Cho Byung-Ki, Park Ji-Kang, Choi Seung-Myung, Kang Sang-Woo, SooHoo Nelson F
Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea.
Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea.
Foot Ankle Surg. 2019 Apr;25(2):231-236. doi: 10.1016/j.fas.2017.10.017. Epub 2017 Nov 11.
Despite a consensus regarding the correlation of peroneal strength deficit with chronic ankle instability (CAI), there are conflicting reports in regards to peroneal strength as assessed by isokinetic dynamometer in patients with CAI. The purpose of this study was to evaluate the changes of isokinetic strength in patients with CAI compared to ankle sprain copers and normal individuals.
Forty-two patients (CAI group) with chronic ankle instability who were scheduled for the modified Broström procedure met inclusion criteria. Thirty-one ankle sprain copers (ASC group) who were eligible at 6 months after acute injury and 30 controls were recruited. The muscle strength associated with four motions of the ankle were evaluated using isokinetic dynamometer.
Peak torque for inversion and eversion at 60°/s angular velocity were significantly lower in the CAI group compared to the ASC and control group (P=.004, P<.001, respectively). Deficit ratio of peak torque for eversion at 60°/s and 120°/s in the CAI group were 33.8% and 19.8%, respectively, which indicated significant side to side differences (both P<.001). The evertor/invertor strength ratio (0.59) for eversion at 60°/s was significantly lower in the CAI group (P<.001).
As compared to the ankle sprain copers and normal individuals, patients with chronic ankle instability who were scheduled for modified Broström procedure demonstrated a significant weakness of isokinetic peroneal strength. Isokinetic muscular assessment can provide the useful preoperative informations regarding functional ankle instability focusing on peroneal weakness.
尽管对于腓骨肌力不足与慢性踝关节不稳（CAI）之间的相关性已达成共识，但关于通过等速测力计评估CAI患者的腓骨肌力，仍存在相互矛盾的报道。本研究的目的是评估与踝关节扭伤恢复者和正常个体相比，CAI患者等速肌力的变化。
42例计划接受改良Broström手术的慢性踝关节不稳患者（CAI组）符合纳入标准。招募了31例急性损伤6个月后符合条件的踝关节扭伤恢复者（ASC组）和30例对照者。使用等速测力计评估与踝关节四个动作相关的肌肉力量。
与ASC组和对照组相比，CAI组在角速度60°/s时内翻和外翻的峰值扭矩显著更低（分别为P = 0.004，P < 0.001）。CAI组在角速度60°/s和120°/s时外翻峰值扭矩的 deficit ratio分别为33.8%和19.8%，这表明两侧存在显著差异（均为P < 0.001）。CAI组在角速度60°/s时外翻的外翻肌/内翻肌力量比（0.59）显著更低（P < 0.001）。
与踝关节扭伤恢复者和正常个体相比，计划接受改良Broström手术的慢性踝关节不稳患者表现出等速腓骨肌力明显减弱。等速肌肉评估可为关注腓骨肌无力的功能性踝关节不稳提供有用的术前信息。
