Shih Yi-Fen, Yu Hsiang-Ting, Chen Wen-Yin, Liao Kwong-Kum, Lin Hsiu-Chen, Yang Yea-Ru
Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan.
Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan.
Phys Ther Sport. 2018 Mar;30:22-28. doi: 10.1016/j.ptsp.2017.12.001. Epub 2017 Dec 20.
To examine the effects of joint mobilization and exercise training on neuromuscular performance in individuals with functional ankle instability (FAI).
A cross-sectional study.
Forty five subjects with FAI were randomized into three groups: control (CG, n = 15, 27.9 ± 6.6yr), training (TG, n = 15, 26.9 ± 5.8yr) and mobilization with training group (MTG, n = 15, 26.5 ± 4.8yr).
Four weeks of neuromuscular training for TG; neuromuscular training and joint mobilization for MTG.
Electromyography of the peroneus longus (PL), tibialis anterior (TA), and soleus (SOL) and the reaching distance of the Y balance test (YBT), dorsiflexion range of motion (DFROM), Cumberland ankle instability tool (CAIT), and global rating scale (GRS). Two-way repeated measures MANOVA were used with the significance level p < .05.
MANOVA found significant group by time interactions on posterolateral reaching distance (p = .032), PL activation (p = .006-.03), DFROM (p < .001), CAIT (p < .001) and GRS (p < .001). The post hoc tests indicated significantly improved PL muscle activity and posterolateral reaching distance for MTG compared to TG (p = .004) and CG (p = .006).
Joint mobilization resulted in additional benefits on self-reported ankle instability severity, dorsiflexion mobility, and posterolateral balance performance in individuals with FAI, but its effects on general improvement, muscle activation, and other balance tasks remained uncertain.
探讨关节松动术和运动训练对功能性踝关节不稳(FAI)患者神经肌肉功能的影响。
横断面研究。
45名FAI患者被随机分为三组:对照组(CG,n = 15,27.9±6.6岁)、训练组(TG,n = 15,26.9±5.8岁)和关节松动术联合训练组(MTG,n = 15,26.5±4.8岁)。
TG进行为期四周的神经肌肉训练;MTG进行神经肌肉训练和关节松动术。
腓骨长肌(PL)、胫骨前肌(TA)和比目鱼肌(SOL)的肌电图,Y平衡测试(YBT)的伸展距离、背屈活动度(DFROM)、坎伯兰踝关节不稳工具(CAIT)和整体评定量表(GRS)。采用双向重复测量多变量方差分析,显著性水平p < 0.05。
多变量方差分析发现,组间在时间上的交互作用对后外侧伸展距离(p = 0.032)、PL激活(p = 0.006 - 0.03)、DFROM(p < 0.001)、CAIT(p < 0.001)和GRS(p < 0.001)有显著影响。事后检验表明,与TG(p = 0.004)和CG(p = 0.006)相比,MTG的PL肌肉活动和后外侧伸展距离有显著改善。
关节松动术对FAI患者自我报告的踝关节不稳严重程度、背屈活动度和后外侧平衡能力有额外益处,但其对整体改善、肌肉激活和其他平衡任务的影响仍不确定。