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慢性踝关节不稳患者的髋部力量及星形偏移平衡测试缺陷

Hip strength and star excursion balance test deficits of patients with chronic ankle instability.

作者信息

McCann Ryan S, Crossett Ian D, Terada Masafumi, Kosik Kyle B, Bolding Brenn A, Gribble Phillip A

机构信息

Department of Rehabilitation Sciences, University of Kentucky, United States.

Orthopaedic Center, University of Utah, United States.

出版信息

J Sci Med Sport. 2017 Nov;20(11):992-996. doi: 10.1016/j.jsams.2017.05.005. Epub 2017 May 25.

Abstract

OBJECTIVES

To examine isometric hip strength in those with and without CAI, and determine the degree of Star Excursion Balance Test (SEBT) variance explained by isometric hip strength.

DESIGN

Single-blinded, cross-sectional, case-control study.

METHODS

Thirty individuals with CAI, 29 lateral ankle sprain (LAS) copers, and 26 healthy controls participated. We assessed dynamic postural control with the SEBT anterior (SEBT-ANT), posteromedial (SEBT-PM), and posterolateral (SEBT-PL) reaches, and isometric hip extension (EXT), abduction (ABD) and external rotation (ER) strength with hand-held dynamometry. The CAI and LAS coper groups' involved limbs and randomly selected limbs in controls were tested. Separate Kruskal-Wallis tests compared SEBT scores and isometric hip strength between groups. Backwards linear regression models determined the degree of SEBT variance explained by isometric hip strength. Statistical significance was set a priori at P<0.05.

RESULTS

The CAI group had lower SEBT-ANT scores compared to LAS copers (P=0.03) and controls (P=0.03). The CAI group had lower ABD compared to LAS copers (P=0.03) and controls (P=0.02). The CAI group had lower ER compared to LAS copers (P=0.01) and controls (P=0.01). ER (R=0.25, P=0.01) and ABD (R=0.25, P=0.01) explained 25% of the CAI group's SEBT-PM and SEBT-PL variances, respectively.

CONCLUSIONS

The CAI group had deficient dynamic postural control and isometric hip strength compared to LAS copers and controls. Additionally, the CAI group's isometric hip strength significantly influenced dynamic postural control performance. Future CAI rehabilitation strategies should consider hip muscular strengthening to facilitate improvements in dynamic postural control.

摘要

目的

研究有无慢性踝关节不稳(CAI)者的等长髋关节力量,并确定等长髋关节力量对等距运动平衡测试(SEBT)差异程度的影响。

设计

单盲、横断面、病例对照研究。

方法

30例CAI患者、29例外侧踝关节扭伤(LAS)恢复者和26例健康对照者参与研究。我们通过SEBT前向(SEBT-ANT)、后内侧(SEBT-PM)和后外侧(SEBT-PL)伸展评估动态姿势控制,并用手持测力计评估等长髋关节伸展(EXT)、外展(ABD)和外旋(ER)力量。对CAI组和LAS恢复组的患侧肢体以及对照组中随机选择的肢体进行测试。采用单独的Kruskal-Wallis检验比较各组之间的SEBT评分和等长髋关节力量。向后线性回归模型确定等长髋关节力量对等距运动平衡测试差异程度的影响。统计学显著性预先设定为P<0.05。

结果

与LAS恢复者(P=0.03)和对照组(P=0.03)相比,CAI组的SEBT-ANT评分较低。与LAS恢复者(P=0.03)和对照组(P=0.02)相比,CAI组的ABD较低。与LAS恢复者(P=0.01)和对照组(P=0.01)相比,CAI组的ER较低。ER(R=0.25,P=0.01)和ABD(R=0.25,P=0.01)分别解释了CAI组SEBT-PM和SEBT-PL差异的25%。

结论

与LAS恢复者和对照组相比,CAI组的动态姿势控制和等长髋关节力量不足。此外,CAI组的等长髋关节力量显著影响动态姿势控制表现。未来CAI康复策略应考虑加强髋关节肌肉力量,以促进动态姿势控制的改善。

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