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不稳定踝关节及代偿者中关节僵硬与肌肉活动的关系

The Relationship Between Joint Stiffness and Muscle Activity in Unstable Ankles and Copers.

作者信息

Needle Alan R, Kaminski Thomas W, Baumeister Jochen, Higginson Jill S, Farquhar William B, Swanik C Buz

出版信息

J Sport Rehabil. 2017 Jan;26(1):15-25. doi: 10.1123/jsr.2015-0061. Epub 2016 Aug 24.

DOI:10.1123/jsr.2015-0061
PMID:27632852
Abstract

CONTEXT

Rolling sensations at the ankle are common after injury and represent failure in neural regulation of joint stiffness. However, deficits after ankle injury are variable and strategies for optimizing stiffness may differ across patients.

OBJECTIVE

To determine if ankle stiffness and muscle activation differ between patients with varying history of ankle injury.

PATIENTS

Fifty-nine individuals were stratified into healthy (CON, n = 20), functionally unstable (UNS, n = 19), and coper (COP, n = 20) groups.

MAIN OUTCOME MEASURES

A 20° supination perturbation was applied to the ankle as position and torque were synchronized with activity of tibialis anterior, peroneus longus, and soleus. Subjects were tested with muscles relaxed, while maintaining 30% muscle activation, and while directed to react and resist the perturbation.

RESULTS

No group differences existed for joint stiffness (F = 0.07, P = .993); however, the UNS group had higher soleus and less tibialis anterior activation than the CON group during passive trials (P < .05). In addition, greater early tibialis anterior activation generally predicted higher stiffness in the CON group (P ≤ .03), but greater soleus activity improved stiffness in the UNS group (P = .03).

CONCLUSION

Although previous injury does not affect the ability to stiffen the joint under laboratory conditions, strategies appear to differ. Generally, the COP has decreased muscle activation, whereas the UNS uses greater plantar-flexor activity. The results of this study suggest that clinicians should emphasize correct preparatory muscle activation to improve joint stiffness in injury-rehabilitation efforts.

摘要

背景

踝关节损伤后常见滚动感,这代表关节僵硬度的神经调节功能失效。然而,踝关节损伤后的功能缺陷存在差异,优化僵硬度的策略可能因患者而异。

目的

确定不同踝关节损伤史患者的踝关节僵硬度和肌肉激活情况是否存在差异。

患者

59名个体被分为健康组(CON,n = 20)、功能不稳定组(UNS,n = 19)和适应组(COP,n = 20)。

主要观察指标

当位置和扭矩与胫骨前肌、腓骨长肌和比目鱼肌的活动同步时,对踝关节施加20°的旋后扰动。受试者在肌肉放松、保持30%肌肉激活以及被指示对扰动做出反应并抵抗扰动的情况下接受测试。

结果

关节僵硬度不存在组间差异(F = 0.07,P = 0.993);然而,在被动试验中,UNS组的比目鱼肌激活程度高于CON组,而胫骨前肌激活程度低于CON组(P < 0.05)。此外,在CON组中,胫骨前肌早期激活程度越高通常预示着僵硬度越高(P ≤ 0.03),但在UNS组中,比目鱼肌活动增强可改善僵硬度(P = 0.03)。

结论

尽管既往损伤在实验室条件下不影响关节变硬的能力,但策略似乎有所不同。一般来说,COP组的肌肉激活程度降低,而UNS组使用更强的跖屈肌活动。本研究结果表明,临床医生在损伤康复过程中应强调正确的预备肌肉激活,以改善关节僵硬度。

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