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比较联合机制踝支持对慢性踝关节不稳定患者静态和动态姿势控制的效果。

Comparison of the Effect of the Combined Mechanism Ankle Support on Static and Dynamic Postural Control of Chronic Ankle Instability Patients.

机构信息

1 Orthotics and Prosthetics Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Foot Ankle Int. 2019 Jun;40(6):702-709. doi: 10.1177/1071100719833993. Epub 2019 Feb 27.

Abstract

BACKGROUND

Chronic ankle instability (CAI) is associated with postural control impairment. Orthotic devices are routinely used to improve postural control of CAI patients and prevent recurrence of ankle sprain. This study aimed to evaluate and compare the effect of combined mechanism ankle support (CMAS) with soft ankle support (SAS) and custom-molded foot orthosis (CFO) on static and dynamic postural control in patients with CAI.

METHODS

Twenty-two patients with CAI and 22 matched healthy subjects were recruited. The participants were evaluated in four orthotic conditions (without orthosis and with the CMAS, SAS, and CFO). Static balance was investigated in single-limb stance on the force platform, and dynamic balance was assessed using the Star Excursion Balance Test (SEBT).

RESULTS

Statistically significant differences were found for the main effects of the groups in all center of pressure (COP) parameters and reach distances in medial (M), anteromedial (AM), and posteromedial (PM) directions of the SEBT ( P < .05). The main effect of the orthotics for all evaluated parameters, except reach distance in the PM direction, was statistically different. All COP parameters were significantly lower with the CMAS compared with other orthotic conditions in CAI patients. Also, the higher reach distances with the CMAS were obtained in the AM and M directions of the SEBT.

CONCLUSION

The CMAS improved impaired postural control in static and dynamic stability tests, but no similar effect was found for SAS and CFO. This result may have implications for the best bracing for CAI.

LEVEL OF EVIDENCE

Level II, comparative study.

摘要

背景

慢性踝关节不稳(CAI)与姿势控制障碍有关。矫形器通常用于改善 CAI 患者的姿势控制,防止踝关节扭伤复发。本研究旨在评估和比较联合机制踝支撑(CMAS)与软踝支撑(SAS)和定制足矫形器(CFO)对 CAI 患者静态和动态姿势控制的影响。

方法

招募了 22 名 CAI 患者和 22 名匹配的健康受试者。参与者在四种矫形器状态(无矫形器和 CMAS、SAS 和 CFO)下进行评估。单腿站立时在力台上进行静态平衡测试,使用星型偏移平衡测试(SEBT)评估动态平衡。

结果

在 SEBT 的所有中心压力(COP)参数和内侧(M)、前内侧(AM)和后内侧(PM)方向的伸展距离中,组间存在显著的主效应差异(P<.05)。除 PM 方向的伸展距离外,矫形器的主效应在所有评估参数上均存在统计学差异。与其他矫形器状态相比,CAI 患者使用 CMAS 时所有 COP 参数均显著降低。此外,CMAS 在 SEBT 的 AM 和 M 方向上获得了更高的伸展距离。

结论

CMAS 改善了静态和动态稳定性测试中受损的姿势控制,但 SAS 和 CFO 没有类似的效果。这一结果可能对 CAI 的最佳支撑有影响。

证据水平

II 级,比较研究。

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