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初次急性外踝扭伤后进行物理康复治疗对慢性踝关节不稳患者静态姿势控制的影响。

The Effect of Attending Physical Rehabilitation After the First Acute Lateral Ankle Sprain on Static Postural Control in Patients With Chronic Ankle Instability.

出版信息

J Sport Rehabil. 2021 Mar 22;30(7):1000-1007. doi: 10.1123/jsr.2020-0346.

Abstract

CONTEXT

Static postural control deficits are commonly documented among individuals with chronic ankle instability (CAI). Evidence suggests individuals with CAI who seek medical attention after an ankle sprain report fewer subjective symptoms. It is unknown if seeking medical attention and receiving supervised physical rehabilitation has a similar effect on objective outcomes, such as static postural control.

OBJECTIVE

To compare measures of single-limb postural control and center of pressure (COP) location between participants with CAI who did or did not self-report attending supervised rehabilitation at the time of their first lateral ankle sprain.

DESIGN

Retrospective cohort.

SETTING

Laboratory. Patients (or Other Participants): Twenty-nine participants with CAI who did (n = 14) or did not (n = 15) self-report attending supervised rehabilitation.

INTERVENTION(S): Self-reported attendance or not of supervised rehabilitation at the time of initial injury.

MAIN OUTCOME MEASURES

Participants performed three 20-second trials of single-limb stance on a force plate with eyes open. Main outcome measures included the COP velocities, time-to-boundary (TTB) absolute minima, mean of TTB minima, and SD of TTB minima in the anteroposterior and mediolateral directions. The spatial distribution of the COP data points under the foot was quantified within 4 equally proportional sections labeled anteromedial, anterolateral, posteromedial, and posterolateral.

RESULTS

Participants who reported attending supervised rehabilitation after their initial ankle sprain had a lower COP velocity in the anterior-posterior direction (P = .030), and higher TTB anterior-posterior absolute minimum (P = .033) and mean minima (P = .050) compared with those who did not attend supervised rehabilitation.

CONCLUSIONS

Among individuals with CAI, not attending supervised rehabilitation at the time of initial injury may lead to worse static postural control outcomes. Clinicians should continue advocating for patients recovering from an acute ankle sprain to seek medical attention and provide continued care in the form of physical rehabilitation.

摘要

背景

慢性踝关节不稳(CAI)患者常存在静态姿势控制缺陷。有证据表明,在踝关节扭伤后寻求医疗帮助的 CAI 患者报告的主观症状较少。目前尚不清楚寻求医疗帮助和接受监督下的物理康复治疗对客观结果(如静态姿势控制)是否有类似的影响。

目的

比较初次踝关节外侧扭伤时报告或未报告接受监督下康复治疗的 CAI 患者的单腿姿势控制和中心压力(COP)位置测量值。

设计

回顾性队列研究。

环境

实验室。

患者(或其他参与者):29 名 CAI 患者,其中 14 名(报告组)或 15 名(未报告组)自我报告在初次损伤时接受监督下的康复治疗。

干预

初次损伤时报告或未报告接受监督下的康复治疗。

主要观察指标

参与者在测力板上单腿站立 20 秒,睁眼进行 3 次试验。主要观察指标包括 COP 速度、边界到达时间(TTB)绝对最小值、TTB 最小值平均值和 TTB 最小值标准差,方向为前后和左右。足底 COP 数据点的空间分布在 4 个等比例的区域内进行量化,分别标记为前内侧、前外侧、后内侧和后外侧。

结果

报告在初次踝关节扭伤后接受监督下康复治疗的患者,其 COP 速度在前-后方向较低(P =.030),TTB 前-后绝对最小值(P =.033)和平均最小值(P =.050)较高。

结论

在 CAI 患者中,初次损伤时未接受监督下的康复治疗可能导致静态姿势控制结果更差。临床医生应继续提倡急性踝关节扭伤患者寻求医疗帮助,并提供物理康复等形式的持续治疗。

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