Department of Exercise and Sport Science, MOTION Science Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Med Sci Sports Exerc. 2022 Jul 1;54(7):1176-1182. doi: 10.1249/MSS.0000000000002902. Epub 2022 Apr 7.
This study aimed to identify associations between dorsiflexion range of motion (DFROM), functional hop test performance, and hopping biomechanics with the magnitude of talar cartilage deformation after a standardized hopping protocol in individuals with and without chronic ankle instability (CAI).
Thirty CAI and 30 healthy individuals participated. Ankle DFROM was assessed using the weight-bearing lunge test. Four different functional hop tests were assessed. Three-dimensional kinematics and kinetics were sampled during a 60-cm single-leg hop. We calculated cartilage deformation after a dynamic loading protocol consisting of sixty 60-cm single-leg forward hops by assessing the change in average thickness for the overall, medial, and lateral talar cartilage. Linear regressions examined the associations between cartilage deformation magnitude and DFROM, functional hop tests, and hop biomechanical variables after accounting for body weight and time since the initial ankle sprain.
In CAI group, lesser static DFROM (ΔR2 = 0.22) and smaller peak ankle dorsiflexion angle (ΔR2 = 0.17) was associated with greater medial deformation. Greater peak vertical ground reaction force (vGRF) (ΔR2 = 0.26-0.28) was associated with greater medial and overall deformation. Greater vGRF loading rate (ΔR2 = 0.23-0.35) was associated with greater lateral and overall deformation. Greater side hop test times (ΔR2 = 0.31-0.36) and ankle plantarflexion at initial contact (ΔR2 = 0.23-0.38) were associated with greater medial, lateral, and overall deformation. In the control group, lesser side hop test times (ΔR2 = 0.14), greater crossover hop distances (ΔR2 = 0.14), and greater single-hop distances (ΔR2 = 0.21) were associated with greater overall deformation.
Our results indicate that lesser static DFROM, poorer functional hop test performance, and hop biomechanics associate with greater talar cartilage deformation after a dynamic loading protocol in those with CAI. These factors may represent targets for therapeutic interventions within this population to slow ankle posttraumatic osteoarthritis progression.
本研究旨在确定在患有和不患有慢性踝关节不稳定（CAI）的个体中，背屈活动度（DFROM）、功能性跳跃测试表现和跳跃生物力学与距骨软骨变形量之间的关联，以及标准化跳跃方案后的距骨软骨变形量。
30 名 CAI 和 30 名健康个体参与了研究。使用负重弓步测试评估踝关节 DFROM。评估了 4 种不同的功能性跳跃测试。在 60cm 单腿跳跃过程中采样三维运动学和动力学。通过评估整个、内侧和外侧距骨软骨的平均厚度变化，计算出动态加载方案（包括 60 次 60cm 单腿向前跳跃）后的软骨变形量。线性回归分析考虑了体重和初次踝关节扭伤后的时间后，评估了距骨软骨变形量与 DFROM、功能性跳跃测试和跳跃生物力学变量之间的关联。
在 CAI 组中，较小的静态 DFROM（ΔR2=0.22）和较小的峰值踝关节背屈角度（ΔR2=0.17）与较大的内侧变形相关。更大的峰值垂直地面反作用力（vGRF）（ΔR2=0.26-0.28）与更大的内侧和整体变形相关。更大的 vGRF 加载率（ΔR2=0.23-0.35）与更大的外侧和整体变形相关。更大的侧跳测试时间（ΔR2=0.31-0.36）和初始接触时的踝关节跖屈（ΔR2=0.23-0.38）与更大的内侧、外侧和整体变形相关。在对照组中，较小的侧跳测试时间（ΔR2=0.14）、更大的交叉跳跃距离（ΔR2=0.14）和更大的单跳距离（ΔR2=0.21）与更大的整体变形相关。
我们的结果表明，在 CAI 患者中，较小的静态 DFROM、较差的功能性跳跃测试表现和跳跃生物力学与动态加载方案后的距骨软骨变形量较大相关。这些因素可能代表该人群中治疗干预的目标，以减缓踝关节创伤后骨关节炎的进展。
