School of Physical Therapy & Athletic Training, Old Dominion University, Norfolk, VA, USA.
College of Sport and Health Sciences, Ritsumeikan University, Kyoto, Japan.
Scand J Med Sci Sports. 2018 Mar;28(3):1227-1234. doi: 10.1111/sms.13004. Epub 2017 Nov 17.
Chronic ankle instability (CAI) is associated with altered energy dissipation patterns, but comparisons to lateral ankle sprain (LAS) copers have not been explored. The purpose of this study was to examine differences in relative sagittal plane energy dissipation during a single-leg landing between female CAI and LAS coper participants. We separated 33 females (23.6 ± 4.6 years, 164.3 ± 6.2 cm, 69.4 ± 13.7 kg) into CAI (n = 17) and LAS coper (n = 16) groups. Participants completed 5 single-leg landings followed by a 5-second stabilization. We collected sagittal plane kinematics and joint moments at the ankle, knee, hip, and proximal joints (knee and hip) combined then calculated each joint's energy dissipation at 50, 100, 150, and 200 ms post-landing. We compared the percentage of total energy dissipated by the ankle, knee, hip, and proximal joints during each interval utilizing independent t tests and Cohen's d effect sizes. Statistical significance was set a priori at P < .05. The CAI group had lower relative energy dissipation from the ankle at 50 (24.7 ± 11.5% vs 39.2 ± 11.8%, P < .01, d = 1.25 [0.47, 1.95]), 100 (66.9 ± 19.4% vs 77.7 ± 6.5%, P = .04, d = 0.74 [0.01, 1.42]), and 150 ms (70.7 ± 17.8% vs 81.0 ± 5.7%, P = .03, d = 0.77 [0.04, 1.46]) compared to LAS copers. The CAI group had a greater hip contribution through 150 ms (17.9 ± 10.7% vs 11.7 ± 4.4%, P = .04, d =-0.75 [-1.44, -0.03]) and the proximal joints at 50 (75.3 ± 11.5% vs 60.8 ± 11.8%, P < .01, d = -1.25 [-1.96, -0.47]), 100 (33.1 ± 19.4% vs 22.3 ± 6.5%, P = .04, d = -0.74 [-1.42, -0.01]), and 150 ms (29.3 ± 17.8 vs 19.0 ± 5.7%, P = .03, d =-0.77 [-1.46, -0.04]) compared to LAS copers. Females with CAI may benefit from therapeutic exercises designed to correct a single-leg energy dissipation strategy that relies less on the ankle joint.
慢性踝关节不稳(CAI)与能量耗散模式的改变有关,但尚未对其与外侧踝关节扭伤(LAS)患者的对比进行研究。本研究的目的是探讨女性 CAI 和 LAS 患者在单腿落地期间矢状面相对能量耗散的差异。我们将 33 名女性(23.6±4.6 岁,164.3±6.2cm,69.4±13.7kg)分为 CAI(n=17)和 LAS 患者(n=16)两组。参与者完成 5 次单腿落地,随后进行 5 秒的稳定。我们收集了踝关节、膝关节、髋关节和近端关节(膝关节和髋关节)的矢状面运动学和关节力矩,然后计算了每个关节在落地后 50、100、150 和 200ms 时的能量耗散情况。我们利用独立 t 检验和 Cohen's d 效应量比较了每个间隔期间踝关节、膝关节、髋关节和近端关节所消耗的总能量的百分比。预设统计学意义为 P<.05。CAI 组在 50ms(24.7±11.5% vs 39.2±11.8%,P<.01,d=1.25[0.47, 1.95])、100ms(66.9±19.4% vs 77.7±6.5%,P=.04,d=0.74[0.01, 1.42])和 150ms(70.7±17.8% vs 81.0±5.7%,P=.03,d=0.77[0.04, 1.46])时的相对能量耗散低于 LAS 患者。CAI 组在 150ms 时髋关节的贡献更大(17.9±10.7% vs 11.7±4.4%,P=.04,d=-0.75[-1.44, -0.03]),在 50ms 时近端关节的贡献更大(75.3±11.5% vs 60.8±11.8%,P<.01,d=-1.25[-1.96, -0.47])、100ms(33.1±19.4% vs 22.3±6.5%,P=.04,d=-0.74[-1.42, -0.01])和 150ms(29.3±17.8% vs 19.0±5.7%,P=.03,d=-0.77[-1.46, -0.04])时也大于 LAS 患者。CAI 女性可能受益于旨在纠正单腿能量耗散策略的治疗性运动,该策略对踝关节的依赖程度降低。