College of Sports and Health, Shandong Sport University, 10600, Century Avenue, Jinan, Shandong, China.
Child Rehabilitation Department, Linyi Maternal and Child Healthcare Hospital, Linyi, China.
BMC Musculoskelet Disord. 2024 Nov 28;25(1):970. doi: 10.1186/s12891-024-08092-8.
BACKGROUND: The Cumberland Ankle Instability Tool (CAIT) is used to screen patients with chronic ankle instability (CAI) and to quantify the severity of ankle instability. Neuromuscular deficits are common in CAI, including proprioception, strength, and balance issues. The relationship between CAIT scores and neuromuscular factors is unclear. The purpose of this study was to investigate the correlation between ankle instability and ankle muscle strength, proprioception, and dynamic balance. METHODS: Thirty-four individuals with chronic ankle instability were included in this study. The participants' CAIT scores, muscle strength (isokinetic) and proprioception in plantarflexion (PF), dorsiflexion (DF), inversion (IV), and eversion (EV), and dynamic balance (Star Excursion Balance Test in anterior, posteromedial, and posterolateral directions) were assessed. Bivariate correlations were used to determine the relationship between CAIT scores and ankle muscle strength, proprioception, and dynamic balance. RESULTS: In terms of muscle strength, ankle PF (r = 0.378, 95%CI: 0.046-0.635, P = 0.027) and IV (r = 0.527, 95%CI: 0.233-0.736, P = 0.001) strength were positively correlated with CAIT Score, whereas ankle DF and EV strength had no significant correlation with CAIT Score. In terms of proprioception, ankle IV proprioception (r = -0.340, 95%CI: -0.608-0.002, P = 0.027) was negatively correlated with CAIT Score, while ankle PF, DF, and EV proprioception had no significant correlation with CAIT Score. In terms of dynamic balance, the SEBT posteromedial (r = 0.444, 95%CI: 0.124-0.680, P = 0.001) was positively correlated with CAIT Score. The SEBT anterior and posterolateral were not significantly correlated with the CAIT Score. CONCLUSION: This study found that increasing ankle plantarflexion and inversion muscle strength, improving dynamic balance in the posteromedial direction, and decreasing ankle inversion proprioceptive thresholds may help improve the subjective stability of CAI. This provides data support for targeted ankle neuromuscular function rehabilitation training for patients. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100044089. Registered on 10 March 2021.
背景：坎伯兰踝关节不稳定性工具（CAIT）用于筛查慢性踝关节不稳定（CAI）患者，并量化踝关节不稳定性的严重程度。神经肌肉功能障碍在 CAI 中很常见，包括本体感觉、力量和平衡问题。CAIT 评分与神经肌肉因素之间的关系尚不清楚。本研究旨在探讨踝关节不稳定与踝关节肌肉力量、本体感觉和动态平衡之间的相关性。
方法：本研究纳入 34 名慢性踝关节不稳定患者。评估患者的 CAIT 评分、踝关节跖屈（PF）、背屈（DF）、内翻（IV）和外翻（EV）的等速肌力和本体感觉，以及动态平衡（前、后内侧和后外侧方向的星形偏移平衡测试）。采用双变量相关分析确定 CAIT 评分与踝关节肌肉力量、本体感觉和动态平衡之间的关系。
结果：就肌肉力量而言，踝关节 PF（r=0.378，95%CI：0.046-0.635，P=0.027）和 IV（r=0.527，95%CI：0.233-0.736，P=0.001）力量与 CAIT 评分呈正相关，而踝关节 DF 和 EV 力量与 CAIT 评分无显著相关性。就本体感觉而言，踝关节 IV 本体感觉（r=-0.340，95%CI：-0.608-0.002，P=0.027）与 CAIT 评分呈负相关，而踝关节 PF、DF 和 EV 本体感觉与 CAIT 评分无显著相关性。就动态平衡而言，SEBT 后内侧（r=0.444，95%CI：0.124-0.680，P=0.001）与 CAIT 评分呈正相关。SEBT 前侧和后外侧与 CAIT 评分无显著相关性。
结论：本研究发现，增加踝关节跖屈和内翻肌力，改善后内侧方向的动态平衡，降低踝关节内翻本体感觉阈值，可能有助于改善 CAI 的主观稳定性。这为针对 CAI 患者的踝关节神经肌肉功能康复训练提供了数据支持。
试验注册：中国临床试验注册中心 ChiCTR2100044089。注册于 2021 年 3 月 10 日。
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