Department of sports medicine of Peking university third hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, No.49 North Garden Road, Haidian, Beijing, 100191, China.
Research Center of Clinical Epidemiology, Peking University Third Hospital, No.49 North Garden Road, Haidian, Beijing, 100191, China.
J Foot Ankle Res. 2022 Feb 1;15(1):9. doi: 10.1186/s13047-022-00514-x.
To determine the effectiveness and sustainability of supervised balance training in people with chronic ankle instability (CAI) with grade III ligament injury.
Twenty young adults (12 males and 8 females) diagnosed with CAI with grade III ligament injury underwent 3 months of supervised balance training. The self-reported functional questionnaire, plantar pressure (walking and single leg standing), and isokinetic ankle strength were consecutively evaluated at pre-training, 3 months, 6 months and one year. Paired T tests were used to explore changes in muscle strength and plantar pressures following the supervised balance training. According to whether the patient had sprain recurrence, the patients were divided into sprain recurrence group and control group. The risk factors of sprain recurrence were explored with univariate analysis and multivariable logistic regression.
The self-reported functional scores, the plantar pressure distribution and the muscle strength showed significant immediate improvements after 3 months of supervised balance training. At 6 months post-training, peak force under 2nd metatarsal, time to peak force under the medial hindfoot, time to boundary measurements and dorsiflexion, and eversion strength were partly declined to the pre-training level. 16 patients (80%) resumed the daily life and sports without sprain recurrence during the follow-up. Four patients (20%) reported ankle sprain during the follow-up, and the sprain recurrence group showed significantly higher Beighton scores (p = 0.012) and weaker initial inversion strength (p = 0.022) than the control group.
Three months' of supervised balance training could effectively improve postural control and muscle strength of CAI cases with grade III ligament injury, although these improvements would partially deceased over time. Additional strength exercises for dorsiflexion and eversion should be supplemented from 6 months. Higher Beighton score and initial inversion muscle strength weakness might increase the risk of sprain recurrence.
ChiCTR, ChiCTR1900023999, Registered 21 June 2019, https://www.chictr.org.cn/edit.aspx?pid=39984&htm=4.
旨在确定监督平衡训练在慢性踝关节不稳（CAI）伴 III 级韧带损伤患者中的有效性和可持续性。
20 名被诊断为 CAI 伴 III 级韧带损伤的年轻成年人接受了 3 个月的监督平衡训练。在训练前、3 个月、6 个月和 1 年后，连续评估自我报告的功能问卷、足底压力（行走和单腿站立）和等速踝关节力量。配对 T 检验用于探讨监督平衡训练后肌肉力量和足底压力的变化。根据患者是否有扭伤复发，将患者分为复发组和对照组。采用单因素分析和多变量逻辑回归探讨扭伤复发的危险因素。
自我报告的功能评分、足底压力分布和肌肉力量在监督平衡训练 3 个月后均显示出显著的即时改善。在训练后 6 个月时，第二跖骨下的峰值力、内后足峰值力时间、边界测量时间和背屈、外翻力量部分恢复到训练前水平。在随访期间，16 名患者（80%）没有扭伤复发，恢复了日常生活和运动。在随访期间，有 4 名患者（20%）报告踝关节扭伤，复发组的 Beighton 评分明显较高（p=0.012），初始外翻力量较弱（p=0.022），与对照组相比。
3 个月的监督平衡训练可以有效改善 CAI 伴 III 级韧带损伤患者的姿势控制和肌肉力量，尽管这些改善会随着时间的推移而部分消失。从 6 个月开始，应补充背屈和外翻的额外力量练习。较高的 Beighton 评分和初始外翻肌肉力量较弱可能会增加扭伤复发的风险。
ChiCTR，ChiCTR1900023999，注册于 2019 年 6 月 21 日，https://www.chictr.org.cn/edit.aspx？pid=39984&htm=4。
