Nekar Daekook M, Lee Dong-Yeop, Hong Ji-Heon, Kim Jin-Seop, Kim Seong-Gil, Nam Yeon-Gyo, Yu Jae-Ho
Department of Physical Therapy, Sun Moon University, Asan 31460, Republic of Korea.
Healthcare (Basel). 2023 Dec 28;12(1):70. doi: 10.3390/healthcare12010070.
Functional ankle instability (FAI), which is characterized by recurrent ankle sprains and perceived joint instability, arises from various factors contributing to compromised biomechanical control during activities, particularly those involving landing tasks. While current research predominantly addresses lower-extremity and core stabilization interventions for FAI, the contribution of upper body control to landing biomechanics in this population remains insufficiently explored. In this study, 42 participants (19 males, 23 females) with FAI were randomly assigned to either the upper-body control training group (UBCTG) or the core muscle stabilization training group (CMSTG). The groups underwent six-week interventions, with the UBCTG receiving a dynamic core exercise program including upper body control and the CMSTG receiving static core muscle training. Pre- and post-intervention assessments encompassed electromyography of the gastrocnemius, tibialis anterior, and peroneus longus, motion analysis of the lower extremities, and ground reaction force (GRF) readings during a single-leg-jump task. Additionally, dynamic balance was assessed using the Y balance test and self-reported measurements of ankle instability were performed. The results showed similar increases in muscle activation, joint movement, and self-reported ankle instability scores within both groups. However, significant between-group differences were observed in terms of knee flexion angle, dynamic balance, and ankle instability scores, favoring the UBCTG. Although the peak vertical GRF significantly decreased and the time to peak vertical GRF increased in both groups, more changes were noted in the UBCTG. Our results demonstrated that dynamic core exercises with additional upper body control training enhance landing biomechanics, dynamic balance, and stability in individuals with FAI. Consequently, we recommend incorporating shoulder girdle exercises, proprioceptive drills, and balance exercises into dynamic core training.
功能性踝关节不稳(FAI)的特征是反复出现踝关节扭伤以及感觉关节不稳,它源于多种因素,这些因素导致活动期间生物力学控制受损,尤其是那些涉及落地任务的活动。虽然目前的研究主要针对FAI的下肢和核心稳定干预措施,但该人群中上身控制对落地生物力学的贡献仍未得到充分探索。在本研究中,42名患有FAI的参与者(19名男性,23名女性)被随机分配到上身控制训练组(UBCTG)或核心肌肉稳定训练组(CMSTG)。两组都接受了为期六周的干预,UBCTG接受了包括上身控制的动态核心锻炼计划,而CMSTG接受了静态核心肌肉训练。干预前后的评估包括腓肠肌、胫骨前肌和腓骨长肌的肌电图、下肢运动分析以及单腿跳跃任务期间的地面反作用力(GRF)读数。此外,使用Y平衡测试评估动态平衡,并进行自我报告的踝关节不稳测量。结果显示两组在肌肉激活、关节运动和自我报告的踝关节不稳评分方面都有类似的增加。然而,在膝关节屈曲角度、动态平衡和踝关节不稳评分方面观察到显著的组间差异,UBCTG表现更优。虽然两组的垂直GRF峰值均显著下降,达到垂直GRF峰值的时间增加,但UBCTG的变化更为明显。我们的结果表明,附加上身控制训练的动态核心锻炼可改善FAI患者的落地生物力学、动态平衡和稳定性。因此,我们建议将肩带锻炼、本体感觉训练和平衡锻炼纳入动态核心训练中。