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距下软骨变形与具有和不具有慢性踝关节不稳的个体的时空步态模式。

Talar-Cartilage Deformation and Spatiotemporal Gait Patterns in Individuals With and Those Without Chronic Ankle Instability.

机构信息

Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington.

Department of Athletic Training, Keiser University-Flagship Campus, West Palm Beach, FL.

出版信息

J Athl Train. 2022 Jun 1;57(6):564-570. doi: 10.4085/1062-6050-733-20.

Abstract

CONTEXT

Individuals with chronic ankle instability (CAI) present with alterations in the compositional structure of their talar articular cartilage. These alterations likely influence how the talar cartilage responds to the loading associated with activities of daily living, such as walking. Ultrasonography has emerged as an alternative imaging modality for assessing the amount of cartilage deformation in response to loading because it is clinically accessible and cost effective for routine measurements.

OBJECTIVES

To (1) compare talar-cartilage deformation in response to a standardized exercise protocol between those with and those without CAI and (2) examine the association between spatiotemporal walking gait parameters and cartilage deformation.

DESIGN

Case-control study.

SETTING

Research laboratory.

PATIENTS OR OTHER PARTICIPANTS

A volunteer sample of 24 participants with self-reported CAI (age = 23.2 ± 3.9 years, body mass index [BMI] = 25.1 ± 3.7 kg/m2) and 24 uninjured controls (age = 24.3 ± 2.9 years, BMI = 22.9 ± 2.8 kg/m2).

MAIN OUTCOME MEASURE(S): Spatiotemporal walking gait was first assessed from 5 self-selected trials using an electronic walkway with data sampled at 120 Hz. An 8- to 13-MHz linear-array ultrasound transducer placed transversely in line with the medial and lateral malleoli captured 3 images before and after a standardized loading protocol consisting of 30 single- and double-limb squats, 2-minute single-limb balance, and 10 single-legged drops from a 40-cm-height box.

RESULTS

After controlling for BMI, we found that the participants with CAI had greater deformation than the uninjured control participants (P = .034). No other between-groups differences were observed (P values > .05). No significant partial correlations were noted between talar-cartilage deformation and spatiotemporal gait parameters when controlling for BMI (P > .05).

CONCLUSIONS

Individuals with CAI had greater talar-cartilage deformation in response to a standardized exercise protocol than control individuals. The amount of talar-cartilage deformation was not associated with the spatiotemporal walking gait.

摘要

背景

患有慢性踝关节不稳定(CAI)的个体其距骨关节软骨的组成结构发生改变。这些改变可能会影响距骨软骨对日常生活活动相关负荷的反应方式,例如行走。超声检查已成为评估负荷下软骨变形量的替代成像方式,因为它对临床具有可及性且对于常规测量而言具有成本效益。

目的

(1)比较 CAI 患者和无 CAI 患者在标准化运动方案下距骨软骨的变形情况,(2)检查时空步态参数与软骨变形之间的相关性。

设计

病例对照研究。

设置

研究实验室。

患者或其他参与者

志愿者样本包括 24 名自我报告患有 CAI 的参与者(年龄=23.2±3.9 岁,体重指数[BMI]=25.1±3.7kg/m2)和 24 名未受伤的对照者(年龄=24.3±2.9 岁,BMI=22.9±2.8kg/m2)。

主要观察指标

首先使用电子步道从 5 个自选试验中评估时空步态,数据以 120Hz 的速度进行采样。一个 8-13MHz 的线性阵列超声换能器放置在内外踝的横向线上,在一个由 30 次单腿和双腿深蹲、2 分钟单腿平衡和 10 次从 40cm 高的箱子单腿跳下组成的标准化负荷方案前后捕获 3 个图像。

结果

在控制 BMI 后,我们发现 CAI 患者的变形大于未受伤的对照组(P=0.034)。未观察到其他组间差异(P 值>.05)。在控制 BMI 后,未观察到距骨软骨变形与时空步态参数之间存在显著的部分相关关系(P>.05)。

结论

与对照组相比,CAI 患者在标准化运动方案下距骨软骨的变形更大。距骨软骨的变形量与时空步行步态无关。

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2
An Updated Model of Chronic Ankle Instability.慢性踝关节不稳的更新模型。
J Athl Train. 2019 Jun;54(6):572-588. doi: 10.4085/1062-6050-344-18. Epub 2019 Jun 4.
3
Epidemiology of Ankle Sprains and Chronic Ankle Instability.踝关节扭伤和慢性踝关节不稳定的流行病学。
J Athl Train. 2019 Jun;54(6):603-610. doi: 10.4085/1062-6050-447-17. Epub 2019 May 28.

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