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慢性踝关节不稳对单足跳落地任务中下肢运动学、动态姿势稳定性和肌肉活动的影响:系统评价和荟萃分析。

Effect of chronic ankle instability on lower extremity kinematics, dynamic postural stability, and muscle activity during unilateral jump-landing tasks: A systematic review and meta-analysis.

机构信息

Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore, 117597, Singapore.

Department of Orthopaedic Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore; SingHealth Duke-NUS Musculoskeletal Sciences Academic Clinical Programme, 20 College Road, Academia Level 4, Singapore, 169865, Singapore.

出版信息

Phys Ther Sport. 2022 May;55:176-188. doi: 10.1016/j.ptsp.2022.04.005. Epub 2022 Apr 12.

Abstract

OBJECTIVE

To determine if individuals with chronic ankle instability (CAI) demonstrate altered landing kinematics, muscle activity, and impaired dynamic postural stability during a unilateral jump-landing task.

METHODS

21 studies were included from PubMed, MEDLINE, Embase and CINAHL searched on September 26, 2021. Mean differences in joint angles and muscle activity between CAI and controls were analysed as continuous variables and pooled using a random-effects model to obtain standardised mean differences and 95% confidence intervals. Dynamic postural stability measured using time to stabilisation (TTS) was assessed qualitatively.

RESULTS

We found greater plantarflexion (pooled SMD = 0.33, 95%CI [0.02,0.65]), reduced knee flexion (pooled SMD = -0.67, 95%CI [-0.97, -0.37]), and reduced hip flexion (pooled SMD = -0.52, 95%CI [-0.96, -0.07]) in CAI after landing. Regarding muscle activity, we observed reduced peroneus longus muscle activation (pooled SMD = -0.77, 95% CI [-1.17, -0.36]) in CAI prior to landing.

CONCLUSION

Our study provides preliminary evidence of altered landing kinematics in the sagittal plane and reduced peroneus muscle activity in CAI during a dynamic jump-landing task. These results may have clinical implications in the development of more effective and targeted rehabilitation programmes for patients with CAI.

摘要

目的

确定慢性踝关节不稳定(CAI)患者在单足跳跃着陆任务中是否表现出不同的着陆运动学、肌肉活动和动态姿势稳定性受损。

方法

2021 年 9 月 26 日,从 PubMed、MEDLINE、Embase 和 CINAHL 搜索中纳入了 21 项研究。使用随机效应模型对 CAI 和对照组之间的关节角度和肌肉活动的平均差异进行分析,作为连续变量,并汇总以获得标准化均数差值和 95%置信区间。使用稳定时间(TTS)定性评估动态姿势稳定性。

结果

我们发现 CAI 患者在着陆后出现更大的跖屈(汇总 SMD=0.33,95%CI [0.02,0.65])、更小的膝关节屈曲(汇总 SMD=-0.67,95%CI [-0.97,-0.37])和更小的髋关节屈曲(汇总 SMD=-0.52,95%CI [-0.96,-0.07])。关于肌肉活动,我们观察到 CAI 患者在着陆前腓骨长肌的激活减少(汇总 SMD=-0.77,95%CI [-1.17,-0.36])。

结论

我们的研究提供了初步证据,表明在动态跳跃着陆任务中,CAI 患者在矢状面的着陆运动学发生改变,腓骨肌活动减少。这些结果可能对开发更有效和有针对性的 CAI 患者康复计划具有临床意义。

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