Jeon Hyung Gyu, Kang Jiho, Kim Se Jong, Ko Jupil, Song Kyeongtak, Lee Sae Yong
Department of Kinesiology, Yonsei University, Republic of Korea.
School of Health and Kinesiology, University of Nebraska at Omaha, United States of America.
Clin Biomech (Bristol). 2025 Feb;122:106437. doi: 10.1016/j.clinbiomech.2025.106437. Epub 2025 Jan 17.
We aimed to synthesize the kinematics and kinetics during landing and walking/running tasks of ankle copers compared with patients with chronic ankle instability and controls.
We systematically searched PubMed, CINAHL, SPORTDiscus, and Web of Science. Tri-planar lower extremity biomechanics (joint angle and moment at maximum and initial contact, and joint displacement) were synthesized using standard mean difference and 95 % confidence intervals. We assessed methodological quality, study heterogeneity, and publication bias.
We identified 13 studies. Pooled evidence indicated that copers had less inversion and eversion angles, and ankle frontal displacement during landing compared with patients with chronic ankle instability (|standard mean difference| 0.31-0.40). Copers revealed greater dorsiflexion, plantarflexion, and ankle sagittal displacement during landing and less plantarflexion moment during walking than patients with chronic ankle instability (|standard mean difference| 0.29-0.46); however, most ankle biomechanics of copers were not significantly different from those of controls. In the proximal joints, copers revealed less knee valgus angle at maximum and initial contact (|standard mean difference| 0.25-0.33); and less hip flexion angle at maximum and initial contact, hip external rotation angle and sagittal and frontal displacement during landing (standard mean difference 0.49-0.73) than patients with chronic ankle instability. Copers had less hip extension moment during walking and greater maximum hip adduction angle during landing than controls (|standard mean difference| 0.66-0.77).
Our results provide insight into the lower extremity biomechanics of copers during dynamic tasks, contributing injury coping mechanisms and developing rehabilitation programs to return to sports.
我们旨在综合比较踝关节代偿者与慢性踝关节不稳患者及对照组在着陆和行走/跑步任务中的运动学和动力学。
我们系统检索了PubMed、CINAHL、SPORTDiscus和科学网。使用标准平均差和95%置信区间综合分析三平面下肢生物力学(最大和初始接触时的关节角度和力矩,以及关节位移)。我们评估了方法学质量、研究异质性和发表偏倚。
我们纳入了13项研究。汇总证据表明,与慢性踝关节不稳患者相比,代偿者在着陆时的内翻和外翻角度以及踝关节额状面位移较小(|标准平均差|0.31 - 0.40)。与慢性踝关节不稳患者相比,代偿者在着陆时表现出更大的背屈、跖屈和踝关节矢状面位移,在行走时跖屈力矩较小(|标准平均差|0.29 - 0.46);然而,代偿者的大多数踝关节生物力学指标与对照组无显著差异。在近端关节,代偿者在最大和初始接触时的膝外翻角度较小(|标准平均差|0.25 - 0.33);与慢性踝关节不稳患者相比,在最大和初始接触时的髋屈曲角度、着陆时的髋外旋角度以及矢状面和额状面位移较小(标准平均差0.49 - 0.73)。与对照组相比,代偿者在行走时的髋伸展力矩较小,着陆时的最大髋内收角度较大(|标准平均差|0.66 - 0.77)。
我们的结果为代偿者在动态任务中的下肢生物力学提供了见解,有助于了解损伤应对机制并制定重返运动的康复计划。