School of Sport Human Science, Beijing Sport University, Beijing, 100084, China.
College of Physical and Health Education, Guangxi Normal University, Guilin, 541006, China.
Sci Rep. 2024 Sep 27;14(1):22095. doi: 10.1038/s41598-024-73646-8.
Functional ankle instability (FAI) patients often experience restricted ankle dorsiflexion, increased inversion angle, and elevated ground reaction forces during walking, all related to altered kinematics of the talocrural and subtalar joints. This study aimed to investigate the potential positive impact of joint mobilization on FAI patients from a biomechanical perspective. The experimental group (EG, n = 17; Age: 20.06 ± 1.34 years; Height: 1.74 ± 0.07 m; Weight: 69.79 ± 11.20 kg; BMI:22.88 ± 2.63 kg/m; CAIT:15.59 ± 2.58; M/F: 15/2) received joint mobilization + routine rehabilitation training, while the control group (CG, n = 16; Age: 20.50 ± 0.73 years; Height: 1.73 ± 0.09 m; Weight: 64.59 ± 7.21 kg; BMI: 21.65 ± 2.47 kg/m; CAIT: 16.75 ± 2.21; M/F: 14/2) only received regular rehabilitation training. Biomechanical tests were performed in both groups after the 4-week intervention. The spatial parameters during walking (including step length, stride length, step width, step time, cadence, step speed, support time, and swing time), ankle flexion and dorsiflexion angle, inversion, and eversion angles, internal and external rotation angles, ankle torque, as well as the vertical ground reaction force were measured before and after the intervention. The results of the two-way ANOVA showed that the main effect of time was significant for step length (P < 0.001), stride length (P = 0.008), step speed (P < 0.001), the sagittal plane angle at touchdown (P < 0.001), maximum dorsiflexion angle (P = 0.005), sagittal plane toe off-ground angle (P < 0.001), peak flexion-dorsiflexion torque (P = 0.033), the first peak vGRF (P = 0.013), and second peak vGRF (P = 0.011). The main effect of Time * Group was significant for step speed (P = 0.044). The EG demonstrated significant improvements in step speed (P = 0.047), maximum dorsiflexion angle (P = 0.047), and the first peak vGRF (P = 0.028) compared to the CG. This study reveals that joint mobilization intervention enhances gait spatiotemporal parameters, kinematics, and kinetics, particularly in step speed, maximum dorsiflexion angle, and the first vGRF peak for the EG compared to the CG. Therefore, the rehabilitation strategy for patients with functional ankle instability should appropriately increase the use of joint movement to promote the functional recovery of FAI patients.
功能性踝关节不稳（FAI）患者在行走时经常出现踝关节背屈受限、内翻角度增加和地面反作用力升高，这些都与距下关节和跗骨关节运动学改变有关。本研究旨在从生物力学角度探讨关节松动术对 FAI 患者的潜在积极影响。实验组（EG，n=17；年龄：20.06±1.34 岁；身高：1.74±0.07 米；体重：69.79±11.20 千克；BMI：22.88±2.63 千克/米；CAIT：15.59±2.58；M/F：15/2）接受关节松动术+常规康复训练，对照组（CG，n=16；年龄：20.50±0.73 岁；身高：1.73±0.09 米；体重：64.59±7.21 千克；BMI：21.65±2.47 千克/米；CAIT：16.75±2.21；M/F：14/2）仅接受常规康复训练。干预 4 周后，两组均进行生物力学测试。在干预前后测量行走时的空间参数（包括步长、步幅、步宽、步速、步频、步速、支撑时间和摆动时间）、踝关节背屈和跖屈角度、内翻和外翻角度、内外旋转角度、踝关节扭矩以及垂直地面反作用力。双向方差分析的结果显示，时间的主要效应在步长（P<0.001）、步幅（P=0.008）、步速（P<0.001）、矢状面触地角度（P<0.001）、最大背屈角度（P=0.005）、矢状面足离地角度（P<0.001）、屈伸扭矩峰值（P=0.033）、第一峰值 vGRF（P=0.013）和第二峰值 vGRF（P=0.011）方面有显著意义。时间*组的主要效应在步速（P=0.044）方面有显著意义。与 CG 相比，EG 在步速（P=0.047）、最大背屈角度（P=0.047）和第一峰值 vGRF（P=0.028）方面有显著改善。本研究表明，关节松动术干预可提高步行时空参数、运动学和动力学，特别是 EG 的步速、最大背屈角度和第一 vGRF 峰值。因此，功能性踝关节不稳患者的康复策略应适当增加关节运动的使用，以促进 FAI 患者的功能恢复。
