Mulligan Edward P, DeVahl Julie
Department of Physical Therapy, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Int J Sports Phys Ther. 2020 Dec;15(6):1061-1072. doi: 10.26603/ijspt20201061.
Ankle instability can be problematic in an active population with multiple risk factors associated with recurrence.
The aim of this study was to determine if deficits in weight-bearing and non-weight bearing assessment of hip strength or dynamic balance in lower extremity reaching tasks from flat and inclined surfaces can differentiate subjects classified as controls, ankle sprain copers, or those with chronic, recurrent ankle sprains.
Quasiexperimental, Ex post facto.
A convenience sample of 60 subjects was classified into control, coper, or chronic ankle sprain groups based on the results of the Identification of Functional Ankle Instability Questionnaire. Subjects were tested for peak force production of their hip extensors, hip abductors, and a composite of hip extension and external rotation while in a standing position using a hand-held dynamometer. Additionally, each subject performed a modified Star Excursion Balance Test in anterior, posterolateral, and posteromedial directions from both a flat and 15 ° inverted stance position. One-way analysis of variance was calculated for between group differences of hip strength and balance reach ability and ankle stability classification. Pearson product-moment correlation coefficients were derived to evaluate relationships between hip strength and dynamic balance tests.
Twenty-one subjects were assigned to the control group, 23 to the coper group, and 16 to the chronic group. There were no significant differences between groups in self-report of Foot and Ankle Ability Measures or Tegner activity levels. Mean hip strength was not significantly different between ankle sprain classification groups (p = 0.66 - 0.82). The mean limb symmetry index for hip strength comparing injured and uninjured ankles was nearly symmetrical in all ankle stability groups (p = 0.34 - 0.97). The same symmetry was present when comparing injured and uninjured abilities for all dynamic balance reach tasks from both flat and inclined surfaces. (p = 0.16 - 0.62). There was a fair relationship between hip extension and weight-bearing hip extension/external rotation strength and the posteromedial and posterolateral reach tasks with correlation coefficients in the range of 0.33 - 0.43.
Performance measures of tri-planar, static, isometric hip strength and lower extremity reach in dynamic balance tasks could not differentiate subjects without a history of injury from those subjects with one or more lateral ligamentous ankle sprains.
2b; Ex post facto.
在有多种复发风险因素的活跃人群中，踝关节不稳定可能是个问题。
本研究的目的是确定在负重和非负重状态下评估髋关节力量的不足，以及在从平面和倾斜表面进行的下肢伸展任务中的动态平衡，是否能够区分被归类为对照组、踝关节扭伤应对者或患有慢性复发性踝关节扭伤的受试者。
准实验性，事后分析。
根据功能性踝关节不稳定问卷的结果，将60名受试者的便利样本分为对照组、应对组或慢性踝关节扭伤组。使用手持测力计，让受试者在站立位测试其髋伸肌、髋外展肌的峰值力量产生，以及髋伸展和外旋的综合力量。此外，每个受试者从平面和15°倒置姿势位置，在前、后外侧和后内侧方向进行改良的星形偏移平衡测试。计算髋关节力量、平衡伸展能力和踝关节稳定性分类的组间差异的单因素方差分析。推导皮尔逊积矩相关系数，以评估髋关节力量与动态平衡测试之间的关系。
21名受试者被分配到对照组，23名到应对组，16名到慢性组。在足踝能力测量的自我报告或泰格纳活动水平方面，各组之间没有显著差异。踝关节扭伤分类组之间的平均髋关节力量没有显著差异（p = 0.66 - 0.82）。在所有踝关节稳定性组中，比较受伤和未受伤踝关节的髋关节力量的平均肢体对称指数几乎对称（p = 0.34 - 0.97）。在比较平面和倾斜表面上所有动态平衡伸展任务的受伤和未受伤能力时，也存在同样的对称性（p = 0.16 - 0.62）。髋关节伸展与负重髋关节伸展/外旋力量以及后内侧和后外侧伸展任务之间存在适度的关系，相关系数在0.33 - 0.43范围内。
在动态平衡任务中，三平面静态等长髋关节力量和下肢伸展的性能测量，无法区分没有受伤史的受试者和有一次或多次外侧韧带踝关节扭伤的受试者。
2b；事后分析。
