慢性踝关节不稳患者步态起始各阶段的姿势调整及肌肉活动：一项观察性研究
Postural adjustment and muscle activity during each phase of gait initiation in chronic ankle instability: an observational study.
作者信息
Mortezanejad Marzieh, Ebrahimabadi Zahra, Rahimi Abbas, Maleki Ali, Baghban Alireza Akbarzadeh, Ehsani Fatemeh
机构信息
Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
出版信息
BMC Sports Sci Med Rehabil. 2024 Dec 18;16(1):248. doi: 10.1186/s13102-024-01033-x.
BACKGROUND
Gait initiation (GI) can be divided into three sections according to the center of pressure (COP) trace (S1, S2, and S3). Almost all studies do not separate each phase of the GI profile in postural control assessment and muscular investigation, whereas differences in the COP and muscles are found in each phase of the GI profile in people with gait problems.
METHODS
Twenty individuals with CAI and twenty healthy controls were included in the present study. A force plate synchronized with Qualisys motion analysis, MEGAWIN electromyography, and a pair of auditory cues were used for data capture. The participants carried out five trials of GI with the affected leg (dominant leg). The peak and mean COP excursions; the mean and maximum velocities of COP excursion during S1, S2,, S3, and the total phases in the mediolateral (ML) and anterior‒posterior (AP) directions; the root mean square (RMS); and the onset activity of the Tibialis Anterior (TA) and Soleus (SOL) muscles for both legs were used for statistical analysis. Independent t tests and Mann‒Whitney U tests were used for statistical analysis on the basis of a significance level of ≤ 0.05.
RESULTS
Compared with those of healthy controls, independent t tests revealed a significant decrease in the peak COP excursion in the AP direction during S2 (P = 0.021) and in the mean velocity of COP excursion in the AP direction during S1 (P = 0.044) in the CAI group. Additionally, there was a significant increase in the duration of S1 in the GI profile (P = 0.045) in the CAI group compared with the healthy control group. There was no significant difference in the other COP variables, TA or SOL RMS or onset activity for either leg during S1, S2, or S3 between the two groups (P > 0.065).
CONCLUSION
Individuals with CAI exhibit increased stiffness in the AP direction in the injured ankle. This leads to a reduction in the velocity and peak of COP excursion, as well as an increase in the time required for postural control adjustment. These findings highlight the challenges individuals with CAI may face in meeting postural demands when trying to unload the affected foot.
ETHICAL CODE
IR.SBMU.RETECH.REC.1402.095, 2023-5-28.
背景
根据压力中心（COP）轨迹，步态起始（GI）可分为三个阶段（S1、S2和S3）。在姿势控制评估和肌肉研究中，几乎所有研究都未区分GI过程的各个阶段，然而在步态有问题的人群中，GI过程的每个阶段在COP和肌肉方面均存在差异。
方法
本研究纳入了20名慢性踝关节不稳（CAI）患者和20名健康对照者。使用与Qualisys运动分析、MEGAWIN肌电图同步的测力台以及一对听觉提示进行数据采集。参与者用患侧腿（优势腿）进行5次GI试验。统计分析使用的指标包括：COP偏移的峰值和平均值；S1、S2、S3以及整个阶段在内外侧（ML）和前后方向（AP）上COP偏移的平均速度和最大速度；均方根（RMS）；以及双腿胫骨前肌（TA）和比目鱼肌（SOL）的起始活动。基于显著性水平≤0.05，使用独立t检验和曼-惠特尼U检验进行统计分析。
结果
独立t检验显示，与健康对照者相比，CAI组在S2期间AP方向上COP偏移的峰值显著降低（P = 0.021），在S1期间AP方向上COP偏移的平均速度显著降低（P = 0.044）。此外，与健康对照组相比，CAI组GI过程中S1的持续时间显著增加（P = 0.045）。两组在S1、S2或S3期间，其他COP变量、TA或SOL的RMS或双腿的起始活动均无显著差异（P > 0.065）。
结论
CAI患者受伤踝关节在AP方向上表现出刚度增加。这导致COP偏移的速度和峰值降低，以及姿势控制调整所需时间增加。这些发现突出了CAI患者在试图卸载患侧足部时满足姿势需求可能面临的挑战。
伦理代码
IR.SBMU.RETECH.REC.1402.095，2023年5月28日
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