Cornwall Mark W, Jain Tarang, Hagel Taylor
Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ 86011, United States.
Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ 86011, United States.
Gait Posture. 2019 May;70:130-135. doi: 10.1016/j.gaitpost.2019.02.021. Epub 2019 Mar 3.
It is estimated that nearly 2 million individuals sprain their ankle each year in the US. A majority of these are recurrent injuries, which often results in chronic ankle instability. To better understand the cause of instability, previous research has looked at the coupling or coordination between leg and foot motion during locomotion.
Determine the coupling between the tibia and the calcaneus during the stance phase of walking in those without a history of ankle instability compared to those with either moderate or severe instability.
Fifty-four individuals between the age of 18-30 years (15 males; 39 females) participated in this study. Each participant's history of ankle sprains and score on the Cumberland Ankle Instability survey was used to assign them to either a no, moderate or severe instability group. Electromagnetic sensors attached to the tibia and calcaneus recorded three-dimensional movement of their tibia and calcaneus during the stance phase of barefoot over ground walking. The kinematic data was referenced to the subject's standing position and time normalized to each subject's stance phase duration. The relative phase (RP) angle and RP variability between tibia internal/external rotation and calcaneal inversion/eversion motion was then calculated. A one-way analysis of variance test was used to determine if significant differences existed between the three groups of subjects on mean RP angle or variability. An alpha level of .05 was used to determine statistical significance.
A significant increase in RP angle and variability was found during the mid-stance phase of walking for those with severe ankle joint instability compared to those with moderate or no instability.
The observed decreased coordination and increased coupling variability observed for those with severe ankle instability suggests either residual ligamentous damage, inadequate sensorimotor control, or both.
据估计，美国每年有近200万人脚踝扭伤。其中大多数是复发性损伤，常导致慢性踝关节不稳定。为了更好地理解不稳定的原因，先前的研究着眼于运动过程中腿部和足部运动之间的耦合或协调性。
与中度或重度踝关节不稳定者相比，确定无踝关节不稳定病史者在步行站立期胫骨与跟骨之间的耦合情况。
54名年龄在18至30岁之间的个体（15名男性；39名女性）参与了本研究。根据每位参与者的踝关节扭伤病史和坎伯兰踝关节不稳定调查得分，将他们分为无、中度或重度不稳定组。附着在胫骨和跟骨上的电磁传感器记录了他们在赤足地面行走站立期胫骨和跟骨的三维运动。运动学数据以受试者的站立姿势为参考，并将时间归一化到每个受试者的站立期持续时间。然后计算胫骨内/外旋转与跟骨内翻/外翻运动之间的相对相位（RP）角和RP变异性。使用单因素方差分析来确定三组受试者在平均RP角或变异性上是否存在显著差异。显著性水平设定为0.05以确定统计学意义。
与中度或无踝关节不稳定者相比，重度踝关节不稳定者在步行中期站立阶段的RP角和变异性显著增加。
观察到的重度踝关节不稳定者协调性下降和耦合变异性增加表明可能存在残留韧带损伤、感觉运动控制不足或两者皆有。
