Ma Yuanbo, Yin Keyi, Zhuang Wei, Zhang Cui, Jiang Yong, Huang Jin, Manor Brad, Zhou Junhong, Liu Yu
School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China.
Shandong Institute of Sport Science, Sports Biomechanics Laboratory, Jinan 250000, China.
Brain Sci. 2020 Oct 17;10(10):749. doi: 10.3390/brainsci10100749.
(1) Background: Balance decline is highly prevalent in people suffering from chronic ankle instability (CAI). The control of balance depends upon multiple neurophysiologic systems including the activation of cortical brain regions (e.g., the primary sensorimotor cortex). The excitability of this region, however, is diminished in people with CAI. In this pilot double-blinded randomized controlled trial, we tested the effects of high-definition transcranial direct current stimulation (HD-tDCS) designed to facilitate the excitability of M1 and S1 in combination with short-foot exercise (SFE) training on proprioception and dynamic balance performance in individuals with CAI. (2) Methods: Thirty young adults completed baseline assessments including the Active Movement Extent Discrimination Apparatus (AMEDA), Joint Position Reproduction (JPR) test, Y-balance test, and the Sensory Organization Test (SOT). They were then randomized to receive a four-week intervention of SFE in combination with tDCS (i.e., HD-tDCS+SFE) or sham (i.e., control) stimulation. Baseline assessments were repeated once-weekly throughout the intervention and during a two-week follow-up period. (3) Results: Twenty-eight participants completed this study. Blinding procedures were successful and no adverse events were reported. As compared to the control group, the HD-tDCS+SFE group exhibited significant improvements in the JPR test, the Y balance test, and the SOT at different time points. No group by time interaction was observed in AMEDA test performance. (4) Conclusions: HD-tDCS combined with SFE may improve dynamic balance and proprioception in CAI. Larger, more definitive trials with extended follow-up are warranted.
（1）背景：平衡能力下降在慢性踝关节不稳（CAI）患者中极为普遍。平衡的控制依赖于多个神经生理系统，包括皮质脑区（如初级感觉运动皮层）的激活。然而，该区域的兴奋性在CAI患者中会降低。在这项先导性双盲随机对照试验中，我们测试了旨在增强M1和S1兴奋性的高清经颅直流电刺激（HD-tDCS）与短足运动（SFE）训练相结合对CAI个体本体感觉和动态平衡能力的影响。（2）方法：30名年轻成年人完成了基线评估，包括主动运动范围辨别仪（AMEDA）、关节位置再现（JPR）测试、Y平衡测试和感觉组织测试（SOT）。然后他们被随机分为接受SFE与tDCS联合治疗（即HD-tDCS+SFE）或假刺激（即对照组）的四周干预。在整个干预过程和两周的随访期内，每周重复进行一次基线评估。（3）结果：28名参与者完成了本研究。盲法程序成功，未报告不良事件。与对照组相比，HD-tDCS+SFE组在不同时间点的JPR测试、Y平衡测试和SOT中均表现出显著改善。在AMEDA测试表现中未观察到组间与时间的交互作用。（4）结论：HD-tDCS联合SFE可能改善CAI患者的动态平衡和本体感觉。有必要进行更大规模、更具确定性且随访期更长的试验。
