Zhang Lei, Liu Tianyu, Zhou Xin, Chen Junyao, Zhang Haopeng, Leng Rao, Shi Houyin, Wang Guoyou
Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China.
Center for Orthopedic Diseases Research, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China.
Sports Health. 2024 Sep 15:19417381241277804. doi: 10.1177/19417381241277804.
Despite growing applications of backward walking (BW) in assessing and rehabilitating neuromuscular conditions, its effects on gait in chronic ankle instability (CAI) remain unclear. Moreover, linking patient-reported and clinically generated measures is imperative for understanding CAI.
Patients with CAI will exhibit worse and compensatory spatio-temporal and kinetic gait parameters during BW, and patient-reported outcomes (PROs) will be correlated significantly with gait parameters.
Case-control study.
Level 4.
A total of 46 volunteers participated (23 per group). Patients filled out scales for pain, functions, and fear-avoidance beliefs before testing. All participants walked 6 times each in both forward and backward conditions, and gait was recorded using the Win-Track system. A 2-way mixed analysis of variance was performed to compare gait parameters. The relationship between PRO and gait outcomes was assessed through the Pearson product correlation coefficient.
The CAI group demonstrated prolonged support and swing phases, increased walk-off angle, and plantar pressure area, but decreased step length and plantar pressure versus controls ( < 0.05). The CAI group had a smaller right walk-off angle during BW than FW; the control group showed the opposite ( < 0.05). The left single stance duration was greater in the CAI group, while the right was not ( < 0.05). PRO correlated significantly with gait parameters, particularly spatial parameters ( < 0.05).
The CAI group exhibited worse gait parameters during BW. The CAI group exhibited a characteristic compensatory gait pattern. Linking the self-reported scores provides a better representation of gait changes in CAI.
These results suggest that BW may be an effective strategy for identifying and evaluating CAI. It may be feasible to apply BW to the rehabilitation of CAI.
尽管向后行走（BW）在评估和康复神经肌肉疾病方面的应用日益广泛，但其对慢性踝关节不稳（CAI）患者步态的影响仍不明确。此外，将患者报告的指标与临床测量指标相联系对于理解CAI至关重要。
CAI患者在向后行走时将表现出更差的、代偿性的时空和动力学步态参数，且患者报告的结果（PROs）将与步态参数显著相关。
病例对照研究。
4级。
共有46名志愿者参与（每组23名）。患者在测试前填写疼痛、功能和恐惧回避信念量表。所有参与者在向前和向后两种情况下各行走6次，使用Win-Track系统记录步态。进行双向混合方差分析以比较步态参数。通过Pearson积差相关系数评估PRO与步态结果之间的关系。
与对照组相比，CAI组的支撑期和摆动期延长，离地角度和足底压力面积增加，但步长和足底压力降低（<0.05）。CAI组在向后行走时的右侧离地角度小于向前行走时；对照组则相反（<0.05）。CAI组的左侧单支撑持续时间更长，而右侧则不然（<0.05）。PRO与步态参数显著相关，尤其是空间参数（<0.05）。
CAI组在向后行走时表现出更差的步态参数。CAI组表现出特征性的代偿步态模式。将自我报告得分相联系能更好地反映CAI患者的步态变化。
这些结果表明，向后行走可能是识别和评估CAI的有效策略。将其应用于CAI的康复可能是可行的。
