Kobayashi Takumi, Koshino Yuta, Miki Takahiro
Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, 2-10 Satomi, Chitose, Hokkaido, 066-0055, Japan.
Rehabilitation Center, NTT Medical Center Sapporo, Sapporo, Hokkaido, Japan.
BMC Musculoskelet Disord. 2021 Aug 12;22(1):683. doi: 10.1186/s12891-021-04537-6.
To prevent recurrent ankle sprain, it is important to clarify the pathology of chronic ankle instability (CAI). An association has been reported between CAI and abnormalities of foot posture and ankle alignment. There is no consensus on the types of these abnormalities that occur in individuals with CAI. The objective of this systematic review is to clarify the relevance of abnormality of foot posture and ankle alignment for CAI.
A systematic computerized literature search was performed of the PubMed, CINAHL, SPORTDiscus, Web of Science, and the Cochrane Register of Clinical Trials databases. The selected studies either compared CAI patients with a control group or CAI ankles with contralateral healthy ankles and specifically reported foot posture and alignment of the ankle in the outcomes. They were written in English and published prior to June 2021. The methodological quality of the included studies was evaluated using a 16-question index. Data were extracted independently by two reviewers, and the certainty of evidence was assessed using GRADE approach.
Sixteen studies including 872 patients of high to low methodological quality were included. These showed there was significant anterior displacement and internal rotation of the talus in CAI ankles (low evidence), but there was no consensus on fibular alignment or foot posture.
This review showed there was significant anterior displacement and internal rotation of the talus in CAI ankles but found no consensus on the characteristics of fibular and foot alignment. Further investigations are required to clarify the characteristic foot and ankle malalignment in CAI to facilitate the development of efficient interventions.
为预防复发性踝关节扭伤，明确慢性踝关节不稳（CAI）的病理机制至关重要。已有报道称CAI与足部姿势及踝关节对线异常有关。对于CAI患者中出现的这些异常类型，目前尚无共识。本系统评价的目的是阐明足部姿势和踝关节对线异常与CAI的相关性。
对PubMed、CINAHL、SPORTDiscus、Web of Science和Cochrane临床试验注册数据库进行系统的计算机文献检索。所选研究要么将CAI患者与对照组进行比较，要么将CAI踝关节与对侧健康踝关节进行比较，并在结果中具体报告足部姿势和踝关节对线情况。研究需为英文撰写且发表于2021年6月之前。采用一个包含16个问题的指标评估纳入研究的方法学质量。由两名 reviewers 独立提取数据，并使用GRADE方法评估证据的确定性。
纳入了16项研究，共872例患者，方法学质量从高到低不等。这些研究表明，CAI踝关节中距骨存在明显的向前移位和内旋（证据质量低），但在腓骨对线或足部姿势方面尚无共识。
本评价表明，CAI踝关节中距骨存在明显的向前移位和内旋，但在腓骨和足部对线特征方面未达成共识。需要进一步研究以明确CAI中足部和踝关节排列不齐的特征，以促进有效干预措施的发展。
