Hu Xiaomei, Hou Xihe, Wang Lin
Sports Medicine and Rehabilitation Center, Shanghai University of Sport, Shanghai, China.
School of Athletic Performance, Shanghai University of Sport, Shanghai, China.
J Exerc Sci Fit. 2025 Jan;23(1):21-31. doi: 10.1016/j.jesf.2024.12.002. Epub 2024 Dec 11.
This study aimed to evaluate bilateral sensorimotor function in patients with unilateral CAI. Furthermore, sensory reweighting ability and vestibular modulation were assessed.
Twenty individuals with unilateral CAI and twenty healthy controls participated in this study. All participants executed ankle proprioception, plantar sensation, unilateral stance, Y balance, motor control test (MCT) and sensory organisation test (SOT) assessments. Proprioception assessment included joint position sense and force sense (FS), and plantar sensation evaluation consisted of light-touch, vibration and two-point discrimination (TPD) thresholds at the heel, head of the first metatarsal (1 MF), base of the fifth metatarsal (5 MF), centre of foot and forefoot. MCT and SOT tests were conducted using NeuroCom Balance Manager System. Except for SOT, all tests evaluated bilateral limbs, and the order of limbs was randomly selected. 2 (group) × 2 (limb) mixed model analyses of variance were performed for outcome measures of unilateral stance, Y balance and MCT, and independent -test was used to analyse the outcomes of SOT between two groups. Mann-Whitney U and Wilcoxon test were applied to examine the differences in plantar sensation between groups and limbs.
For plantar sensation, increased light-touch threshold at heel and 1 MF and the TPD threshold at 1 MF were observed bilaterally in CAI group ( < 0.05). No differences were observed in joint position sense (JPS), but bilateral deficit was found in plantarflexor FS with moderate effect size (uninjured side: ES = 0.67; injured side: ES = 0.61) in CAI group. For unilateral stance with eyes closed, moderate postural instability was displayed bilaterally in the anteroposterior direction (uninjured side: ES = 0.71; injured side: ES = 0.86). The delayed latency of MCT with medium-backward translation was also observed in both sides of unilateral CAI (uninjured: ES = 0.74; injured: ES = 0.92). Compared with healthy controls, higher visual reliance was shown moderately in the injured and uninjured sides of unilateral CAI (uninjured: ES = 0.78; injured: ES = 0.91). Sensory analysis of SOT displayed decreased use of visual (p = 0.001) and vestibular information ( < 0.000) in CAI group.
Unilateral CAI presented impaired plantar sensation and ankle proprioception on both sides. Higher visual reliance, delayed motor response and postural instability under unreliable visual clues were also displayed bilaterally. Except for bilateral sensorimotor alterations, reduced ability of sensory reweighting and fixed sensory strategy also presented in CAI group, but the somatosensory clue still served as the main sensory source in CAI.
本研究旨在评估单侧慢性踝关节不稳（CAI）患者的双侧感觉运动功能。此外，还评估了感觉重新加权能力和前庭调节功能。
20名单侧CAI患者和20名健康对照者参与了本研究。所有参与者均进行了踝关节本体感觉、足底感觉、单腿站立、Y平衡、运动控制测试（MCT）和感觉组织测试（SOT）评估。本体感觉评估包括关节位置觉和力觉（FS），足底感觉评估包括足跟、第一跖骨头（1MF）、第五跖骨基底（5MF）、足中部和前足的轻触觉、振动觉和两点辨别觉（TPD）阈值。使用NeuroCom Balance Manager系统进行MCT和SOT测试。除SOT外，所有测试均评估双侧肢体，肢体顺序随机选择。对单腿站立、Y平衡和MCT的结果测量进行2（组）×2（肢体）混合模型方差分析，并用独立样本t检验分析两组之间SOT的结果。采用Mann-Whitney U检验和Wilcoxon检验来检验组间和肢体间足底感觉的差异。
对于足底感觉，CAI组双侧足跟和1MF处的轻触觉阈值升高，1MF处的TPD阈值升高（P<0.05）。关节位置觉（JPS）未观察到差异，但CAI组双侧跖屈肌FS存在缺陷，效应量中等（未受伤侧：ES = 0.67；受伤侧：ES = 0.61）。对于闭眼单腿站立，双侧在前后方向均表现出中度姿势不稳（未受伤侧：ES = 0.71；受伤侧：ES = 0.86）。在单侧CAI的两侧也观察到MCT在中等向后平移时延迟潜伏期（未受伤侧：ES = 0.74；受伤侧：ES = 0.92）。与健康对照相比，单侧CAI的受伤侧和未受伤侧均适度表现出更高的视觉依赖（未受伤侧：ES = 0.78；受伤侧：ES = 0.91）。SOT的感觉分析显示CAI组视觉（P = （此处原文有误，推测应为P = 0.001））和前庭信息的使用减少（P<0.000）。
单侧CAI双侧出现足底感觉和踝关节本体感觉受损。在不可靠的视觉线索下，双侧还表现出更高的视觉依赖、运动反应延迟和姿势不稳。除双侧感觉运动改变外，CAI组还存在感觉重新加权能力降低和感觉策略固定的情况，但体感线索仍是CAI的主要感觉来源。
