School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA.
Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA.
PM R. 2023 Dec;15(12):1557-1564. doi: 10.1002/pmrj.13000. Epub 2023 Jun 27.
Lateral ankle sprains (LAS) frequently lead to residual soft tissue impairments, often attributed to biomechanical dysfunction during movement.
To compare running biomechanics between adolescent runners with soft tissue pathologies following LAS (injured) and healthy runners (control) and between limbs.
Retrospective cohort study.
Hospital-affiliated sports injury prevention center.
Twenty-five adolescent runners with a history of LAS and current ankle impingement or tendinopathy (23 female, 2 male; age: 15 ± 2 years; body mass index [BMI]: 19.5 ± 2.5 kg/m ; symptom duration: 1.1 ± 0.9 years), and 23 healthy controls without any LAS history (19 female, 4 male; age: 15 ± 1 years; BMI: 19.2 ± 2.7 kg/m ) were included in this study.
All participants completed a clinical gait assessment in which they ran at a self-selected speed on a force-plate instrumented treadmill, while two video cameras recorded two-dimensional sagittal and coronal views.
Foot rotation, step width, contact time, and cadence were compared between groups and limbs (involved, uninvolved [or "better" for bilateral cases]) using a multivariate analysis of variance (MANOVA). Rearfoot landing and foot strike type were compared between groups and limbs using a chi-square analysis.
The injured group had significantly increased step width (F = 4.71, p = .04; mean difference [MD] with SE: 1.5 [0.7] cm) compared to controls. The injured groups' involved limb had longer contact time (F = 4.62, p = .03; MD : 12 [7] ms, MD : 22 [11] ms) with more internal foot rotation (F = 14.60, p < .001; MD : 2.2 [1.2] degrees, MD : 4.2 [1.3] degrees) compared to controls and their contralateral limb. There were no significant differences for cadence (F = 2.43, p = .13; MD: 4 [3] steps/min), foot landing (X = 1.28, p = .53), or foot strike (X = 1.24, p = .54).
Spatiotemporal and kinematic running adaptations may predispose young runners with initial LAS to secondary soft tissue dysfunction due to loss of stability from ligamentous structures and an overreliance on myotendinous control. Clinicians may consider targeting these maladaptations during gait-training interventions.
外侧踝关节扭伤 (LAS) 常导致软组织损伤残留，通常归因于运动过程中的生物力学功能障碍。
比较有 LAS 病史的青少年跑步者（受伤）和健康跑步者（对照组）以及肢体之间的跑步生物力学。
回顾性队列研究。
医院附属运动伤害预防中心。
25 名有 LAS 病史且当前踝关节撞击或肌腱病（23 名女性，2 名男性；年龄：15 ± 2 岁；体重指数 [BMI]：19.5 ± 2.5 kg/m ；症状持续时间：1.1 ± 0.9 年）的青少年跑步者，以及 23 名无任何 LAS 病史的健康对照组（19 名女性，4 名男性；年龄：15 ± 1 岁；BMI：19.2 ± 2.7 kg/m ）被纳入本研究。
所有参与者都完成了临床步态评估，他们在测力平板跑步机上以自选择的速度跑步，同时两个摄像机记录二维矢状面和冠状面视图。
使用多变量方差分析 (MANOVA) 比较组间和肢体间（受伤、未受伤[或双侧病例中的“更好”]）的足部旋转、步幅、接触时间和步频。使用卡方分析比较组间和肢体间的后足着地和足触地类型。
与对照组相比，受伤组的步幅明显增加（F=4.71，p=0.04；均值差异[MD]，SE：1.5 [0.7] cm）。受伤组的受累肢体接触时间更长（F=4.62，p=0.03；MD：12 [7] ms，MD：22 [11] ms），足部内旋更多（F=14.60，p<0.001；MD：2.2 [1.2] 度，MD：4.2 [1.3] 度）与对照组和对侧肢体相比。步频无显著差异（F=2.43，p=0.13；MD：4 [3] 步/min），足部着地（X 2=1.28，p=0.53）或足触地类型（X 2=1.24，p=0.54）。
时空和运动学跑步适应可能使有初始 LAS 的年轻跑步者易患继发性软组织功能障碍，原因是韧带结构丧失稳定性和过度依赖肌腱控制。临床医生在进行步态训练干预时可能需要针对这些适应不良进行治疗。
