Kosik Kyle B, Terada Masafumi, McCann Ryan, Thomas Abbey, Johnson Nathan, Gribble Phillip
University of Kentucky, Lexington, KY, United States.
Ritsumeikan University, Kusatsu, Shiga-ken, Japan.
Gait Posture. 2019 May;70:403-407. doi: 10.1016/j.gaitpost.2019.03.032. Epub 2019 Apr 5.
Chronic ankle instability (CAI) is associated with an increased risk of developing post-traumatic osteoarthritis (PTOA). Altered temporal gait parameters likely contribute to the early development and progression of PTOA in CAI. However, it is unknown if increased clinical symptoms of ankle PTOA influence temporal gait parameters among those with CAI.
Compare temporal gait parameters and Ankle Osteoarthritis Scale (AOS) scores between individuals with and without CAI.
Thirty CAI participants and 30 healthy-controls volunteered to participate in this retrospective case-control study. Participants completed the Pain and Disability subscales of the AOS. Temporal gait parameters were assessed using a GAITRite® electronic walkway. Participants performed 5 walking trials, which were subsequently combined into a single test. Temporal variables (swing, stance, single-limb support and double-limb support) were extracted for the involved limb and normalized to percent of gait cycle (%GC).
Participants with CAI had higher scores on the Pain (P < 0.001) and Disability (P = 0.001, d = 0.87[0.33,1.39]) subscales of the AOS. CAI individuals spent less time during swing (P = 0.022]) and single-limb support (P = 0.030) phases and more time during the double-limb support (P = 0.021) phase. Single-limb support time was moderately correlated with higher scores on the AOS pain (r=-0.416, P = 0.011) and disability (r=-0.473 P = 0.004) subscales.
Individuals with CAI spend varying times in each phase of the gait cycle compared to uninjured controls. Individuals with CAI may adopt this abnormal gait strategy due to increased clinical symptoms of ankle PTOA. Rehabilitation programs should focus on minimizing the symptoms of ankle PTOA to restore normal temporal gait parameters.
慢性踝关节不稳（CAI）与创伤后骨关节炎（PTOA）发生风险增加相关。步态时间参数改变可能促成CAI患者PTOA的早期发生和进展。然而，踝关节PTOA临床症状加重是否会影响CAI患者的步态时间参数尚不清楚。
比较有和没有CAI的个体之间的步态时间参数和踝关节骨关节炎量表（AOS）评分。
30名CAI参与者和30名健康对照者自愿参与这项回顾性病例对照研究。参与者完成了AOS的疼痛和残疾分量表。使用GAITRite®电子步道评估步态时间参数。参与者进行5次步行试验，随后合并为一次测试。提取患侧肢体的时间变量（摆动、站立、单腿支撑和双腿支撑），并将其标准化为步态周期百分比（%GC）。
CAI参与者在AOS的疼痛（P＜0.001）和残疾（P = 0.001，d = 0.87[0.33,1.39]）分量表上得分更高。CAI个体在摆动期（P = 0.022）和单腿支撑期（P = 0.030）花费的时间更少，而在双腿支撑期（P = 0.021）花费的时间更多。单腿支撑时间与AOS疼痛（r = -0.416，P = 0.011）和残疾（r = -0.473，P = 0.004）分量表上的较高得分中度相关。
与未受伤的对照组相比，CAI个体在步态周期各阶段花费的时间不同。CAI个体可能由于踝关节PTOA临床症状加重而采用这种异常步态策略。康复计划应侧重于将踝关节PTOA的症状降至最低，以恢复正常的步态时间参数。
