Tan Jingwang, Li Jiatao, Lei Jianbin, Lu Shuyi, Feng Yongjian, Ma Tao, Luan Lijiang, Adams Roger, Song Yagang, Han Jia, Zou Yu
Department of Sport and Exercise Science, College of Education, Zhejiang University, 886 Yuhangtang Road, Zhejiang, 310058, Hangzhou, China.
School of Elite Sport, Shanghai University of Sport, Shanghai, China.
BMC Sports Sci Med Rehabil. 2023 Jul 18;15(1):88. doi: 10.1186/s13102-023-00698-0.
Chronic ankle instability (CAI) is a form of musculoskeletal disease that can occur after a lateral ankle sprain, and it is characterized by pain, recurrent ankle sprains, a feeling of "giving way" at the ankle joint, and sensorimotor deficits. There has been increasing evidence to suggest that plastic changes in the brain after the initial injury play an important role in CAI. As one modality to treat CAI, whole-body vibration (WBV) has been found to be beneficial for treating the sensorimotor deficits accompanying CAI, but whether these benefits are associated with brain plasticity remains unknown. Therefore, the current study aims to investigate the effect of WBV on sensorimotor deficits and determine its correlation with plastic changes in the brain.
The present study is a single-blind randomized controlled trial. A total of 80 participants with CAI recruited from the university and local communities will be divided into 4 groups: whole-body vibration and balance training (WBVBT), balance training (BT), whole-body vibration (WBV), and control group. Participants will be given the WBV intervention (25-38 Hz, 1.3-2 mm, 3-time per week, 6-week) supervised by a professional therapist. Primary outcome measures are sensorimotor function including strength, balance, proprioception and functional performance. Brain plasticity will be evaluated by corticomotor excitability, inhibition, and representation of muscles, as measured by transcranial magnetic stimulation. Activation of brain areas will be assessed through functional near-infrared spectroscopy. Secondary outcome measures are self-reported functional outcomes involving the Cumberland Ankle Instability Tool and the Foot and Ankle Ability Measure. All tests will be conducted before and after the WBV intervention, and at 2-week follow-up. Per‑protocol and intention-to-treat analysis will be applied if any participants withdraw.
This is the first trial to investigate the role of brain plasticity in sensorimotor changes brought by WBV for individuals with CAI. As plastic changes in the brain have been an increasingly important aspect in CAI, the results of the current study can provide insight into the treatment of CAI from the perspective of brain plasticity.
Chinese Clinical Trial Registry (ChiCTR2300068972); registered on 02 March 2023.
慢性踝关节不稳（CAI）是一种肌肉骨骼疾病，可发生于外侧踝关节扭伤后，其特征为疼痛、反复踝关节扭伤、踝关节“打软”感及感觉运动功能缺陷。越来越多的证据表明，初次损伤后大脑的可塑性变化在CAI中起重要作用。作为治疗CAI的一种方式，全身振动（WBV）已被发现对治疗CAI伴发的感觉运动功能缺陷有益，但这些益处是否与大脑可塑性相关尚不清楚。因此，本研究旨在探讨WBV对感觉运动功能缺陷的影响，并确定其与大脑可塑性变化的相关性。
本研究为单盲随机对照试验。从大学和当地社区招募的80例CAI患者将被分为4组：全身振动与平衡训练（WBVBT）组、平衡训练（BT）组、全身振动（WBV）组和对照组。参与者将在专业治疗师的监督下接受WBV干预（25 - 38赫兹，1.3 - 2毫米，每周3次，共6周）。主要结局指标为感觉运动功能，包括力量、平衡、本体感觉和功能表现。大脑可塑性将通过经颅磁刺激测量的皮质运动兴奋性、抑制性及肌肉代表区进行评估。脑区激活将通过功能近红外光谱进行评估。次要结局指标为自我报告的功能结局，包括坎伯兰踝关节不稳工具和足踝关节能力测量。所有测试将在WBV干预前后及2周随访时进行。若有参与者退出，将采用符合方案分析和意向性分析。
这是第一项研究大脑可塑性在WBV给CAI个体带来的感觉运动变化中所起作用的试验。由于大脑可塑性变化在CAI中已成为一个越来越重要的方面，本研究结果可从大脑可塑性角度为CAI的治疗提供见解。
中国临床试验注册中心（ChiCTR2300068972）；于2023年3月2日注册。
