Department of Orthopaedics and Sports Medicine, Morsani College of Medicine, University of South Florida, Tampa; Departments of.
Biostatistics and Epidemiology.
J Athl Train. 2018 Jun;53(6):568-577. doi: 10.4085/1062-6050-385-16. Epub 2018 Jul 5.
Functional rehabilitation may improve the deficits associated with chronic ankle instability (CAI).
To determine if balance- and strength-training protocols improve the balance, strength, and functional performance deficits associated with CAI.
Randomized controlled clinical trial.
Athletic training research laboratory.
Participants were 39 volunteers with CAI, which was determined using the Identification of Functional Ankle Instability Questionnaire. They were randomly assigned to 1 of 3 groups: balance-training protocol (7 males, 6 females; age = 23.5 ± 6.5 years, height = 175.0 ± 8.5 cm, mass = 72.8 ± 10.9 kg), strength-training protocol (8 males, 5 females; age = 24.6 ± 7.7 years, height = 173.2 ± 9.0 cm, mass = 76.0 ± 16.2 kg), or control (6 males, 7 females; age = 24.8 ± 9.0 years, height = 175.5 ± 8.4 cm, mass = 79.1 ± 16.8 kg).
INTERVENTION(S): Each group participated in a 20-minute session, 3 times per week, for 6 weeks. The control group completed a mild to moderately strenuous bicycle workout.
MAIN OUTCOME MEASURE(S): Participants completed baseline testing of eccentric and concentric isokinetic strength in each ankle direction (inversion, eversion, plantar flexion, and dorsiflexion) and the Balance Error Scoring System (BESS), Star Excursion Balance Test (SEBT), and side-hop functional performance test. The same variables were tested again at 6 weeks after the intervention. Two multivariate repeated-measures analyses of variance with follow-up univariate analyses were conducted. The α level was set a priori at .05.
We observed time-by-group interactions in concentric ( P = .02) and eccentric ( P = .01) inversion, eccentric eversion ( P = .01), concentric ( P = .001) and eccentric ( P = .03) plantar flexion, BESS ( P = .01), SEBT ( P = .02), and side hop ( P = .004). With pairwise comparisons, we found improvements in the balance- and strength-training protocol groups in concentric and eccentric inversion and concentric and eccentric plantar flexion and the BESS, SEBT, and side hop (all P values = .001). Only the strength-training protocol group improved in eccentric eversion. The control group did not improve in any dependent variable.
Both training protocols improved strength, balance, and functional performance. More clinicians should incorporate hop-to-stabilization exercises into their rehabilitation protocols to improve the deficits associated with CAI.
功能康复可能会改善慢性踝关节不稳定（CAI）相关的缺陷。
确定平衡和力量训练方案是否可以改善 CAI 相关的平衡、力量和功能表现缺陷。
随机对照临床试验。
运动训练研究实验室。
39 名志愿者患有 CAI，使用功能性踝关节不稳定识别问卷确定。他们被随机分配到 3 组中的 1 组：平衡训练方案（7 名男性，6 名女性；年龄=23.5±6.5 岁，身高=175.0±8.5cm，体重=72.8±10.9kg）、力量训练方案（8 名男性，5 名女性；年龄=24.6±7.7 岁，身高=173.2±9.0cm，体重=76.0±16.2kg）或对照组（6 名男性，7 名女性；年龄=24.8±9.0 岁，身高=175.5±8.4cm，体重=79.1±16.8kg）。
每组均参加 20 分钟的训练，每周 3 次，持续 6 周。对照组进行轻度到中度剧烈的自行车运动。
参与者在每个踝关节方向（内翻、外翻、跖屈和背屈）和平衡错误评分系统（BESS）、星型偏移平衡测试（SEBT）和侧跳功能表现测试中完成离心和向心等速力量的基线测试。干预 6 周后再次进行相同的变量测试。采用 2 种多元重复测量方差分析，结合后续单变量分析。预先设定 α 水平为 0.05。
我们观察到在向心（P=0.02）和离心（P=0.01）内翻、离心外翻（P=0.01）、向心（P=0.001）和离心（P=0.03）跖屈、BESS（P=0.01）、SEBT（P=0.02）和侧跳（P=0.004）中存在时间与组的交互作用。通过两两比较，我们发现平衡和力量训练方案组在向心和离心内翻以及向心和离心跖屈和 BESS、SEBT 和侧跳方面都有改善（所有 P 值均为 0.001）。只有力量训练方案组在外翻离心方面有所改善。对照组在任何依赖变量上都没有改善。
两种训练方案都改善了力量、平衡和功能表现。更多的临床医生应该将跳跃到稳定化的练习纳入他们的康复方案中，以改善 CAI 相关的缺陷。
