Ihmels Wyatt D, Seymore Kayla D, Brown Tyler N
Department of Kinesiology, Boise State University, Boise, Idaho, USA.
Am J Sports Med. 2020 May;48(6):1496-1504. doi: 10.1177/0363546520911048. Epub 2020 Mar 30.
Despite success at preventing ankle sprain, prophylactics that restrict ankle plantarflexion motion may produce deleterious knee biomechanics and increase injury risk.
To determine if ankle prophylactics that restrict plantar- and dorsiflexion motion produce changes in knee biomechanics during a single-leg cut and whether those changes differ between sexes.
Controlled laboratory study.
A total of 17 male and 17 female participants performed a single-leg cut with 4 conditions: Ankle Roll Guard (ARG), lace-up brace, nonelastic tape, and an unbraced control. Peak stance knee flexion, abduction, and internal rotation joint angle and moment; total knee reaction moment (TKM) and its components (sagittal, frontal, and transverse); and ankle plantarflexion and inversion range of motion (ROM) and peak stance joint moments were tested with a repeated measures analysis of variance to determine the main effect and interaction of condition and sex.
Brace and tape restricted plantarflexion ROM as compared with ARG and control (all < .001). With the brace, women had increased peak knee abduction angle versus ARG ( = .012) and control ( = .009), and men had decreased peak knee internal rotation moment as compared with ARG ( = .032), control ( = .006), and tape ( = .003). Although the restrictive tape decreased inversion ROM when compared with ARG ( = .004) and brace ( = .017), it did not change knee biomechanics. Neither brace nor tape produced significant changes in TKM or components, yet sagittal TKM increased with ARG versus control ( = .016). Women exhibited less ankle inversion ROM ( = .003) and moment ( = .049) than men, while men exhibited significantly greater frontal TKM ( = .022) and knee internal rotation moment with the ARG ( = .029), control ( = .007), and tape ( = .016).
Prophylactics that restrict ankle plantarflexion motion may elicit knee biomechanical changes during a single-leg cut, but these changes may depend on prophylactic design and user's sex and may increase women's injury risk.
Sex-specific ankle prophylactic designs may be warranted to reduce knee injury during sports.
尽管在预防踝关节扭伤方面取得了成功，但限制踝关节跖屈运动的预防性护具可能会产生有害的膝关节生物力学变化并增加受伤风险。
确定限制跖屈和背屈运动的踝关节预防性护具在单腿切入动作期间是否会引起膝关节生物力学变化，以及这些变化在性别之间是否存在差异。
对照实验室研究。
共有17名男性和17名女性参与者在4种条件下进行单腿切入动作：踝关节滚动防护护具（ARG）、系带式护具、非弹性胶带和无支撑对照。采用重复测量方差分析测试了站立期膝关节屈曲、外展和内旋的峰值关节角度和力矩；总膝关节反应力矩（TKM）及其分量（矢状面、额状面和横断面）；以及踝关节跖屈和内翻活动范围（ROM）和站立期峰值关节力矩，以确定条件和性别的主效应及交互作用。
与ARG和对照相比，护具和胶带限制了跖屈ROM（均P <.001）。佩戴护具时，与ARG相比，女性的膝关节外展峰值角度增加（P = 0.012），与对照相比也增加（P = 0.009）；与ARG相比，男性的膝关节内旋峰值力矩降低（P = 0.032），与对照相比降低（P = 0.006），与胶带相比也降低（P = 0.003）。尽管与ARG相比，限制性胶带降低了内翻ROM（P = 0.004），与护具相比也降低了（P = 0.017），但它并未改变膝关节生物力学。护具和胶带均未使TKM或其分量产生显著变化，但与对照相比，ARG使矢状面TKM增加（P = 0.016）。女性的踝关节内翻ROM（P = 0.003）和力矩（P = 0.049）均小于男性，而男性在使用ARG、对照和胶带时，额状面TKM（P = 0.022）和膝关节内旋力矩显著更大。
限制踝关节跖屈运动的预防性护具在单腿切入动作期间可能会引发膝关节生物力学变化，但这些变化可能取决于预防性护具的设计和使用者的性别，并且可能会增加女性的受伤风险。
可能需要针对性别的踝关节预防性护具设计，以减少运动期间的膝关节损伤。
