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一种推力手法对慢性踝关节症状影响的神经和/或生物力学因素的研究:一项观察性研究。

An investigation of neurological and/or biomechanical factors underpinning the effect of a thrust manipulation on chronic ankle symptoms: an observational study.

机构信息

Krannert School of Physical Therapy, University of Indianapolis, IN, USA.

Department of Kinesiology, University of Indianapolis, IN, USA.

出版信息

J Man Manip Ther. 2024 Apr;32(2):198-205. doi: 10.1080/10669817.2023.2251864. Epub 2023 Sep 11.

Abstract

BACKGROUND

Ankle sprains are a commonly occurring musculoskeletal injury potentially resulting in persistent pain and/or altered motion. Thrust manipulation may serve as an interventional strategy but limited evidence exists on the mechanism(s) by which a change to symptoms might occur.

OBJECTIVE

The study sought to quantify the immediate effect of a thrust manipulation to the ankle to determine a mechanism by which change to symptoms occurred.

METHODS

Eleven participants (6 m/5f, 26.09 ± 4.25 yrs) with a history of ankle sprain that occurred greater than three months ago with recurring pain and/or altered motion were recruited. Participants underwent neurophysiological testing to assess any pain alterations and instrumented gait analysis (IGA) for biomechanical assessment pre-post thrust manipulation to the ankle.

RESULTS

There were no significant differences in ankle dorsiflexion (DF) ( = 0.62), plantarflexion (PF) ( = 0.23), ground reaction force (GRF), or velocity ( = 0.63) following thrust manipulation compared to baseline; however, pre- and post-data did show differences in pain pressure threshold ( = 0.046). There were no significant differences in dynamic pain measurements.

CONCLUSIONS

Ankle sprains that result in persistent pain and/or altered motion can be impacted by a thrust manipulation which appears to act through neurophysiological mechanisms.

摘要

背景

踝关节扭伤是一种常见的肌肉骨骼损伤,可能导致持续疼痛和/或运动改变。推力手法可能是一种干预策略,但关于症状变化发生的机制存在有限的证据。

目的

本研究旨在定量分析踝关节推力手法的即刻效应,以确定症状变化发生的机制。

方法

招募了 11 名(6 名男性/5 名女性,26.09±4.25 岁)有踝关节扭伤史的参与者,扭伤发生时间超过三个月,伴有反复疼痛和/或运动改变。参与者接受神经生理测试以评估任何疼痛变化,并进行仪器步态分析(IGA)以进行生物力学评估,在踝关节推力手法前后进行。

结果

与基线相比,推力手法后踝关节背屈(DF)( = 0.62)、跖屈(PF)( = 0.23)、地面反力(GRF)或速度( = 0.63)均无显著差异;然而,术前和术后数据确实显示疼痛压力阈值( = 0.046)存在差异。动态疼痛测量无显著差异。

结论

导致持续疼痛和/或运动改变的踝关节扭伤可以受到推力手法的影响,该手法似乎通过神经生理机制发挥作用。

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