Jain Tarang Kumar, Wauneka Clayton N, Liu Wen
Department of Physical Therapy and Athletic Training, Northern Arizona University, USA.
Bioengineering Graduate Program, University of Kansas, Lawrence, USA.
Int J Sports Exerc Med. 2016;2(1). doi: 10.23937/2469-5718/1510036. Epub 2016 Jan 15.
Balance training has been shown to be effective in preventing ankle sprain recurrences in subjects with chronic ankle instability (CAI) but the biomechanical pathways underlying the clinical outcomes are still unknown. This study was conducted to determine if a 4-week balance training intervention can alter the mechanical characteristics in ankles with CAI.
Twenty-two recreationally active subjects with unilateral CAI were randomized to either a control (n = 11, 35.1 ± 9.3 years) or intervention (n = 11, 33.5 ± 6.6 years) group. Subjects in the intervention group were trained on the affected limb with static and dynamic components using a Biodex balance stability system for 4-weeks. The ankle joint stiffness and neutral zone in inversion and eversion directions on the involved and uninvolved limbs was measured at baseline and post-intervention using a dynamometer.
At baseline, the mean values of the inversion stiffness (0.69 ± 0.37 Nm/degree) in the involved ankle was significantly lower ( < 0.011, 95% CI [0.563, 0.544]) than that of uninvolved contralateral ankle (0.99 ± 0.41 Nm/degree). With the available sample size, the eversion stiffness, inversion neutral zone, and eversion neutral zone were not found to be significantly different between the involved and uninvolved contralateral ankles. The 4-week balance training intervention failed to show any significant effect on the passive ankle stiffness and neutral zones in inversion and eversion.
Decreased inversion stiffness in the involved chronic unstable ankle was found that of uninvolved contralateral ankle. The 4-week balance training program intervention was ineffective in altering the mechanical characteristics of ankles with CAI.
Randomized controlled clinical trial; Level of evidence, 1.
平衡训练已被证明对预防慢性踝关节不稳（CAI）患者的踝关节扭伤复发有效，但临床疗效背后的生物力学途径仍不清楚。本研究旨在确定为期4周的平衡训练干预是否能改变CAI患者踝关节的力学特征。
22名单侧CAI的休闲活动受试者被随机分为对照组（n = 11，35.1±9.3岁）或干预组（n = 11，33.5±6.6岁）。干预组的受试者使用Biodex平衡稳定系统，在患侧肢体上进行静态和动态成分的训练，为期4周。在基线和干预后，使用测力计测量患侧和未患侧肢体在内翻和外翻方向上的踝关节刚度和中立区。
在基线时，患侧踝关节的内翻刚度平均值（0.69±0.37 Nm/度）显著低于对侧未患侧踝关节（0.99±0.41 Nm/度）（<0.011，95%CI[0.563，0.544]）。在现有样本量下，未发现患侧和对侧未患侧踝关节之间的外翻刚度、内翻中立区和外翻中立区有显著差异。为期4周的平衡训练干预未能对被动踝关节刚度以及内翻和外翻中立区产生任何显著影响。
发现患侧慢性不稳定踝关节的内翻刚度低于对侧未患侧踝关节。为期4周的平衡训练计划干预未能改变CAI患者踝关节的力学特征。
随机对照临床试验；证据水平，1级。
