Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
Knee Surg Sports Traumatol Arthrosc. 2020 Jan;28(1):326-333. doi: 10.1007/s00167-018-4960-0. Epub 2018 Apr 27.
PURPOSE: (1) To describe ankle strength and postural stability in patients with chronic lateral ankle instability and (2) to analyse the correlation between deficits in ankle strength and postural stability. METHODS: Results of preoperative isokinetic and balance tests in 203 patients whose contralateral ankle was normal were retrospectively reviewed. Isokinetic peak torque values of eversion and inversion at 2 angular velocities (30°/s and 120°/s) were measured in the injured and normal ankles. In the balance test, the percent differences of 3 actual scores (overall, anterior-posterior, and medial-lateral) between the injured and normal ankles were calculated. Additional statistical analyses were performed to evaluate weakness of ankle strength, postural stability deficits, and their correlation. RESULTS: Significant differences in 4 peak torque values and 4 relative peak torque values (peak torque/body weight) were found between the injured and normal ankles. All 8 values were significantly lower in the injured ankles. Weakness was severe during inversion and at 30°/s. In the balance test, 49 subjects (24.1%) had significant deficits in postural stability and 109 (53.7%) had favourable results. No strong association was found between weakness of ankle strength and deficits in postural stability. CONCLUSIONS: Strength measurement alone is insufficient to evaluate preoperative functional deficits, and other functional tests are required to measure postural stability. The results of this study provide further evidence for a rehabilitation programme consisting of proprioceptive training as well as strengthening. The proprioceptive training must be an integral part of the rehabilitation programme in addition to strengthening exercise. LEVEL OF EVIDENCE: Case series, Level IV.
目的:(1)描述慢性外侧踝关节不稳定患者的踝关节力量和姿势稳定性,(2)分析踝关节力量缺陷与姿势稳定性之间的相关性。
方法:回顾性分析 203 例对侧踝关节正常的患者术前等速和平衡测试的结果。在受伤和正常踝关节中测量外翻和内翻的 2 个角速度(30°/s 和 120°/s)的等速峰值扭矩值。在平衡测试中,计算受伤和正常踝关节之间 3 个实际分数(整体、前后和内外)的百分比差异。进行了额外的统计分析,以评估踝关节力量的减弱、姿势稳定性缺陷及其相关性。
结果:受伤和正常踝关节之间的 4 个峰值扭矩值和 4 个相对峰值扭矩值(峰值扭矩/体重)存在显著差异。受伤踝关节的所有 8 个值均显著降低。在 30°/s 时,内翻和内翻时的力量明显较弱。在平衡测试中,49 名受试者(24.1%)存在姿势稳定性明显缺陷,109 名受试者(53.7%)结果良好。未发现踝关节力量减弱与姿势稳定性缺陷之间存在强烈关联。
结论:单独的力量测量不足以评估术前的功能缺陷,需要其他功能测试来测量姿势稳定性。本研究结果为包含本体感觉训练和强化的康复计划提供了进一步的证据。本体感觉训练必须是强化运动之外康复计划的一个组成部分。
证据水平:病例系列,IV 级。
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