Faghihi Rezvane, Khanmohammadi Roya
Physical Therapy Department, Rehabilitation Faculty, Tehran University of Medical Sciences, Tehran, Iran.
Sci Rep. 2024 Dec 28;14(1):31448. doi: 10.1038/s41598-024-83071-6.
The study aimed to determine if virtual reality (VR) games could enhance neuromuscular control and improve anticipatory and compensatory strategies in ball-kicking for soccer players. It was a single-blind randomized clinical trial involving 32 male soccer players with chronic ankle instability. Participants were divided into two groups: VR games and balance training. The primary outcomes measured were the amplitude and onset time of muscle activities in the peroneus longus (PL), tibialis anterior (TA), soleus (SOL), rectus femoris (RF), biceps femoris (BF), and gluteus medius (GM) in three phases: anticipatory (APA), compensatory 1 (CPA1), and compensatory 2 (CPA2). Secondary outcomes included the Y-balance test and perceived ankle instability. Evaluations were done before and after treatment. Both groups underwent 12 sessions, three times a week, each lasting 60 min. In the VR games group, there was a significant decrease in SOL muscle activity amplitude during CPA2 after treatment (P = 0.033), and the BF muscle activated earlier (P = 0.043). The balance training group showed a significant increase in GM muscle activity amplitude during APA (P = 0.037) and earlier activation of the GM muscle post-treatment (P = 0.050). Additionally, this group demonstrated significant decreases in RF activity during CPA1 and PL activity in CPA1 and CPA2 (P = 0.048, P = 0.030, and P = 0.050, respectively). Between-group comparisons indicated a significant increase in GM muscle activity amplitude during APA and a reduction during CPA1 for the balance training group compared to the VR games group (P = 0.050 and P = 0.012, respectively). Both groups showed significant reductions in perceived ankle instability (VR group: P = 0.002, balance training group: P < 0.001) and improvements on the Y-balance test (VR group: P < 0.021, balance training group: P < 0.033), although neither group showed significant improvement in the anterior direction. Overall, both VR games and balance training effectively enhanced perceived ankle stability and dynamic postural control, with neither approach showing clear superiority. Both groups exhibited improvements in muscle activation timing, though neither outperformed the other. While both interventions led to increased muscle activity amplitude during the anticipatory and compensatory phases, the balance training group achieved somewhat greater improvements. These results suggest that both VR games and balance training are effective rehabilitation approaches for chronic ankle instability, providing comparable benefits for enhancing ankle stability and neuromuscular control, without a distinct advantage of one over the other.RCT Registration: On the Iranian Registry of Clinical Trials (IRCT20230124057197N1). Registration date: 30/06/2023.
该研究旨在确定虚拟现实（VR）游戏是否能增强足球运动员的神经肌肉控制，并改善其在踢球时的预期和补偿策略。这是一项单盲随机临床试验，涉及32名患有慢性踝关节不稳定的男性足球运动员。参与者被分为两组：VR游戏组和平衡训练组。主要测量结果是在三个阶段（预期阶段（APA）、补偿阶段1（CPA1）和补偿阶段2（CPA2））中，腓骨长肌（PL）、胫骨前肌（TA）、比目鱼肌（SOL）、股直肌（RF）、股二头肌（BF）和臀中肌（GM）的肌肉活动幅度和起始时间。次要结果包括Y平衡测试和感知到的踝关节不稳定。在治疗前后进行评估。两组均接受12次训练，每周三次，每次持续60分钟。在VR游戏组中，治疗后CPA2期间SOL肌肉活动幅度显著降低（P = 0.033），BF肌肉激活更早（P = 0.043）。平衡训练组在APA期间GM肌肉活动幅度显著增加（P = 0.037），治疗后GM肌肉激活更早（P = 0.050）。此外，该组在CPA1期间RF活动以及CPA1和CPA2期间PL活动显著降低（分别为P = 0.048、P = 0.030和P = 0.050）。组间比较表明，与VR游戏组相比，平衡训练组在APA期间GM肌肉活动幅度显著增加，在CPA1期间降低（分别为P = 0.050和P = 0.012）。两组在感知到的踝关节不稳定方面均显著降低（VR组：P = 0.002，平衡训练组：P < 0.001），在Y平衡测试中均有改善（VR组：P < 0.021，平衡训练组：P < 0.033），尽管两组在前向方向上均未显示出显著改善。总体而言，VR游戏和平衡训练均有效增强了感知到的踝关节稳定性和动态姿势控制，两种方法均未显示出明显优势。两组在肌肉激活时间方面均有改善，尽管没有一组优于另一组。虽然两种干预措施在预期和补偿阶段均导致肌肉活动幅度增加，但平衡训练组的改善程度略大。这些结果表明，VR游戏和平衡训练都是治疗慢性踝关节不稳定的有效康复方法，在增强踝关节稳定性和神经肌肉控制方面提供了相当的益处，且没有一种方法明显优于另一种。随机对照试验注册：在伊朗临床试验注册中心（IRCT20230124057197N1）。注册日期：2023年6月30日。
