Zhao Yilin, Zhang Tongzhou, Wang Shuhui, Adams Roger, Waddington Gordon, Han Jia
Department of Rehabilitation Medicine, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School of Nanjing Medical University, Suzhou, China.
Mass Sports Research Laboratory, Shanxi Institute of Sport Science, Taiyuan, Shanxi, China.
Eur J Sport Sci. 2025 Jan;25(1):e12238. doi: 10.1002/ejsc.12238. Epub 2024 Dec 10.
Proprioception plays an important role in joint stability, and ankle sprains usually happen involving plantarflexion, internal rotation, and inversion. However, ankle 3D movement proprioception has never been measured in weight-bearing. Accordingly, the active 3-dimensional movement extent discrimination apparatus (AMEDA-3D) was developed and its reliability and validity were investigated. A total of 58 subjects volunteered for this trial, with 12 subjects with chronic ankle instability (CAI) and 12 healthy controls in the test-retest reliability study. There were 17 subjects with CAI and 17 healthy controls in the validity study. An intraclass correlation coefficient (ICC) and Minimum Detectable Change at the 90% confidence interval (MDC) were computed. AMEDA-3D scores were analysed by independent samples t-tests, and Youden's index was used to calculate the optimal AMEDA-3D cut-off for discriminating individuals with CAI. Pearson's correlation analysis was used to explore the relationship between AMEDA-3D scores and Y Balance Test (YBT), Time In Balance Test (TIB), and Cumberland Ankle Instability Tool (CAIT) scores. The main results were as follows: (1) The ICC value of AMEDA-3D scores was 0.817 (95% CI = 0.452-0.945) in CAI subjects. (2) The AMEDA-3D proprioceptive area under the curve score used to discriminate CAI subjects from healthy controls was 0.778, with a sensitivity of 94% and a specificity of 82%. (3) AMEDA-3D proprioceptive scores were moderately correlated with CAIT scores (r = 0.58 and p < 0.001), YBT (r = 0.47 and p = 0.005), and TIB (r = 0.68 and p < 0.001). Our findings suggest that the AMEDA-3D tool shows good reliability and validity for clinical assessment of proprioceptive deficits associated with CAI. Improved ankle 3D motor proprioception may positively impact subjects' balance control, self-rated symptoms, and function.
本体感觉在关节稳定性中起着重要作用，踝关节扭伤通常发生在跖屈、内旋和内翻时。然而，踝关节三维运动本体感觉从未在负重状态下进行测量。因此，开发了主动三维运动范围辨别仪（AMEDA-3D），并对其可靠性和有效性进行了研究。共有58名受试者自愿参加该试验，在重测可靠性研究中有12名慢性踝关节不稳（CAI）受试者和12名健康对照者。在有效性研究中有17名CAI受试者和17名健康对照者。计算了组内相关系数（ICC）和90%置信区间的最小可检测变化（MDC）。通过独立样本t检验分析AMEDA-3D得分，并使用约登指数计算区分CAI个体的最佳AMEDA-3D临界值。采用Pearson相关分析探讨AMEDA-3D得分与Y平衡测试（YBT）、平衡时间测试（TIB）和坎伯兰踝关节不稳工具（CAIT）得分之间的关系。主要结果如下：（1）CAI受试者中AMEDA-3D得分的ICC值为0.817（95%CI = 0.452-0.945）。（2）用于区分CAI受试者与健康对照者的AMEDA-3D本体感觉曲线下面积得分为0.778，敏感性为94%，特异性为82%。（3）AMEDA-3D本体感觉得分与CAIT得分（r = 0.58，p < 0.001）、YBT（r = 0.47，p = 0.005）和TIB（r = 0.68，p < 0.001）中度相关。我们的研究结果表明，AMEDA-3D工具在临床评估与CAI相关的本体感觉缺陷方面显示出良好的可靠性和有效性。改善踝关节三维运动本体感觉可能对受试者的平衡控制、自我评定症状和功能产生积极影响。
