1 School of Physical Therapy & Athletic Training, Old Dominion University, Norfolk, VA, USA.
2 College of Sport and Health Science, Ritsumeikan University, Kusatus, Shiga, Japan.
Foot Ankle Int. 2019 Aug;40(8):969-977. doi: 10.1177/1071100719846085. Epub 2019 Apr 25.
Chronic ankle instability (CAI) is associated with hip strength deficits and altered movement in the lower extremity. However, it remains unclear how hip strength deficits contribute to lateral ankle sprain (LAS) mechanisms. We aimed to compare lower extremity landing kinematics and isometric hip strength between individuals with and without CAI and examine associations between hip kinematics and strength.
Seventy-six individuals completed 5 single-leg landings, during which we collected three-dimensional ankle, knee, and hip kinematics from 200 milliseconds pre-initial contact to 50 milliseconds post-initial contact. We calculated average peak torque (Nm/kg) from 3 trials of isometric hip extension, abduction, and external rotation strength testing. One-way analyses of variance assessed group differences (CAI, LAS coper, and control) in hip strength and kinematics. Pearson product moment correlations assessed associations between hip kinematics and strength. We adjusted the kinematic group comparisons and correlation analyses for multiple comparisons using the Benjamini-Hochberg method.
The CAI group exhibited less hip abduction during landing than LAS copers and controls. The CAI group had lower hip external rotation strength than LAS copers ( = .04, = 0.62 [0.05, 1.17]) and controls ( < .01, = 0.87 [0.28, 1.43]). Effect sizes suggest that the CAI group had deficits in EXT compared with controls ( = 0.63 [0.06, 1.19]). Hip strength was not associated with hip landing kinematics for any group.
Altered landing mechanics displayed by the CAI group may promote mechanisms of LAS, but they are not associated with isometric hip strength. However, hip strength deficits may negatively impact other functional tasks, and they should still be considered during rehabilitation.
Level III, case-control study.
慢性踝关节不稳定（CAI）与髋关节力量不足和下肢运动改变有关。然而，髋关节力量不足如何导致外侧踝关节扭伤（LAS）机制仍不清楚。我们旨在比较 CAI 患者和无 CAI 患者的下肢落地运动学和等长髋关节力量，并探讨髋关节运动学与力量之间的关系。
76 名个体完成了 5 次单腿着地，在此期间，我们从初始接触前 200 毫秒到初始接触后 50 毫秒收集了三维踝关节、膝关节和髋关节运动学数据。我们从 3 次等长髋关节伸展、外展和外旋力量测试中计算了平均峰值扭矩（Nm/kg）。单因素方差分析评估了髋关节力量和运动学的组间差异（CAI、LAS 参与者和对照组）。皮尔逊积矩相关评估了髋关节运动学与力量之间的关系。我们使用 Benjamini-Hochberg 方法对运动学组比较和相关分析进行了多次比较调整。
CAI 组在落地时髋关节外展幅度小于 LAS 参与者和对照组。CAI 组髋关节外旋力量低于 LAS 参与者（ =.04， = 0.62 [0.05，1.17]）和对照组（ <.01， = 0.87 [0.28，1.43]）。效应大小表明，CAI 组与对照组相比，EXT 存在缺陷（ = 0.63 [0.06，1.19]）。对于任何组，髋关节力量都与髋关节着陆运动学无关。
CAI 组表现出的改变的着陆力学可能会促进 LAS 的发生机制，但与等长髋关节力量无关。然而，髋关节力量不足可能会对其他功能任务产生负面影响，因此在康复过程中仍应考虑到这一点。
III 级，病例对照研究。
