Zhou Zhifeng, Zhou Huiyu, Jie Tianle, Xu Datao, Teo Ee-Chon, Wang Meizi, Gu Yaodong
Faculty of Sports Science, Ningbo University, Ningbo, China.
Faculty of Engineering, University of Pannonia, Veszprem, Hungary.
Front Physiol. 2024 Jul 24;15:1438194. doi: 10.3389/fphys.2024.1438194. eCollection 2024.
Ankle sprains are prevalent in sports, often causing complex injuries to the lateral ligaments. Among these, anterior talofibular ligament (ATFL) injuries constitute 85%, and calcaneofibular ligament (CFL) injuries comprise 35%. Despite conservative treatment, some ankle sprain patients develop chronic lateral ankle instability (CLAI). Thus, this study aimed to investigate stress response and neural control alterations during landing in lateral ankle ligament injury patients.
This study recruited twenty individuals from a Healthy group and twenty CLAI patients performed a landing task using relevant instruments to collect biomechanical data. The study constructed a finite element (FE) foot model to examine stress responses in the presence of laxity of the lateral ankle ligaments. The lateral ankle ligament was modeled as a hyperelastic composite structure with a refined representation of collagen bundles and ligament laxity was simulated by adjusting material parameters. Finally, the validity of the finite element model is verified by a high-speed dual fluoroscopic imaging system (DFIS).
CLAI patients exhibited earlier Vastus medialis ( < 0.001) and tibialis anterior ( < 0.001) muscle activation during landing. The FE analysis revealed that with laxity in the ATFL, the peak von Mises stress in the fifth metatarsal was 20.74 MPa, while with laxity in the CFL, it was 17.52 MPa. However, when both ligaments were relaxed simultaneously, the peak von Mises stress surged to 21.93 MPa. When the ATFL exhibits laxity, the CFL is subjected to a higher stress of 3.84 MPa. Conversely, when the CFL displays laxity, the ATFL experiences a peak von Mises stress of 2.34 MPa.
This study found that changes in the laxity of the ATFL and the CFL are linked to shifts in metatarsal stress levels, potentially affecting ankle joint stability. These alterations may contribute to the progression towards CLAI in individuals with posterolateral ankle ligament injuries. Additionally, significant muscle activation pattern changes were observed in CLAI patients, suggesting altered neural control strategies post-ankle ligament injury.
踝关节扭伤在体育运动中很常见，常导致外侧韧带的复杂损伤。其中，距腓前韧带（ATFL）损伤占85%，跟腓韧带（CFL）损伤占35%。尽管采用了保守治疗，但一些踝关节扭伤患者仍会出现慢性外侧踝关节不稳定（CLAI）。因此，本研究旨在调查外侧踝关节韧带损伤患者在着陆过程中的应力反应和神经控制改变。
本研究招募了20名健康组个体和20名CLAI患者，使用相关仪器进行着陆任务以收集生物力学数据。该研究构建了一个有限元（FE）足部模型，以检查外侧踝关节韧带松弛时的应力反应。外侧踝关节韧带被建模为具有胶原束精细表示的超弹性复合结构，通过调整材料参数来模拟韧带松弛。最后，通过高速双荧光透视成像系统（DFIS）验证有限元模型的有效性。
CLAI患者在着陆过程中股内侧肌（<0.001）和胫前肌（<0.001）的肌肉激活更早。有限元分析显示，ATFL松弛时，第五跖骨的峰值冯·米塞斯应力为20.74MPa，而CFL松弛时为17.52MPa。然而，当两条韧带同时松弛时，峰值冯·米塞斯应力飙升至21.93MPa。当ATFL松弛时，CFL承受的应力更高，为3.84MPa。相反，当CFL松弛时，ATFL的峰值冯·米塞斯应力为2.34MPa。
本研究发现，ATFL和CFL松弛度的变化与跖骨应力水平的改变有关，可能影响踝关节稳定性。这些改变可能导致后外侧踝关节韧带损伤患者发展为CLAI。此外，在CLAI患者中观察到明显的肌肉激活模式变化，表明踝关节韧带损伤后神经控制策略发生了改变。
