulate cognitive loading.

RESULTS

Participants with CAI displayed significantly higher SWM thresholds at the head of the first metatarsal, base of the fifth metatarsal, and sinus tarsi than those of the control participants, and significantly higher thresholds at the base of the fifth metatarsal and calcaneus than those of copers (all, P<.05). Copers showed higher thresholds than those of controls at the sinus tarsi only (P<.05). A main effect of cognitive loading was identified at all 4 sites (P<.05).

CONCLUSION

People with CAI have deficits in plantar sensation relative to controls and copers. Cognitive loading increases plantar cutaneous sensation thresholds irrespective of CAI status.

摘要

研究设计

对照实验室研究。

背景

最近发现,慢性踝关节不稳(CAI)患者足底表面存在轻触觉缺陷,而未受伤的对照组则没有。尚不清楚代偿者是否表现出类似的缺陷。同样,认知负荷已被证明会影响不同人群的姿势控制,但尚不清楚它如何影响感觉知觉。

目的

使用Semmes-Weinstein单丝(SWM)评估未受伤对照组、代偿者和CAI患者在静息状态和认知负荷下的皮肤感觉阈值差异。

方法

根据踝关节不稳仪器评分,共招募45名参与者(平均±标准差年龄,20.2±2.8岁;身高,167.6±9.9厘米;体重,66.3±14.7千克),并将其分为CAI组、代偿者组或对照组。使用4-2-1步进算法,在第一跖骨头、第五跖骨基底、跟骨和跗骨窦处,用SWM评估参与者的皮肤阈值。然后让每位参与者在按照节拍器节奏生成随机数字以模拟认知负荷的同时重新进行测试。

结果

CAI患者在第一跖骨头、第五跖骨基底和跗骨窦处的SWM阈值显著高于对照组参与者,在第五跖骨基底和跟骨处的阈值显著高于代偿者(均P<0.05)。仅在跗骨窦处,代偿者的阈值高于对照组(P<0.05)。在所有4个部位均发现了认知负荷的主要影响(P<0.05)。

结论

与对照组和代偿者相比,CAI患者存在足底感觉缺陷。无论CAI状态如何,认知负荷都会增加足底皮肤感觉阈值。

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