足部损伤会导致踝关节扭伤和慢性踝关节不稳定患者的功能受限。
Foot impairments contribute to functional limitation in individuals with ankle sprain and chronic ankle instability.
机构信息
Department of Kinesiology, University of Virginia, 210 Emmet Street South, Charlottesville, VA, 22904-4407, USA.
Warfighter Performance Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106, USA.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2020 May;28(5):1600-1610. doi: 10.1007/s00167-018-5028-x. Epub 2018 Jul 6.
PURPOSE
To investigate the clinical measures of foot posture and morphology, multisegmented joint motion and play, strength, and dynamic balance in recreationally active young adults with and without a history of a lateral ankle sprain (LAS), copers, and chronic ankle instability (CAI).
METHODS
Eighty recreationally active individuals (healthy: n = 22, coper: n = 21, LAS: n = 17, CAI: n = 20) were included. Foot posture index (FPI), morphologic measures, joint motion (weight-bearing dorsiflexion (WBDF), rearfoot dorsiflexion, plantar flexion, inversion, eversion; forefoot inversion, eversion; hallux flexion, extension), joint play (proximal and distal tibiofibular; talocrural and subtalar, forefoot; 1st tarsometatarsal and metatarsophalangeal), strength (dorsiflexion, plantar flexion, inversion, eversion, hallux flexion, lesser toe flexion), and Star Excursion Balance Test (SEBT) (anterior, posteromedial, posterolateral) were assessed.
RESULTS
There were no group differences in FPI or morphological measures. LAS and CAI groups had decreased ankle dorsiflexion (p = 0.001) and greater frontal plane motion (p < 0.001), first MT plantar flexion, and sagittal excursion (p < 0.001); increased talocrural glide (p = 0.02) and internal rotation (p < 0.001) and decreased forefoot inversion joint play (p < 0.001); and decreased strength in all measures (p < 0.001) except dorsiflexion compared to healthy controls. The LAS group also demonstrated decreased distal tibiofibular (p = 0.04) and forefoot general laxity (p = 0.05) and SEBT performance (anterior: p = 0.02; posteromedial: p < 0.001; posterolateral: p < 0.001).
CONCLUSION
Individuals with LAS or CAI have increased pain, impaired physiologic and accessory joint motion, ligamentous tenderness, and strength in the foot and ankle. Clinicians should assess the multiple segments of the ankle-foot complex when caring for individuals with an LAS or CAI.
LEVEL OF EVIDENCE
II.
目的
研究有和无既往外侧踝关节扭伤（LAS）、踝关节反复扭伤（CAI）病史的娱乐性活跃年轻成年人的足部姿势和形态、多关节运动和活动度、力量和动态平衡的临床测量值。
方法
共纳入 80 名娱乐性活跃的个体（健康组：n=22，适应组：n=21，LAS 组：n=17，CAI 组：n=20）。评估足部姿势指数（FPI）、形态学测量值、关节运动（负重背屈（WBDF）、后足背屈、跖屈、内翻、外翻；前足内翻、外翻；踇趾跖屈、背伸）、关节活动度（胫腓骨近端和远端；距下和跗跖；第 1 跖骨和跖趾关节；近节和远节趾骨）、力量（背屈、跖屈、内翻、外翻、踇趾跖屈、小趾跖屈）和星形偏移平衡测试（SEBT）（前、后内侧、后外侧）。
结果
FPI 或形态学测量值在各组间无差异。LAS 和 CAI 组踝关节背屈减少（p=0.001），额状面运动增加（p<0.001），第 1 跖骨跖屈和矢状面活动度增加（p<0.001）；距下关节滑动增加（p=0.02）和内旋增加（p<0.001），前足内翻关节活动度减少（p<0.001）；所有测量值的力量均减弱（p<0.001），除背屈外与健康对照组相比无差异。LAS 组还表现出距下-胫腓骨远端（p=0.04）和前足一般性松弛（p=0.05）以及 SEBT 表现（前：p=0.02；后内侧：p<0.001；后外侧：p<0.001）降低。
结论
有 LAS 或 CAI 的个体疼痛增加，生理和辅助关节运动、韧带触痛和足踝力量受损。当照顾有 LAS 或 CAI 的个体时，临床医生应评估踝足复合体的多个节段。
证据水平
II 级。
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