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步态起始过程中,应对者、慢性踝关节不稳患者及健康受试者的动力学参数、肌电图活动和运动恐惧之间的关系:一项横断面研究

The Relationship Between the Kinetic Parameters, Electromyography Activity, and Kinesiophobia Among Copers, Chronic Ankle Instability, and Healthy Subjects During Gait Initiation: A Cross-Sectional Study.

作者信息

Mortezanejad Marzieh, Ebrahimabadi Zahra, Rahimi Abbas, Ehsani Fatemeh, Maleki Ali, Akbarzadeh Baghban Alireza

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

J Sport Rehabil. 2025 Apr 25:1-10. doi: 10.1123/jsr.2024-0210.

Abstract

CONTEXT

Following a lateral ankle sprain, chronic ankle instability (CAI) subjects show recurrent episodes of giving way, while copers do not exhibit giving way and overcome the challenging condition of postural control. During gait initiation (GI), individuals with CAI reveal shorter center of pressure (COP) displacement and earlier muscle activity compared with healthy controls. Copers have not been previously compared with healthy controls and individuals with CAI during GI.

DESIGN

The study design was cross-sectional.

METHOD

Sixty participants (20 CAI, 20 copers, and 20 healthy controls) with a right (dominant) limb injury participated in the study based on inclusion and exclusion criteria. The short form of the Tampa Scale of Kinesiophobia was filled out. Participants performed GI with the nonaffected leg on the force plate that was synchronized with Electromyography Megawin for 2 strides. GI was divided into 3 phases based on COP excursion (S1, S2, and S3). Onset time and electromyography activity of both soleus and tibialis anterior muscles were analyzed along with maximum and mean excursion and velocity of COP excursion in the anterior-posterior and medial-lateral directions and the total phases of GI.

RESULTS

The results indicated that the copers had a significantly higher peak of COP excursion in the medial-lateral direction during S2 (P = .029), S3 (P = .018), and total phases (P = .018) of GI compared with the individuals with CAI. Additionally, individuals with CAI showed earlier activation of the right soleus compared with healthy controls (P = .022). There was a significant difference in short form of the Tampa Scale of Kinesiophobia scores between individuals with CAI and other groups (P < .001).

CONCLUSION

The findings demonstrated that individuals with CAI had earlier soleus activation and supraspinal alteration compared with controls. Copers who had lower Tampa Scale of Kinesiophobia scores exhibited an increased peak of COP excursion in the medial-lateral direction during GI compared with individuals with CAI.

摘要

背景

在踝关节外侧扭伤后,慢性踝关节不稳(CAI)患者会反复出现打软腿的情况,而应对者则不会出现打软腿,并能克服姿势控制方面的挑战性状况。在步态起始(GI)过程中,与健康对照组相比,CAI患者的压力中心(COP)位移更短,肌肉活动更早。此前尚未对应对者与健康对照组以及CAI患者在GI过程中的情况进行比较。

设计

本研究设计为横断面研究。

方法

60名右(优势)下肢受伤的参与者(20名CAI患者、20名应对者和20名健康对照组)根据纳入和排除标准参与了研究。填写了坦帕运动恐惧量表简表。参与者用未受伤的腿在与肌电图Megawin同步的测力板上进行2步的GI。根据COP偏移将GI分为3个阶段(S1、S2和S3)。分析了比目鱼肌和胫骨前肌的起始时间和肌电图活动,以及COP在前后和内外方向的最大和平均偏移及速度,还有GI的各个阶段。

结果

结果表明,与CAI患者相比,应对者在GI的S2阶段(P = 0.029)、S3阶段(P = 0.01)和总阶段(P = 0.018)的内外方向COP偏移峰值显著更高。此外,与健康对照组相比,CAI患者右比目鱼肌的激活更早(P = 0.022)。CAI患者与其他组在坦帕运动恐惧量表简表得分上存在显著差异(P < 0.001)。

结论

研究结果表明,与对照组相比,CAI患者的比目鱼肌激活更早,且存在脊髓上改变。与CAI患者相比,坦帕运动恐惧量表得分较低的应对者在GI过程中的内外方向COP偏移峰值增加。

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