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踝关节不稳定装置和康复对慢性踝关节不稳定患者步态生物力学的影响:一项随机对照试验。

Effects of ankle destabilization devices and rehabilitation on gait biomechanics in chronic ankle instability patients: A randomized controlled trial.

机构信息

University of Toledo, Department of Kinesiology, 2801 W. Bancroft St, HH-2505H Mail Stop 119, Toledo, OH 43606, USA.

University of Virginia, Department of Kinesiology, 210 Emmet St. South, Charlottesville, VA 22904, USA; University of Virginia, Department of Orthopaedic Surgery, 545 Ray C Hunt Drive, Charlottesville, VA 22908, USA.

出版信息

Phys Ther Sport. 2016 Sep;21:46-56. doi: 10.1016/j.ptsp.2016.02.006. Epub 2016 Feb 27.

Abstract

UNLABELLED

Patients with chronic ankle instability (CAI) have altered gait patterns, which are characterized by increased inversion positioning during gait. Ankle destabilization devices increase peroneus longus muscle activation during gait, which may increase eversion.

OBJECTIVE

To determine whether incorporating destabilization devices into a 4-week impairment-based rehabilitation program has beneficial effects on gait biomechanics and surface electromyography (sEMG) compared to impairment-based rehabilitation without destabilization devices in CAI patients.

DESIGN

Randomized controlled trial.

SETTING

Laboratory.

PARTICIPANTS

Twenty-six CAI patients.

OUTCOME MEASURES

Patients completed baseline gait trials and were randomized into no device or device groups. Groups completed 4-weeks of rehabilitation with or without devices, and then completed post-intervention gait trials. Lower extremity sagittal and frontal plane kinematics and kinetics and sEMG activity were measured.

RESULTS

The device group increased dorsiflexion during mid-late stance and had lower normalized sEMG amplitude for the peroneus longus during early stance and mid-swing after rehabilitation. The no device group had less peroneus brevis sEMG activity during early stance after rehabilitation.

CONCLUSION

Incorporating destabilization devices in a 4-week rehabilitation program was an effective method of improving dorsiflexion during the stance phase of gait. However, impairment-based rehabilitation, regardless of instability tool, was not effective at improving frontal plane motion.

摘要

目的:与不使用不稳定装置的基于损伤的康复相比,在基于损伤的康复方案中加入不稳定装置是否对慢性踝关节不稳(CAI)患者的步态生物力学和表面肌电图(sEMG)有有益的影响。

方法:随机对照试验。

设置:实验室。

参与者:26 例 CAI 患者。

结果:装置组在中晚期站立时增加背屈,在后期站立和中期摆动时,腓骨长肌的归一化 sEMG 振幅较低。无装置组在康复后早期站立时腓肠短肌的 sEMG 活动减少。

结论:在 4 周的康复计划中加入不稳定装置是改善站立阶段步态背屈的有效方法。然而,基于损伤的康复,无论是否使用不稳定工具,都不能有效地改善额状面运动。

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