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不同背屈活动范围对慢性踝关节不稳定患者落地生物力学的影响。

Effect of varied dorsiflexion range of motion on landing biomechanics in chronic ankle instability.

机构信息

Human Performance Research Center, Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA.

Motion Science Lab, Graduate School of Sports Medicine, CHA University, Seongnam-si, Gyeonggi-do, South Korea.

出版信息

Scand J Med Sci Sports. 2023 Jul;33(7):1125-1134. doi: 10.1111/sms.14339. Epub 2023 Feb 24.

Abstract

BACKGROUND

Limited dorsiflexion range of motion (DFROM) is a risk factor for lateral ankle sprain. However, varied DFROM exists within the chronic ankle instability (CAI) population, and how the variability may influence altered movement patterns during landing is unclear.

OBJECTIVE

The purpose of this study was to identify different movement strategies during maximal jump landing/cutting among CAI patients classified by varied DFROM.

METHODS

One hundred CAI subjects were classified into 3 subgroups based on their DFROM, measured by the weight-bearing lunge test: a Hypo- (≤40°), Normal- (40-50°), and Hyper-DFROM group (≥50°). Participants completed five trials of maximal jump landing/cutting. Lower extremity joint angles and EMG activation of seven muscles were collected from initial contact to toe-off. Functional analyses of variance were used to evaluate between-group differences for these outcome variables.

RESULTS

Hypo-DFROM group (14M, 10F) displayed the reduced ankle dorsiflexion and inversion angles with increased hip flexion angle as a compensatory kinematic chain movement strategy. In addition, motion restrictions of the ankle are associated with altered muscle activation in both distal and proximal muscles during landing/cutting. Normal-DFROM (25M, 30F) and Hyper-DFROM (11M, 10F) groups also have different movement strategies including greater inversion angle and less EMG activation, which could contribute to further ankle injuries.

CONCLUSIONS

Our data suggest that limited DFROM negatively affects the ankle joint during demanding movement within the CAI population. These movement patterns in CAI patients with pathomechanical deficits could contribute to further ankle sprains.

摘要

背景

背屈活动度(DFROM)受限是发生外侧踝关节扭伤的一个危险因素。然而,慢性踝关节不稳(CAI)患者的 DFROM 存在差异,这种差异如何影响踝关节在落地时的运动模式尚不清楚。

目的

本研究旨在根据 DFROM 的不同,确定 CAI 患者在最大跳跃落地/切割时的不同运动策略。

方法

根据负重弓步试验测量的 DFROM,100 名 CAI 患者被分为 3 个亚组:低 DFROM 组(≤40°)、正常 DFROM 组(40-50°)和高 DFROM 组(≥50°)。参与者完成 5 次最大跳跃落地/切割试验。在初始接触到脚趾离地期间,采集下肢关节角度和 7 块肌肉的肌电图激活情况。采用方差分析对这些因变量进行组间差异评估。

结果

低 DFROM 组(14 名男性,10 名女性)表现出背屈和内翻角度减小,髋关节屈曲角度增加的代偿性运动链运动策略。此外,踝关节运动受限与落地/切割时远近端肌肉的肌电激活改变有关。正常 DFROM 组(25 名男性,30 名女性)和高 DFROM 组(11 名男性,10 名女性)也存在不同的运动策略,包括更大的内翻角度和更少的肌电激活,这可能导致进一步的踝关节损伤。

结论

我们的数据表明,在 CAI 人群中,DFROM 受限会对踝关节在高要求运动中产生负面影响。CAI 患者的这些运动模式存在运动力学缺陷,可能导致进一步的踝关节扭伤。

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