Lilley Thomas, Herb Christopher C, Hart Joseph, Hertel Jay
a Department of Kinesiology , Curry School of Education, University of Virginia , Charlottesville , VA , USA.
b Department of Athletic Training and Nutrition , Moyes College of Education, Weber State University , Ogden , UT , USA.
Sports Biomech. 2018 Jun;17(2):261-272. doi: 10.1080/14763141.2017.1287215. Epub 2017 Jun 13.
Chronic ankle instability (CAI) is a condition resulting from a lateral ankle sprain. Shank-rearfoot joint-coupling variability differences have been found in CAI patients; however, joint-coupling variability (VCV) of the ankle and proximal joints has not been explored. Our purpose was to analyse VCV in adults with and without CAI during gait. Four joint-coupling pairs were analysed: knee sagittal-ankle sagittal, knee sagittal-ankle frontal, hip frontal-ankle sagittal and hip frontal-ankle frontal. Twenty-seven adults participated (CAI:n = 13, Control:n = 14). Lower extremity kinematics were collected during walking (4.83 km/h) and jogging (9.66 km/h). Vector-coding was used to assess the stride-to-stride variability of four coupling pairs. During walking, CAI patients exhibited higher VCV than healthy controls for knee sagittal-ankle frontal in latter parts of stance thru mid-swing. When jogging, CAI patients demonstrated lower VCV with specific differences occurring across various intervals of gait. The increased knee sagittal-ankle frontal VCV in CAI patients during walking may indicate an adaptation to deal with the previously identified decrease in variability in transverse plane shank and frontal plane rearfoot coupling during walking; while the decreased ankle-knee and ankle-hip VCV identified in CAI patients during jogging may represent a more rigid, less adaptable sensorimotor system ambulating at a faster speed.
慢性踝关节不稳(CAI)是一种由外侧踝关节扭伤导致的病症。已发现CAI患者存在小腿-后足关节耦合变异性差异;然而,踝关节及近端关节的关节耦合变异性(VCV)尚未得到研究。我们的目的是分析患有和未患有CAI的成年人在步态过程中的VCV。分析了四组关节耦合对:膝关节矢状面-踝关节矢状面、膝关节矢状面-踝关节额状面、髋关节额状面-踝关节矢状面和髋关节额状面-踝关节额状面。27名成年人参与了研究(CAI组:n = 13,对照组:n = 14)。在步行(4.83千米/小时)和慢跑(9.66千米/小时)过程中收集下肢运动学数据。采用矢量编码评估四组耦合对的步幅间变异性。在步行过程中,CAI患者在站立后期至摆动中期,膝关节矢状面-踝关节额状面的VCV高于健康对照组。在慢跑时,CAI患者的VCV较低,且在步态的不同阶段存在特定差异。CAI患者在步行过程中膝关节矢状面-踝关节额状面VCV增加,可能表明其为应对先前发现的步行过程中小腿横断面和后足额状面耦合变异性降低而产生的一种适应性变化;而CAI患者在慢跑过程中踝关节-膝关节和踝关节-髋关节VCV降低,可能代表其在以更快速度行走时,感觉运动系统更加僵硬、适应性更差。