J Sport Rehabil. 2022 Feb 1;31(2):158-164. doi: 10.1123/jsr.2021-0148. Epub 2021 Oct 6.
Ankle positioning gait biofeedback (GBF) has improved ankle inversion for patients with chronic ankle instability. However, the effects on proximal deficits remain unknown. The purpose of this study was to determine the effects of impairment-based rehabilitation with GBF and without biofeedback on gluteal activity during walking in patients with chronic ankle instability.
Randomized controlled trial.
Eighteen patients with chronic ankle instability (14 women and 4 men; age 22 [4] y; height 171 [10] cm; mass 71.6 [13.8] kg) were recruited from a university setting, following International Ankle Consortium guidelines. Patients were randomly allocated to GBF or without biofeedback groups (N = 9 per group). Both groups performed 4 weeks of exercises and treadmill walking. The GBF group alone received feedback on frontal ankle positioning at initial contact during walking. Ultrasound videos of the gluteus maximus and medius were recorded during walking at baseline and follow-up by a blinded clinician. Gluteal activity ratios were obtained at each 10% of the gait cycle. Statistical parametric mapping repeated-measures analysis of variance were used to compare groups and time points.
Both groups demonstrated significantly increased gluteus medius activity across the gait cycle compared with baseline (P < .01, mean differences: 0.13-0.21, Hedge g: 0.97-1.89); however, there were no significant between-group differences. There were no statistically significant changes noted for the gluteus maximus. No adverse events were observed.
Impairment-based rehabilitation led to increased gluteus medius activity, but GBF did not provide any additional improvement to this parameter. Clinicians may consider implementing impairment-based strengthening interventions to improve gluteus medius function during gait for patients with CAI.
踝关节定位步态生物反馈（GBF）已改善慢性踝关节不稳患者的踝关节内翻。然而，其对近端缺陷的影响尚不清楚。本研究旨在确定基于损伤的康复治疗结合 GBF 和无生物反馈对慢性踝关节不稳患者步行时臀肌活动的影响。
随机对照试验。
根据国际踝关节联合会指南，从一所大学环境中招募了 18 名慢性踝关节不稳患者（14 名女性和 4 名男性；年龄 22[4]岁；身高 171[10]厘米；体重 71.6[13.8]千克）。患者随机分配到 GBF 或无生物反馈组（每组 9 名）。两组均进行 4 周的锻炼和跑步机步行。仅 GBF 组在步行初始接触时收到关于前踝定位的反馈。在基线和随访时，由一名盲法临床医生通过超声视频记录臀大肌和臀中肌在步行时的活动。在每个步态周期的 10%处获得臀肌活动比。使用统计参数映射重复测量方差分析比较组间和时间点。
与基线相比，两组在整个步态周期中臀中肌活动均显著增加（P <.01，平均差异：0.13-0.21，Hedge g：0.97-1.89）；然而，组间无显著差异。臀大肌无统计学意义的变化。未观察到不良事件。
基于损伤的康复导致臀中肌活动增加，但 GBF 并未对此参数提供任何额外的改善。临床医生可能会考虑实施基于损伤的强化干预措施，以改善慢性踝关节不稳患者步态时的臀中肌功能。
