距骨前后向松动术对亚急性和慢性踝关节损伤患者活动范围、疼痛及功能能力的影响：一项对照试验。
Effects of Anteroposterior Talus Mobilization on Range of Motion, Pain, and Functional Capacity in Participants With Subacute and Chronic Ankle Injuries: A Controlled Trial.
作者信息
Silva Rafael Duarte, Teixeira Luciana Mundim, Moreira Tarcísio Santos, Teixeira-Salmela Luci Fuscaldi, de Resende Marcos Antônio
机构信息
Postgraduate Program in Rehabilitation Sciences, Physical Therapy Department, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Minas Gerais, Brazil.
Private Practice, Belo Horizonte, Minas Gerais, Brazil; Physical Therapy Department, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Minas Gerais, Brazil.
出版信息
J Manipulative Physiol Ther. 2017 May;40(4):273-283. doi: 10.1016/j.jmpt.2017.02.003. Epub 2017 Apr 6.
OBJECTIVE
The purpose of this study was to measure the acute (1 session) and chronic effects (6 sessions) and the follow-up (2 weeks) of anteroposterior articular mobilization of the talus, grade III of Maitland, on the dorsiflexion range of motion (ROM), pain, and functional capacity of individuals with subacute and chronic traumatic injuries of the ankle.
METHODS
Thirty-eight volunteers, men and women, with a mean age of 40.8 years, with subacute and chronic ankle injuries participated. The volunteers were blinded to the study purpose and were allocated into the experimental group (EG) or sham group (SG). Dorsiflexion ROM, pain, and functional capacity were measured using the universal goniometer, visual analog scale, and Foot and Ankle Ability Measure, respectively. Measurements were taken on 4 different occasions: (1) baseline, (2) after the first session, (3) after the sixth session, and (4) at follow-up. Articular anteroposterior mobilization of the talus grade III of Maitland was applied to the EG, whereas manual contact was applied to the SG. Three series of 30 seconds each with a 30-second rest interval between the series were conducted.
RESULTS
Significant increases in ankle dorsiflexion ROM were observed only for the EG after the first (EG: 9.5 ± 1.1; SG: 7.6 ± 1.1) and sixth (EG: 12.8 ± 1.2; SG: 8.4 ± 1.2) sessions and were maintained at follow-up (EG: 13.2 ± 1.1; SG: 9.3 ± 1.3). Decreases in pain and improvements in functional capacity (FC) were identified for both groups after the first and sixth sessions (Pain, EG: 1.3 ± 0.5; SG: 1.8 ± 0.6 and EG: 0.7 ± 0.3; SG: 0.7 ± 0.3; FC, EG: 64.6 ± 3.5; SG: 67.4 ± 4.4 and EG: 79.9 ± 3.3; SG: 86.2 ± 3.3) and remained at follow-up (Pain, EG: 0.3 ± 0.2; SG: 0.5 ± 0.3; FC, EG: 86.8 ± 2.7; SG: 89.8 ± 3.7).
CONCLUSION
Articular grade III mobilization improved ankle dorsiflexion ROM, when compared with the SG. Changes in pain and functional capacity were similar in both groups.
目的
本研究旨在测量距骨前后关节松动术（梅特兰三级）对亚急性和慢性创伤性踝关节损伤患者背屈活动度（ROM）、疼痛及功能能力的急性（1次治疗）和慢性影响（6次治疗）以及随访情况（2周）。
方法
38名年龄平均为40.8岁的亚急性和慢性踝关节损伤的志愿者（男女均有）参与了研究。志愿者对研究目的不知情，并被分为实验组（EG）或假手术组（SG）。分别使用通用角度计、视觉模拟量表和足踝能力测量工具来测量背屈ROM、疼痛及功能能力。在4个不同时间点进行测量：（1）基线期，（2）第一次治疗后，（3）第六次治疗后，以及（4）随访时。对实验组应用梅特兰三级距骨前后关节松动术，而对假手术组仅进行手法接触。每组进行3组，每组30秒，组间休息30秒。
结果
仅在实验组，第一次（实验组：9.5±1.1；假手术组：7.6±1.1）和第六次（实验组：12.8±1.2；假手术组：8.4±1.2）治疗后观察到踝关节背屈ROM显著增加，并在随访时保持（实验组：13.2±1.1；假手术组：9.3±1.3）。两组在第一次和第六次治疗后均出现疼痛减轻和功能能力（FC）改善（疼痛，实验组：1.3±0.5；假手术组：1.8±0.6，以及实验组：0.7±0.3；假手术组：0.7±0.3；FC，实验组：64.6±3.5；假手术组：67.4±4.4，以及实验组：79.9±3.3；假手术组：86.2±3.3），且在随访时维持（疼痛，实验组：0.3±0.2；假手术组：0.5±0.3；FC，实验组：86.8±2.7；假手术组：89.8±3.7）。
结论
与假手术组相比，三级关节松动术改善了踝关节背屈ROM。两组疼痛和功能能力的变化相似。
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