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整体姿势再教育对拇外翻患者姿势控制、动态平衡及踝关节活动范围的影响。一项随机对照试验。

Effects of global postural reeducation on postural control, dynamic balance, and ankle range of motion in patients with hallux abducto valgus. A randomized controlled trial.

作者信息

Estepa-Gallego Alejandro, Ibañez-Vera Alfonso Javier, Estudillo-Martínez María Dolores, Castellote-Caballero Yolanda, Bergamin Marco, Gobbo Stefano, Lérida-Ortega Miguel Ángel, Cruz-Díaz David

机构信息

Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain.

Department of Statistics, Faculty of Experimental Sciences, University of Jaén, Jaén, Spain.

出版信息

J Orthop Res. 2022 Jun;40(6):1436-1445. doi: 10.1002/jor.25156. Epub 2021 Aug 18.

Abstract

Hallux abducto valgus (HAV) is a common musculoskeletal disorder that has been addressed surgically. Nevertheless, the manual therapy approach may play an important role in the management of this condition. The present study aimed to determine the effectiveness of global postural reeducation (GPR) in subjects with symptomatic mild to moderate HAV in static postural control, dynamic stability, and ankle dorsiflexion range of motion (DFROM). A total of 80 patients with mild to moderate symptomatic HAV were allocated to the intervention group (GPR) or control group (CG) (no treatment) for 8 weeks. Outcome measures were assessed at baseline at 4 and 8 weeks including static postural control (Romberg test), dynamic balance (Star Excursion Balance Test [SEBT]), and ankle DFROM (Weight-Bearing Lunge Test [WBLT]). No improvements were observed at 4 weeks, but there were improvements at 8 weeks in: static postural control mediolateral displacement (X) of center of pressure (CoP) in both eyes open (EO) and eyes closed (EC): XEO (t(36) = 2.892, p = .006, d = 0.67); XEC (t(68) = 2.280, p = .026, d = 054); and velocity (V) of CoP displacement: VEO (t(68) = 2.380, p = .020, d = 0.57); VEC (t(36) = 2.057, p = .047, d = 0.37). It were also improvements in: WBLT (t(36) = -2.869, p = .007, d = 0.54) and SEBT at three directions (anterior, ANT; posteromedial, PM; and posterolateral, PL): SEBT.ANT (t(36) = -2.292, p = .028, d = 0.23); SEBT.PM (t(36) = -4.075, p < .001, d = 0.43); SEBT.PL (t(62) = -3.506, p = .001, d = 0.34). The present study showed that GPR compared to the CG might be effective in enhancing ankle function including postural control, dynamic balance, and DFROM.

摘要

拇外翻(HAV)是一种常见的肌肉骨骼疾病,已经有了手术治疗方法。然而,手法治疗方法在这种疾病的管理中可能发挥重要作用。本研究旨在确定整体姿势再教育(GPR)对有症状的轻度至中度HAV患者在静态姿势控制、动态稳定性和踝关节背屈活动范围(DFROM)方面的有效性。总共80例轻度至中度有症状的HAV患者被分配到干预组(GPR)或对照组(CG,不进行治疗),为期8周。在基线、4周和8周时评估结果指标,包括静态姿势控制(Romberg试验)、动态平衡(星形偏移平衡试验[SEBT])和踝关节DFROM(负重弓步试验[WBLT])。4周时未观察到改善,但8周时出现了以下改善:在双眼睁开(EO)和双眼闭合(EC)时,压力中心(CoP)的静态姿势控制中外侧位移(X):XEO(t(36) = 2.892,p = 0.006,d = 0.67);XEC(t(68) = 2.280,p = 0.026,d = 0.54);以及CoP位移的速度(V):VEO(t(68) = 2.380,p = 0.020,d = 0.57);VEC(t(36) = 2.057,p = 0.047,d = 0.37)。WBLT(t(36) = -2.869,p = 0.007,d = 0.54)以及SEBT在三个方向(前侧,ANT;后内侧,PM;和后外侧,PL)也有改善:SEBT.ANT(t(36) = -2.292,p = 0.028,d = 0.23);SEBT.PM(t(36) = -4.075,p < 0.001,d = 0.43);SEBT.PL(t(62) = -3.506,p = 0.001,d = 0.34)。本研究表明,与CG相比,GPR可能在增强包括姿势控制、动态平衡和DFROM在内的踝关节功能方面有效。

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