Pourkazemi Fereshteh, Hiller Claire, Raymond Jacqueline, Black Deborah, Nightingale Elizabeth, Refshauge Kathryn
The University of Sydney, Lidcombe, New South Wales, Australia.
J Athl Train. 2016 Mar;51(3):213-22. doi: 10.4085/1062-6050-51.4.11. Epub 2016 Mar 11.
The first step to identifying factors that increase the risk of recurrent ankle sprains is to identify impairments after a first sprain and compare performance with individuals who have never sustained a sprain. Few researchers have restricted recruitment to a homogeneous group of patients with first sprains, thereby introducing the potential for confounding.
To identify impairments that differ in participants with a recent index lateral ankle sprain versus participants with no history of ankle sprain.
Cross-sectional study.
We recruited a sample of convenience from May 2010 to April 2013 that included 70 volunteers (age = 27.4 ± 8.3 years, height = 168.7 ± 9.5 cm, mass = 65.0 ± 12.5 kg) serving as controls and 30 volunteers (age = 31.1 ± 13.3 years, height = 168.3 ± 9.1 cm, mass = 67.3 ± 13.7 kg) with index ankle sprains.
MAIN OUTCOME MEASURE(S): We collected demographic and physical performance variables, including ankle-joint range of motion, balance (time to balance after perturbation, Star Excursion Balance Test, foot lifts during single-legged stance, demi-pointe balance test), proprioception, motor planning, inversion-eversion peak power, and timed stair tests. Discriminant analysis was conducted to determine the relationship between explanatory variables and sprain status. Sequential discriminant analysis was performed to identify the most relevant variables that explained the greatest variance.
The average time since the sprain was 3.5 ± 1.5 months. The model, including all variables, correctly predicted a sprain status of 77% (n = 23) of the sprain group and 80% (n = 56) of the control group and explained 40% of the variance between groups ([Formula: see text] = 42.16, P = .03). Backward stepwise discriminant analysis revealed associations between sprain status and only 2 tests: Star Excursion Balance Test in the anterior direction and foot lifts during single-legged stance ([Formula: see text] = 15.2, P = .001). These 2 tests explained 15% of the between-groups variance and correctly predicted group membership of 63% (n = 19) of the sprain group and 69% (n = 48) of the control group.
Balance impairments were associated with a recent first ankle sprain, but proprioception, motor control, power, and function were not.
识别增加复发性踝关节扭伤风险因素的第一步是确定首次扭伤后的功能障碍，并将其表现与从未发生过扭伤的个体进行比较。很少有研究人员将招募对象限制为首次扭伤的同质患者群体，从而引入了混杂因素的可能性。
确定近期首次外侧踝关节扭伤的参与者与无踝关节扭伤史的参与者之间存在差异的功能障碍。
横断面研究。
我们在2010年5月至2013年4月期间招募了一个便利样本，其中包括70名志愿者（年龄=27.4±8.3岁，身高=168.7±9.5厘米，体重=65.0±12.5千克）作为对照组，以及30名首次踝关节扭伤的志愿者（年龄=31.1±13.3岁，身高=168.3±9.1厘米，体重=67.3±13.7千克）。
我们收集了人口统计学和身体表现变量，包括踝关节活动范围、平衡能力（扰动后平衡时间、星形偏移平衡测试、单腿站立时的足部抬起次数、半脚尖平衡测试）、本体感觉、运动计划、内翻-外翻峰值功率和定时楼梯测试。进行判别分析以确定解释变量与扭伤状态之间的关系。进行顺序判别分析以识别解释最大方差的最相关变量。
距扭伤的平均时间为3.5±1.5个月。该模型包括所有变量，正确预测了扭伤组77%（n=23）和对照组80%（n=56）的扭伤状态，并解释了组间差异的40%（[公式：见正文]=42.16，P=.03）。向后逐步判别分析显示扭伤状态仅与两项测试相关：向前方向的星形偏移平衡测试和单腿站立时的足部抬起次数（[公式：见正文]=15.2，P=.001）。这两项测试解释了组间差异的15%，并正确预测了扭伤组63%（n=19）和对照组69%（n=48）的组成员身份。
平衡功能障碍与近期首次踝关节扭伤有关，但本体感觉、运动控制、力量和功能无关。
