Oh Minsub, Lee Hyunwook, Han Seunguk, Hopkins J Ty
Department of Exercise Science, Brigham Young University, Provo, UT.
Department of Exercise and Sport Science, University of North Carolina, Chapel Hill.
J Athl Train. 2025 Mar 1;60(3):218-223. doi: 10.4085/1062-6050-0261.24.
Chronic ankle instability (CAI) patients exhibit altered movement patterns during jump landing/cutting movements. Persistent pain is one of the residual symptoms that may affect movements. Calculating joint energetics affected by chronic pain offers a novel method to understand how chronic pain influences energetics of lower extremity joints in CAI patients.
To identify the effects of chronic pain on lower extremity energy dissipation and generation during jump landing and cutting in patients with CAI.
Cross-sectional study.
Laboratory.
Fifteen CAI patients with higher pain (6 men and 9 women; age = 22.1 ± 2.1 years, height = 1.74 ± 0.09 m, mass = 71.3 ± 10.6 kg, pain = 66.9 ± 9.4), 15 patients with CAI and lower pain (6 men and 9 women; age = 22.3 ± 2.1 years, height = 1.74 ± 0.08 m, mass = 70.1 ± 10.7 kg, pain = 89.3 ± 2.6), and 15 healthy control individuals (6 men and 9 women; age = 21.3 ± 1.7 years, height = 1.73 ± 0.08 m, mass = 70 ± 10.3 kg, pain = 100 ± 0).
MAIN OUTCOME MEASURE(S): Ground reaction force data were collected during 5 trials of maximal jump landing/cutting tasks. Joint power was defined as the product of angular velocity and joint moment. Energy dissipation and generation by the ankle, knee, and hip joints were calculated by integrating regions of the joint power curve.
CAI patients with higher pain displayed less ankle energy dissipation (P = .013 and P = .018) and generation in the ankle (P = .002 and P = .028) than CAI patients with lower pain and healthy control individuals during the jump landing/cutting phase. CAI patients with higher pain showed more hip energy generation than CAI patients with lower pain (P = .038) and healthy control individuals (P = .013) during the cutting phase.
CAI patients with higher pain changed both energy dissipation and generation in the lower extremities, reducing the burden of the ankle joint during jump landing/cutting and having a hip-dominant compensatory strategy during the cutting phase. Our results suggest that chronic pain could be one of the factors that affect motor strategies in the CAI population.
慢性踝关节不稳（CAI）患者在跳跃着陆/变向动作过程中表现出运动模式改变。持续性疼痛是可能影响运动的残留症状之一。计算受慢性疼痛影响的关节能量学提供了一种新方法，以了解慢性疼痛如何影响CAI患者下肢关节的能量学。
确定慢性疼痛对CAI患者跳跃着陆和变向过程中下肢能量消散和产生的影响。
横断面研究。
实验室。
15名疼痛程度较高的CAI患者（6名男性和9名女性；年龄=22.1±2.1岁，身高=1.74±0.09米，体重=71.3±10.6千克，疼痛程度=66.9±9.4），15名疼痛程度较低的CAI患者（6名男性和9名女性；年龄=22.3±2.1岁，身高=1.74±0.08米，体重=70.1±10.7千克，疼痛程度=89.3±2.6），以及15名健康对照个体（6名男性和9名女性；年龄=21.3±1.7岁，身高=1.73±0.08米，体重=70±10.3千克，疼痛程度=100±0）。
在5次最大跳跃着陆/变向任务试验中收集地面反作用力数据。关节功率定义为角速度和关节力矩的乘积。通过对关节功率曲线区域进行积分来计算踝关节、膝关节和髋关节的能量消散和产生。
在跳跃着陆/变向阶段，疼痛程度较高的CAI患者与疼痛程度较低的CAI患者及健康对照个体相比，踝关节能量消散（P = 0.013和P = 0.018）及产生（P = 0.002和P = 0.028）较少。在变向阶段，疼痛程度较高的CAI患者比疼痛程度较低的CAI患者（P = 0.038）及健康对照个体（P = 0.013）髋关节能量产生更多。
疼痛程度较高的CAI患者改变了下肢的能量消散和产生，在跳跃着陆/变向时减轻了踝关节的负担，并在变向阶段采用以髋关节为主的代偿策略。我们的结果表明，慢性疼痛可能是影响CAI人群运动策略的因素之一。
