J Sport Rehabil. 2019 Aug 1;28(6):614-622. doi: 10.1123/jsr.2017-0364.
CONTEXT: Following a lateral ankle sprain, ∼40% of individuals develop chronic ankle instability (CAI), characterized by recurrent injury and sensations of giving way. Deafferentation due to mechanoreceptor damage postinjury is suggested to contribute to arthrogenic muscle inhibition (AMI). Whole-body vibration (WBV) has the potential to address the neurophysiologic deficits accompanied by CAI and, therefore, possibly prevent reinjury. OBJECTIVE: To determine if an acute bout of WBV can improve AMI and proprioception in individuals with CAI. DESIGN AND PARTICIPANTS: The authors examined if an acute bout of WBV can improve AMI and proprioception in individuals with CAI with a repeated-measures design. A total of 10 young adults with CAI and 10 age-matched healthy controls underwent a control, sham, and WBV condition in randomized order. SETTING: Biomechanics laboratory. INTERVENTION: WBV. MAIN OUTCOME MEASURES: Motoneuron pool recruitment was assessed via Hoffmann reflex (H-reflex) in the soleus. Proprioception was evaluated using ankle joint position sense at 15° and 20° of inversion. Both were assessed prior to, immediately following, and 30 minutes after the intervention (pretest, posttest, and 30mPost, respectively). RESULTS: Soleus maximum H-reflex:M-response (H:M) ratios were 25% lower in the CAI group compared with the control group (P = .03). Joint position sense mean constant error did not differ between groups (P = .45). Error at 15° in the CAI (pretest 0.8 [1.6], posttest 2.0 [2.8], 30mPost 2.0 [1.9]) and control group (pretest 0.8 [2.0], posttest 0.6 [2.9], 30mPost 0.5 [2.1]) did not improve post-WBV. Error at 20° did not change post-WBV in the CAI (pretest 1.3 [1.7], posttest 1.0 [2.4], 30mPost 1.5 [2.2]) or control group (pretest -0.3 [3.0], posttest 0.8 [2.1], 30mPost 0.6 [1.8]). CONCLUSION: AMI is present in the involved limb of individuals with CAI. The acute response following a single bout of WBV did not ameliorate the presence of AMI nor improve proprioception in those with CAI.
背景：踝关节外侧扭伤后，约有 40%的个体发展为慢性踝关节不稳定（CAI），其特征为反复受伤和感觉不稳定。受伤后机械感受器损伤导致的去传入被认为与关节源性肌肉抑制（AMI）有关。全身振动（WBV）有可能解决 CAI 伴随的神经生理缺陷，因此可能预防再受伤。
目的：确定单次 WBV 是否可以改善 CAI 患者的 AMI 和本体感觉。
设计和参与者：作者采用重复测量设计，研究单次 WBV 是否可以改善 CAI 患者的 AMI 和本体感觉。共有 10 名 CAI 年轻患者和 10 名年龄匹配的健康对照者接受了随机顺序的对照、假和 WBV 条件。
地点：生物力学实验室。
干预：WBV。
主要观察指标：通过比目鱼肌的 Hoffmann 反射（H 反射）评估运动神经元池募集。本体感觉通过踝关节在 15°和 20°外翻时的位置感觉进行评估。分别在干预前（预测试）、干预后即刻（后测试）和 30 分钟后（30mPost）进行评估。
结果：比目鱼肌最大 H 反射：M 反应（H：M）比值在 CAI 组比对照组低 25%（P =.03）。两组间关节位置感觉平均恒常误差无差异（P =.45）。CAI 组在 15°的误差（预测试 0.8 [1.6]，后测试 2.0 [2.8]，30mPost 2.0 [1.9]）和对照组（预测试 0.8 [2.0]，后测试 0.6 [2.9]，30mPost 0.5 [2.1]）在 WBV 后均未改善。CAI 组在 20°的误差在 WBV 后没有改变（预测试 1.3 [1.7]，后测试 1.0 [2.4]，30mPost 1.5 [2.2]）或对照组（预测试 -0.3 [3.0]，后测试 0.8 [2.1]，30mPost 0.6 [1.8]）。
结论：CAI 患者受累肢体存在 AMI。单次 WBV 后急性反应未能改善 AMI 的存在，也未能改善 CAI 患者的本体感觉。
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