Children's Hospital of the King's Daughters, 601 Childrens' Ln, Norfolk, VA, 23507, USA.
Atlantic Orthopaedic Specialists, 1800 Camelot Dr Suite 300, Virginia Beach, VA, 23454, USA.
J Bodyw Mov Ther. 2024 Oct;40:1263-1268. doi: 10.1016/j.jbmt.2024.07.042. Epub 2024 Jul 23.
Individuals with chronic ankle instability (CAI) often experience deficits in balance, hip strength, and lumbopelvic stability. Unilateral balance training can lead to improved balance in the contralateral limb, but it is unknown if similar cross-education effects occur for hip strength and lumbopelvic stability. Our purpose was to determine if unilateral balance training improved balance, hip strength, and lumbopelvic stability of the contralateral limbs in individuals with CAI.
Using a randomized-controlled trial, 30 individuals with CAI were separated into control (CON) and balance (BAL). Uninvolved limbs underwent testing at baseline and post-intervention. We tested balance with the star excursion balance test in anterior (SEBT-ANT), posterolateral (SEBT-PL), and posteromedial (SEBT-PM) directions. We tested hip strength with a handheld dynamometer in extension (EXT), abduction (ABD), and external rotation (ER). We tested lumbopelvic stability with a unilateral hip bridge. After baseline, BAL completed an 8-week balance training program on the involved limb. CON did not participate in the intervention. Two-way repeated measures ANOVAs analyzed effects of group and time on each outcome. Cohen's d effect sizes analyzed each group's changes from baseline to post-intervention.
Eleven participants discontinued the study (5 CON, 6 BAL) before completion. There were significant group-by-time interactions for SEBT-PL (P = 0.03) and hip bridge (P = 0.03). BAL had moderate to large effect sizes for SEBT-PM (d = 0.69 [-0.06,1.41]), SEBT-PL (d = 0.87 [0.10,1.60]), EXT (d = 0.73 [-0.02,1.45]), ABD (d = 0.79 [0.03,1.51]), and hip bridge (d = 0.83 [0.07,1.55]).
A balance training program for limbs with CAI led to contralateral improvements in balance, hip strength, and lumbopelvic stability.
慢性踝关节不稳定（CAI）患者常存在平衡、髋关节力量和腰骶部稳定性方面的缺陷。单侧平衡训练可导致对侧肢体平衡能力提高，但髋关节力量和腰骶部稳定性是否存在类似的交叉教育效应尚不清楚。本研究旨在确定单侧平衡训练是否能改善 CAI 患者对侧肢体的平衡、髋关节力量和腰骶部稳定性。
采用随机对照试验，将 30 名 CAI 患者分为对照组（CON）和平衡组（BAL）。非受累肢体在基线和干预后进行测试。我们使用前向（SEBT-ANT）、后外侧（SEBT-PL）和后内侧（SEBT-PM）方向的星型偏移平衡测试（star excursion balance test）来测试平衡。我们使用手持式测力计测试髋关节力量，包括伸展（EXT）、外展（ABD）和外旋（ER）。我们使用单侧髋关节桥测试腰骶部稳定性。基线后，BAL 对受累肢体进行了 8 周的平衡训练。CON 未参与干预。采用双向重复测量方差分析评估组间和时间对各项结果的影响。Cohen's d 效应量分析了每组从基线到干预后的变化。
11 名参与者（5 名 CON，6 名 BAL）在研究完成前退出。SEBT-PL（P=0.03）和髋关节桥（P=0.03）的组间和时间存在显著交互作用。BAL 在 SEBT-PM（d=0.69 [-0.06,1.41]）、SEBT-PL（d=0.87 [0.10,1.60]）、EXT（d=0.73 [-0.02,1.45]）、ABD（d=0.79 [0.03,1.51]）和髋关节桥（d=0.83 [0.07,1.55]）方面具有中等至较大的效应量。
针对 CAI 肢体的平衡训练方案可导致对侧平衡、髋关节力量和腰骶部稳定性的改善。
