Cerbezer Nilüfer, Çil Elif Tuğçe, Subaşı Feryal
Yeditepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.
Yeditepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.
Foot (Edinb). 2023 Sep;56:101992. doi: 10.1016/j.foot.2023.101992. Epub 2023 Mar 2.
This study aimed to compare and investigate the effectiveness of neuromuscular exercise combined with vestibular-ocular reflex training and only neuromuscular exercise training on balance, isokinetic muscle strength, and proprioception in chronic ankle instability (CAI).
The study included 20 patients with unilateral CAI. The functional status was evaluated with the Foot and Ankle Ability Measure (FAAM). The star-excursion balance test was used for dynamic balance, and the joint position sense test assessed proprioception. Ankle concentric muscle strength was measured by an isokinetic dynamometer. The subjects were randomly divided into neuromuscular and vestibular-ocular reflex training (VOG, n = 10) and neuromuscular training group (NG, n = 10). Both rehabilitation protocols were applied for four weeks.
Although VOG had higher means of all parameters, no superiority was found between the two groups in post-treatment results. However, the VOG significantly improved FAAM scores at the sixth-month follow-up than NG (P < .05). In the linear regression analysis, the post-treatment proprioception inversion-eversion for unstable side and FAAM- S were found to be independent factors of FAAM-S scores at the six months follow -up in VOG. Post-treatment isokinetic strength for inversion of unstable side (120 º /s) and FAAM- S were determined as predictor factors of FAAM- S scores at the six months follow -up (p < .05) in NG.
The Neuromuscular combined with vestibular-ocular reflex training protocol effectively managed unilateral CAI. Furthermore, it may be considered an effective strategy for clinical outcomes for a long-term period in terms of functional status.
本研究旨在比较并调查神经肌肉锻炼联合前庭眼反射训练与单纯神经肌肉锻炼训练对慢性踝关节不稳(CAI)患者平衡能力、等速肌力和本体感觉的效果。
本研究纳入20名单侧CAI患者。采用足踝能力测量量表(FAAM)评估功能状态。采用星形偏移平衡测试评估动态平衡,采用关节位置觉测试评估本体感觉。使用等速测力计测量踝关节向心肌力。将受试者随机分为神经肌肉和前庭眼反射训练组(VOG组,n = 10)和神经肌肉训练组(NG组,n = 10)。两种康复方案均实施四周。
虽然VOG组所有参数的均值更高,但两组治疗后的结果并无优势。然而,在六个月随访时,VOG组的FAAM评分显著高于NG组(P <.05)。在线性回归分析中,VOG组在六个月随访时,患侧本体感觉内翻-外翻和FAAM-S被发现是FAAM-S评分的独立因素。在NG组中,患侧内翻等速肌力(120º/s)和FAAM-S在六个月随访时被确定为FAAM-S评分的预测因素(p <.05)。
神经肌肉锻炼联合前庭眼反射训练方案能有效治疗单侧CAI。此外,就功能状态而言,它可能被认为是一种长期临床疗效的有效策略。