Feldbrugge Chase M, Pathoomvanh Megan M, Powden Cameron J, Hoch Matthew C
Old Dominion University, School of Physical Therapy and Athletic Training, 3120 Health Sciences Building, Norfolk, VA, 23529, USA.
Indiana State University, Department of Applied Medicine and Rehabilitation, North 5th Street, Terre Haute, IN, 47809, USA.
J Bodyw Mov Ther. 2019 Jan;23(1):194-201. doi: 10.1016/j.jbmt.2017.09.026. Epub 2017 Dec 15.
To complete preliminary analysis regarding the effects joint mobilization timing during a 4-week calf stretching intervention on clinician-oriented and patient-oriented outcomes in individuals with chronic ankle instability (CAI). Additionally, a secondary objective was to examine the combined effect of joint mobilization and calf stretching.
Randomized two-group pretest posttest design.
Laboratory.
Ten adults (age = 24.4 ± 4.7years; height = 172.1 ± 11.3 cm; weight = 76.2 ± 17.1 kg) with self-reported CAI participated.
Participants completed outcome measures at three collection sessions (baseline, pre-intervention, and post-intervention). Participants were randomized into either into an early-mobilization or late-mobilization group in which they completed a joint mobilization intervention during the first or last 2 weeks of a 4-week calf stretching intervention.
Outcome measures included: dorsiflexion ROM, dynamic postural control, single-limb postural control, Disablement in the Physically Active Scale (DPA), Foot and Ankle Ability Measure (FAAM), and Fear-Avoidance Beliefs Questionnaire (FABQ). Wilcoxon Sign Rank Tests examined pre-intervention to post-intervention differences for each dependent variable. Mann-Whitney U tests examined differences between early-mobilization and late-mobilization groups. Alpha was set a priori at p < .05.
No significant differences were identified between early-mobilization and late-mobilization groups at post intervention (p > .095). FAAM-Activities of Daily Living, DPA, FABQ-Physical Activity, and dorsiflexion ROM were significantly improved at post-intervention compared to pre-intervention (p < .047). No other significant differences were identified between pre-intervention and post-intervention (p > .057).
Preliminarily results suggest the timing of joint mobilization when used in conjunction with calf stretching does not effect treatment efficacy. However, the combination of joint mobilization and calf stretching can improve dorsiflexion ROM and self-reported function in individuals with CAI. Improvements from the combined intervention are similar to previously reported effects of isolated joint mobilization or stretching.
对为期4周的小腿拉伸干预过程中关节松动时机对慢性踝关节不稳(CAI)患者的临床导向和患者导向结局的影响进行初步分析。此外,次要目的是研究关节松动和小腿拉伸的联合效果。
随机两组前后测设计。
实验室。
10名自我报告患有CAI的成年人(年龄 = 24.4 ± 4.7岁;身高 = 172.1 ± 11.3厘米;体重 = 76.2 ± 17.1千克)参与。
参与者在三个收集阶段(基线、干预前和干预后)完成结局测量。参与者被随机分为早期松动组或晚期松动组,在为期4周的小腿拉伸干预的前2周或后2周完成关节松动干预。
结局指标包括:背屈活动度(ROM)、动态姿势控制、单腿姿势控制、体力活动障碍量表(DPA)、足踝能力测量(FAAM)和恐惧回避信念问卷(FABQ)。Wilcoxon符号秩检验检查每个因变量干预前到干预后的差异。Mann-Whitney U检验检查早期松动组和晚期松动组之间的差异。α预先设定为p <.05。
干预后早期松动组和晚期松动组之间未发现显著差异(p >.095)。与干预前相比,干预后FAAM-日常生活活动、DPA、FABQ-体力活动和背屈ROM有显著改善(p <.047)。干预前和干预后未发现其他显著差异(p >.057)。
初步结果表明,与小腿拉伸联合使用时,关节松动的时机不影响治疗效果。然而,关节松动和小腿拉伸的联合可以改善CAI患者的背屈ROM和自我报告的功能。联合干预的改善与先前报道的单独关节松动或拉伸的效果相似。