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慢性踝关节不稳患者踝关节内翻本体感觉损伤具有任务特异性。

Ankle Inversion Proprioception Impairment in Persons with Chronic Ankle Instability Is Task-Specific.

机构信息

College of Rehabilitation Sciences, 191610Shanghai University of Medicine and Health Sciences, Shanghai, China.

Research Institute for Sport and Exercise, 2234University of Canberra, Canberra, ACT, Australia.

出版信息

Percept Mot Skills. 2022 Dec;129(6):1736-1748. doi: 10.1177/00315125221125608. Epub 2022 Sep 14.

Abstract

While investigators have often compared ankle proprioception between groups with and without chronic ankle instability (CAI), findings have been inconsistent. Possibly this is because ankle proprioceptive impairment in this population is task-specific. Thus, we aimed to compare ankle inversion proprioception in individuals with and without CAI in two task conditions: (i) when standing (not challenging) and (ii) when on a step-down landing (minimally-challenging). Ankle inversion proprioception was measured in both conditions for 38 recreational sport player volunteers with CAI ( = 19) and without CAI ( = 19). We used the Active Movement Extent Discrimination Apparatus (AMEDA) for the standing condition and the Ankle Inversion Discrimination Apparatus-Landing (AIDAL) for step-down landing. From analysis of variance (ANOVA) tests, CAI and non-CAI participants performed equally well on the AMEDA when standing; but the CAI group performed significantly worse than the non-CAI group on the AIDAL step-down landing task ( = 0.03). Within the non-CAI group, the AIDAL proprioceptive scores, as area under the receiver operating characteristics curve (AUC), were significantly higher than their AMEDA AUC scores ( = 0.03), while there was no significant difference between AIDAL and AMEDA AUC scores in the CAI group. Cumberland Ankle Instability Tool CAIT scores were significantly correlated with AIDAL scores (Spearman's rho = 0.391, = 0.015), but not with the AMEDA scores; and there was no significant correlation between the AIDAL and AMEDA scores. Thus an ankle inversion proprioceptive deficit was evident for persons with CAI on the step-down AIDAL, and in a dose-response way, but not evident on the standing AMEDA, suggesting that ankle proprioceptive impairment is task-specific. Selected proprioceptive tests must present some minimal degree of challenge to the ankle joint in a functional task in order to differentiate CAI from non-CAI participants.

摘要

尽管研究人员经常比较有和没有慢性踝关节不稳定 (CAI) 的人群之间的踝关节本体感觉,但结果并不一致。这可能是因为该人群的踝关节本体感觉损伤是特定于任务的。因此,我们旨在比较有和没有 CAI 的个体在两种任务条件下的踝关节内翻本体感觉:(i) 站立时(不具挑战性)和 (ii) 从台阶上跳下时(具有挑战性)。使用主动运动范围辨别仪(AMEDA)进行站立条件下的踝关节内翻本体感觉测量,使用踝关节内翻辨别仪-台阶下降(AIDAL)进行台阶下降时的踝关节内翻本体感觉测量。从方差分析 (ANOVA) 测试的结果来看,在站立时,CAI 和非 CAI 参与者在 AMEDA 上的表现相同;但 CAI 组在 AIDAL 台阶下降任务上的表现明显差于非 CAI 组( = 0.03)。在非 CAI 组中,AIDAL 本体感觉评分,作为受试者工作特征曲线下的面积 (AUC),明显高于其 AMEDA AUC 评分( = 0.03),而 CAI 组的 AIDAL 和 AMEDA AUC 评分之间没有显著差异。坎伯兰踝关节不稳定工具 (CAIT) 评分与 AIDAL 评分显著相关(Spearman rho = 0.391, = 0.015),但与 AMEDA 评分无关;AIDAL 和 AMEDA 评分之间没有显著相关性。因此,CAI 患者在台阶下降 AIDAL 上存在明显的踝关节内翻本体感觉缺陷,并且呈剂量反应方式,但在站立 AMEDA 上没有明显缺陷,这表明踝关节本体感觉损伤是特定于任务的。为了将 CAI 与非 CAI 参与者区分开来,选择的本体感觉测试必须在功能任务中对踝关节施加一定程度的挑战。

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