Physical Medicine and Rehabilitation Unit, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
II Clinic of Orthopaedics and Traumatology, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy.
Gait Posture. 2021 Oct;90:340-373. doi: 10.1016/j.gaitpost.2021.09.182. Epub 2021 Sep 20.
It has been reported that individuals with chronic ankle instability (CAI) show motor control abnormalities. The study of muscle activations by means of surface electromyography (sEMG) plays a key role in understanding some of the features of movement abnormalities.
Do common sEMG activation abnormalities and strategies exists across different functional movements?
Literature review was conducted on PubMed, Web-of-Science and Cochrane databases. Studies published between 2000 and 2020 that assessed muscle activations by means of sEMG during any type of functional task in individuals with CAI, and used healthy individuals as controls, were included. Methodological quality was assessed using the modified Downs&Black checklist. Since the methodologies of different studies were heterogeneous, no meta-analysis was conducted.
A total of 63 articles investigating muscle activations during gait, running, responses to perturbations, landing and hopping, cutting and turning; single-limb stance, star excursion balance task, forward lunges, ball-kicking, y-balance test and single-limb squatting were considered. Individuals with CAI showed a delayed activation of the peroneus longus in response to sudden inversion perturbations, in transitions between double- and single-limb stance, and in landing on unstable surfaces. Apparently, while walking on ground there are no differences between CAI and controls, walking on a treadmill increases the variability of muscles activations, probably as a "safety strategy" to avoid ankle inversion. An abnormal activation of the tibialis anterior was observed during a number of tasks. Finally, hip/spine muscles were activated before ankle muscles in CAI compared to controls.
Though the methodology of the studies herein considered is heterogeneous, this review shows that the peroneal and tibialis anterior muscles have an abnormal activation in CAI individuals. These individuals also show a proximal muscle activation strategy during the performance of balance challenging tasks. Future studies should investigate whole-body muscle activation abnormalities in CAI individuals.
已有研究报道，慢性踝关节不稳（CAI）患者存在运动控制异常。表面肌电图（sEMG）技术可以用于研究肌肉激活情况，这对于理解运动异常的某些特征具有重要作用。
不同功能运动中是否存在常见的 sEMG 激活异常和策略？
在 PubMed、Web-of-Science 和 Cochrane 数据库中进行文献回顾。纳入了 2000 年至 2020 年间发表的评估 CAI 患者在任何类型的功能性任务中通过 sEMG 进行肌肉激活的研究，并将健康个体作为对照。使用改良的 Downs&Black 清单评估方法学质量。由于不同研究的方法学存在异质性，因此未进行荟萃分析。
共纳入 63 篇研究，涉及步态、跑步、对扰动的反应、着陆和跳跃、切割和转弯、单腿站立、星形伸展平衡测试、前弓步、踢球、Y 平衡测试和单腿深蹲等功能运动。CAI 患者在对突然内翻扰动、从双腿支撑到单腿支撑的过渡以及在不稳定表面着陆时，腓骨长肌的激活延迟。显然，在地面行走时，CAI 与对照组之间没有差异，而在跑步机上行走会增加肌肉激活的可变性，这可能是一种避免踝关节内翻的“安全策略”。在多项任务中观察到胫骨前肌的异常激活。最后，与对照组相比，CAI 患者在进行平衡挑战任务时，髋关节/脊柱肌肉比踝关节肌肉更早激活。
尽管本文考虑的研究方法具有异质性，但本综述表明，腓骨长肌和胫骨前肌在 CAI 患者中存在异常激活。这些患者在进行平衡挑战任务时还表现出近端肌肉激活策略。未来的研究应调查 CAI 患者的全身肌肉激活异常。
