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慢性踝关节不稳患者经过4周康复干预6个月后的患者报告疗效

Patient-Reported Efficacy 6 Months After a 4-Week Rehabilitation Intervention in Individuals With Chronic Ankle Instability.

作者信息

Wright Cynthia J, Linens Shelley W

出版信息

J Sport Rehabil. 2017 Jul;26(4):250-256. doi: 10.1123/jsr.2016-0044. Epub 2016 Nov 11.

DOI:10.1123/jsr.2016-0044
PMID:27834579
Abstract

OBJECTIVE

To track the patient-reported efficacy of a 4-wk intervention (wobble board [WB] or resistance tubing [RT]) in decreasing symptoms of chronic ankle instability (CAI) at 6 mo postintervention (6PI) as compared with immediately postintervention (IPI).

DESIGN

Randomized controlled trial.

PARTICIPANTS

Fourteen of 21 participants (66.7%) responded to an electronic 6-m follow-up questionnaire (age 19.6 ± 0.9 y, height 1.63 ± 0.18 m, weight 70.5 ± 16.3 kg; 2 male, 12 female; 5 WB, 9 RT). All participants met CAI criteria at enrollment, including a history of ankle sprain and recurrent episodes of giving way.

INTERVENTIONS

Participants completed either RT or WB protocols, both 12 sessions over 4 wk of progressive exercise. WB sessions consisted of five 40-s sets of clockwise and counterclockwise rotations. RT sessions consisted of 30 contractions against resistance tubing in each of 4 ankle directions.

MAIN OUTCOME MEASUREMENTS

Patient-reported symptoms of "giving way" preintervention and at 6PI, global rating of change (GRC) frequencies at IPI and 6PI, and resprains at 6PI were reported descriptively. Changes in global rating of function (GRF) and giving way were compared using Wilcoxon tests, while GRC was compared with Fisher exact test.

RESULTS

All participants reported giving way preintervention, only 57.1% reported giving way at 6PI. Resprains occurred in 21.4% of participants. Giving-way frequency (P = .017), but not GRF or GRC (P > .05), was significantly different at IPI vs 6PI.

CONCLUSIONS

Simple 4-wk interventions maintained some but not all improvements at 6PI. At least 42.9% of participants would no longer meet the current study's CAI inclusion criteria due to a reduction in giving way.

摘要

目的

追踪患者报告的为期4周的干预措施(摆动板[WB]或弹力带[RT])在干预后6个月(6PI)与干预后即刻(IPI)相比减轻慢性踝关节不稳(CAI)症状的疗效。

设计

随机对照试验。

参与者

21名参与者中有14名(66.7%)回复了一份6个月的电子随访问卷(年龄19.6±0.9岁,身高1.63±0.18米,体重70.5±16.3千克;2名男性,12名女性;5名使用WB,9名使用RT)。所有参与者在入组时均符合CAI标准,包括踝关节扭伤史和反复出现的打软腿发作。

干预措施

参与者完成RT或WB方案,均为4周内进行12节渐进性锻炼课程。WB课程包括五组,每组40秒的顺时针和逆时针旋转。RT课程包括在4个踝关节方向上每组对抗弹力带进行30次收缩。

主要观察指标

描述性报告患者报告的干预前和6PI时的“打软腿”症状、IPI和6PI时的总体变化评分(GRC)频率以及6PI时的再次扭伤情况。使用Wilcoxon检验比较功能总体评分(GRF)和打软腿的变化,而GRC则与Fisher精确检验进行比较。

结果

所有参与者在干预前均报告有打软腿情况,6PI时只有57.1%的人报告有打软腿。21.4%的参与者出现再次扭伤。IPI与6PI时,打软腿频率(P = 0.017)有显著差异,但GRF或GRC无显著差异(P>0.05)。

结论

简单的4周干预措施在6PI时保持了部分而非全部改善。由于打软腿情况减少,至少42.9%的参与者将不再符合当前研究的CAI纳入标准。

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