Department of Health Science, Gachon University Graduate School, Incheon 21936, Korea.
Graduate School of Integrative Medicine, CHA University, Seongnam 13488, Korea.
Int J Environ Res Public Health. 2020 Jul 11;17(14):4997. doi: 10.3390/ijerph17144997.
Manipulative therapies and exercises are commonly used for the management of chronic ankle instability (CAI), but there is no evidence regarding the efficacy of high-velocity low-amplitude manipulation (HVLA) in addition to ankle therapeutic exercise to improve CAI in adolescent baseball players (ABP). To compare the effects of HVLA plus ankle therapeutic exercise and ankle therapeutic exercise alone on ankle status, pain intensity, pain pressure threshold (PPT), range of motion (ROM) of the ankle joint, and balance ability in ABP with CAI, a single-blinded randomized controlled trial was conducted. A total of 31 ABP with CAI were randomly allocated to the intervention (n = 16) or control (n = 15) groups. The intervention group received HVLA plus resistance exercise twice a week for 4 weeks, while the control group received resistance exercise alone. Ankle status, pain intensity, PPT, ROM, and balance ability were assessed before and after the intervention. The American Orthopedic Foot and Ankle Society scores showed significant group and time interactions (total, = 0.002; pain, < 0.001; alignment, = 0.001). There were significant group and time interactions in pain intensity (resting pain, = 0.008; movement pain, < 0.001). For ROM, there were significant group and time interactions on dorsiflexion ( = 0.006) and eversion ( = 0.026). The unipedal stance of the balance ability showed significant group and time interactions in path length ( = 0.006) and velocity ( = 0.006). Adding HVLA to resistance exercises may be synergistically effective in improving the ankle status, pain intensity, ROM, and balance ability in ABP with CAI.
手法治疗和运动常用于慢性踝关节不稳定（CAI）的管理，但目前尚无证据表明高频低幅手法（HVLA）联合踝关节运动疗法除了改善青少年棒球运动员（ABP）CAI 之外是否有效。为了比较 HVLA 联合踝关节运动疗法和单纯踝关节运动疗法对 CAI 的 ABP 踝关节状态、疼痛强度、疼痛压力阈值（PPT）、踝关节活动度（ROM）和平衡能力的影响，进行了一项单盲随机对照试验。共有 31 名 CAI 的 ABP 随机分为干预组（n = 16）和对照组（n = 15）。干预组每周接受 HVLA 联合阻力运动治疗 2 次，共 4 周，而对照组仅接受阻力运动治疗。在干预前后评估踝关节状态、疼痛强度、PPT、ROM 和平衡能力。美国矫形足踝协会评分显示组间和时间交互作用有统计学意义（总分， = 0.002；疼痛， < 0.001；对线， = 0.001）。疼痛强度的组间和时间交互作用有统计学意义（静息痛， = 0.008；运动痛， < 0.001）。ROM 方面，背屈（ = 0.006）和外翻（ = 0.026）有显著的组间和时间交互作用。平衡能力的单足站立试验在路径长度（ = 0.006）和速度（ = 0.006）方面有显著的组间和时间交互作用。在阻力运动治疗中加入 HVLA 可能会协同有效改善 CAI 的 ABP 踝关节状态、疼痛强度、ROM 和平衡能力。
