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反复踝关节扭伤的个体在未受伤侧表现出姿势不稳和神经肌肉控制缺陷。

Individuals with recurrent ankle sprain demonstrate postural instability and neuromuscular control deficits in unaffected side.

机构信息

Department of Sports Medical Center, Korea University College of Medicine, Anam Hospital, Seoul, Republic of Korea.

Department of Orthopedic Surgery, College of Medicine, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2020 Jan;28(1):184-192. doi: 10.1007/s00167-018-5190-1. Epub 2018 Oct 5.

Abstract

PURPOSE

To compare proprioception, postural stability, and neuromuscular control between patients with mechanical laxity and recurrent ankle sprain.

METHODS

Among 86 patients with ankle instability, 45 patients had mechanical laxity (mean age 27.2 ± 7.0 years) and 41 had recurrent ankle sprain (mean age 25.1 ± 9.2 years). Both the affected and unaffected ankles of each patient were evaluated. Proprioception and neuromuscular control tests were conducted using an isokinetic machine, and postural stability was tested using a postural stabilometry system.

RESULTS

Proprioception was not significantly different between the unaffected or affected ankles of the mechanical laxity group compared with those of the recurrent ankle sprain group (n.s). Static and dynamic postural stability and neuromuscular control were similar in the affected ankles between the two groups (n.s). However, postural stability (static, overall: p = 0.009, anterior-posterior: p = 0.028, medial-lateral: p = 0.022; dynamic, overall: p = 0.012, anterior-posterior: p = 0.004, medial-lateral: p = 0.001) and neuromuscular control (inversion: p = 0.031, eversion: p = 0.039, dorsiflexion: p = 0.029, plantarflexion: p = 0.035) were significantly decreased in the unaffected ankles of the recurrent ankle sprain group compared with those of the mechanical laxity group.

CONCLUSION

The unaffected ankles of the recurrent ankle sprain group showed significant decreases in both postural stability and neuromuscular control compared with the mechanical laxity group. Clinicians and therapists should consider unaffected ankle rehabilitation in patients with recurrent ankle sprain to prevent future sprain events.

LEVEL OF EVIDENCE

Case-control study, III.

摘要

目的

比较机械松弛和复发性踝关节扭伤患者的本体感觉、姿势稳定性和神经肌肉控制。

方法

在 86 名踝关节不稳定的患者中,45 名患者患有机械松弛(平均年龄 27.2±7.0 岁),41 名患者患有复发性踝关节扭伤(平均年龄 25.1±9.2 岁)。每位患者的患侧和健侧踝关节均进行评估。使用等速机器进行本体感觉和神经肌肉控制测试,使用姿势稳定测试系统进行姿势稳定性测试。

结果

与复发性踝关节扭伤组相比,机械松弛组患侧和健侧踝关节的本体感觉无显著差异(n.s)。两组患侧踝关节的静态和动态姿势稳定性和神经肌肉控制相似(n.s)。然而,复发性踝关节扭伤组健侧踝关节的姿势稳定性(静态,整体:p=0.009,前-后:p=0.028,内-外:p=0.022;动态,整体:p=0.012,前-后:p=0.004,内-外:p=0.001)和神经肌肉控制(内翻:p=0.031,外翻:p=0.039,背屈:p=0.029,跖屈:p=0.035)显著低于机械松弛组(p<0.05)。

结论

与机械松弛组相比,复发性踝关节扭伤组的健侧踝关节在姿势稳定性和神经肌肉控制方面均有明显下降。临床医生和治疗师应考虑对复发性踝关节扭伤患者进行健侧踝关节康复,以预防未来的扭伤事件。

证据水平

病例对照研究,III 级。

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